Persistent Nasal Congestion: Causes and Solutions

Q: Persistent Nasal Congestion: Causes and Solutions

Hello, based on your description： There are many causes of nasal congestion, the most common being allergic rhinitis combined with insufficient nasal space (such as a deviated septum and hypertrophic rhinitis). <br>However, conditions such as nasopharyngeal or nasal tumors (like

Nasal congestion all day?

Hello Doctor: Since March, I have been experiencing some nasal congestion on the right side (approximately one-third of my nostril, persisting throughout the day).
When riding my bike, I initially feel like there is a round object (or something similar to a cap) blocking my nose.
When I take a shower, the right side becomes completely blocked, and I also experience total nasal congestion while sleeping (the congestion changes with my position; as soon as I turn, the blockage quickly shifts to the other side).
During this period, there have been times when my nose was completely blocked, making it nearly impossible to breathe (I have taken antihistamines, but the effect seems limited).
Around mid-April to May, the congestion worsened to nearly the entire nose (the other side also feels like it’s not getting much air), and it remains blocked all day.
Riding my bike, showering, and sleeping still result in complete blockage.
However, I recently noticed that after changing my sleeping position, the speed of the nasal congestion shifting has slowed down; it takes a while before it switches to the other side! What could be the possible causes of this? Thank you.

Kecy, 20~29 year old female. Ask Date: 2020/06/04

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description: There are many causes of nasal congestion, the most common being allergic rhinitis combined with insufficient nasal space (such as a deviated septum and hypertrophic rhinitis).
However, conditions such as nasopharyngeal or nasal tumors (like nasopharyngeal carcinoma), sinusitis, fungal infections, and nasal trauma can also lead to nasal congestion.
It is advisable to consult an otolaryngologist.
If oral medications, nasal sprays, and nasal irrigation do not provide satisfactory relief, surgical treatment may also be considered.
Wishing you peace and health.
This is purely an exchange of ideas; all decisions should be based on the physician's actual examination.
Sincerely, Dr.
Chi Chao-Yun, Head of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2020/06/04

More Info

Persistent nasal congestion can be a frustrating and debilitating condition, affecting your quality of life and overall well-being. Understanding the underlying causes and potential solutions is crucial for effective management. Based on your description, it seems that you are experiencing significant nasal obstruction, particularly on the right side, which has progressively worsened over the months.

Possible Causes of Persistent Nasal Congestion
1. Structural Abnormalities: One common cause of unilateral nasal congestion is a deviated septum, where the cartilage dividing the nostrils is displaced to one side. This can lead to chronic obstruction, especially if the deviation is significant. Additionally, nasal polyps, which are non-cancerous growths in the nasal passages, can also obstruct airflow and lead to persistent congestion.

2. Chronic Rhinosinusitis: This condition involves inflammation of the nasal passages and sinuses, often accompanied by symptoms such as nasal congestion, facial pain, and post-nasal drip. Chronic rhinosinusitis can be caused by infections, allergies, or structural issues in the nasal cavity.

3. Allergic Rhinitis: Allergies can lead to nasal congestion due to inflammation and swelling of the nasal mucosa. If you are exposed to allergens such as pollen, dust mites, or pet dander, this could exacerbate your symptoms. The fact that antihistamines have limited effectiveness suggests that your congestion may not solely be due to allergies.

4. Vasomotor Rhinitis: This condition is characterized by nasal congestion that is not caused by allergies or infections. It can be triggered by environmental factors such as changes in temperature, humidity, strong odors, or even stress. The fact that your symptoms change with body position may indicate a component of vasomotor rhinitis.

5. Infection: A lingering viral or bacterial infection can lead to prolonged nasal congestion. If you have had a recent cold or sinus infection, it could contribute to your ongoing symptoms.

Solutions and Management Strategies
1. Consult an ENT Specialist: Given the persistence and severity of your symptoms, it is advisable to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, including nasal endoscopy, to visualize the nasal passages and identify any structural abnormalities or polyps.

2. Imaging Studies: A CT scan of the sinuses may be recommended to assess for chronic sinusitis or other structural issues that could be contributing to your nasal congestion.

3. Nasal Corticosteroids: These are often the first-line treatment for chronic nasal congestion, particularly if inflammation is a significant factor. They can help reduce swelling in the nasal passages and improve airflow.

4. Saline Nasal Irrigation: Regularly rinsing your nasal passages with saline solution can help clear mucus and allergens, providing relief from congestion.

5. Allergy Testing: If allergies are suspected, consider undergoing allergy testing to identify specific triggers. This can help tailor your treatment plan, which may include avoidance strategies or allergy medications.

6. Surgery: If structural issues such as a deviated septum or nasal polyps are identified, surgical intervention may be necessary to correct these problems and improve airflow.

7. Lifestyle Modifications: Avoid known triggers, maintain good hydration, and consider using a humidifier in your home to keep the air moist, which can help alleviate nasal congestion.

Conclusion
Persistent nasal congestion can stem from various causes, including structural abnormalities, chronic rhinosinusitis, allergic rhinitis, and vasomotor rhinitis. A comprehensive evaluation by an ENT specialist is essential to determine the underlying cause and develop an appropriate treatment plan. In the meantime, consider implementing some of the management strategies mentioned above to help alleviate your symptoms. Remember, addressing the root cause is key to finding lasting relief from nasal congestion.

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