Nasal Congestion and Blood-Streaked Mucus: When to Seek Help - Otolaryngology

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Nasal congestion accompanied by blood-streaked mucus can be concerning, especially if it persists or worsens over time. Based on your description, it seems that you have been experiencing intermittent nasal congestion in your left nostril, which sometimes improves when you manipulate your nostrils. The presence of blood in your mucus, particularly after forceful nose blowing, raises a few important considerations.

Firstly, the most common cause of blood-streaked mucus is the rupture of small blood vessels in the nasal mucosa. This can occur due to several factors, including:
1. Dry Air: If you live in a dry climate or are exposed to dry indoor air (especially during winter months), the nasal mucosa can become dry and cracked, leading to bleeding.

2. Allergies: Given that you mentioned having allergies, it’s possible that the inflammation and irritation caused by allergic rhinitis could lead to increased nasal congestion and subsequent nose blowing, which may exacerbate the bleeding.

3. Forceful Nose Blowing: As you noted, you tend to blow your nose forcefully. This can cause trauma to the delicate blood vessels in the nasal lining, resulting in bleeding.

4. Underlying Conditions: While less common, conditions such as chronic sinusitis, nasal polyps, or even structural abnormalities in the nasal passages can contribute to persistent nasal congestion and bleeding.

Regarding your question about whether you need a nasal endoscopy, it depends on several factors. Since you had a normal endoscopy earlier this month, it may not be immediately necessary unless your symptoms change or worsen. However, if you continue to experience blood-streaked mucus, increased nasal congestion, or any new symptoms such as facial pain, fever, or a foul-smelling discharge, it would be prudent to consult an ear, nose, and throat (ENT) specialist again. They may recommend further evaluation to rule out any underlying issues that could be contributing to your symptoms.

In the meantime, here are some self-care measures you can consider:
- Humidification: Use a humidifier in your home to add moisture to the air, which can help keep your nasal passages hydrated and reduce the likelihood of bleeding.

- Saline Nasal Spray: Regular use of saline nasal sprays can help moisturize the nasal mucosa and may alleviate some of the congestion.

- Gentle Nose Blowing: Try to blow your nose gently to minimize trauma to the nasal lining.

- Avoid Irritants: Stay away from smoke, strong odors, and allergens that can irritate your nasal passages.

- Stay Hydrated: Drink plenty of fluids to help keep your mucous membranes moist.

If your symptoms persist or you notice any significant changes, such as increased bleeding or new symptoms, do not hesitate to seek medical attention. It’s always better to err on the side of caution when it comes to your health.