Sudden Right Nasal Congestion and Pain: When to Seek Medical Attention?

Sudden nasal congestion in the right nostril accompanied by pain inside the nose when inhaling forcefully?

Hello Dr.
Zheng, last night (August 17) about an hour after dinner (I did not choke while eating, and there were no issues with my nose during normal breathing), I suddenly felt congestion in my right nostril.
Naturally, I cleared my nose, but there was no mucus or foreign object.
However, I noticed a sharp pain in my right nostril when I forcefully inhaled or exhaled, specifically in the area above the right nostril near the outside.
I used a cotton swab to gently touch the inside of my nostril and did not find any bleeding.
This morning (August 18), the congestion and pain in my nose have resolved.
I would like to ask if I still need to see a doctor at the hospital? What could this be a sign of? Should I go to the hospital immediately if I experience similar symptoms in the future?
Additionally, I have some other symptoms related to my head that I am unsure if they are connected: 1.
Yesterday morning (August 17), after standing on the balcony and looking at a distant park for a few minutes, I noticed a half-arc-shaped black and white flash like a neon light in my right eye while using the computer.
This symptom disappeared in about an hour.
2.
On the same day (August 17), in the morning (when I had the flash), around noon (after 12 PM) when I went out, and in the evening (after 6 PM) when I went out, I experienced some pain in my head (specifically along a line connecting both temples, which was painful).
This symptom lasted for about 10 minutes.
Thank you for your help! :D

Li Zhen, 40~49 year old female. Ask Date: 2015/08/18

Dr. Zheng Jueyi reply Otolaryngology

Hello, the symptoms are more similar to those of a migraine.
If they occur frequently and affect your daily life, it is advisable to visit a hospital's neurology department.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the ENT Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/08/18

More Info

Based on the symptoms you've described, it appears that you experienced a sudden onset of right nasal congestion and pain, which resolved relatively quickly. The absence of nasal discharge or bleeding upon examination with a cotton swab is a positive sign, suggesting that there may not be an active infection or significant injury. However, the accompanying symptoms, such as the visual disturbance (the arc-like flashes in your vision) and the transient headache, warrant further consideration.

Possible Causes
1. Nasal Irritation or Inflammation: The sudden nasal congestion and pain could be due to a temporary irritation or inflammation of the nasal mucosa. This can occur due to various factors, including environmental allergens, irritants, or even a mild viral infection. Given that the symptoms resolved quickly, it may not be a cause for concern.

2. Sinus Issues: Conditions such as acute sinusitis or rhinitis can cause similar symptoms. While you did not report any nasal discharge, sinus pressure can sometimes lead to localized pain, especially if there is inflammation in the sinus cavities.

3. Migraine or Aura: The visual disturbance you experienced could be related to a migraine aura, which can occur even in the absence of a headache. This is characterized by visual phenomena such as flashes of light or zigzag patterns. The headache that followed could also be a tension-type headache or a mild migraine.

4. Neurological Concerns: Although less likely, the combination of nasal pain, visual disturbances, and headaches could indicate a neurological issue, such as increased intracranial pressure or a transient ischemic attack (TIA). However, these conditions typically present with more severe and persistent symptoms.

When to Seek Medical Attention
Given that your symptoms resolved quickly and did not recur, immediate medical attention may not be necessary. However, you should consider seeking medical advice if:
- The nasal pain or congestion returns and persists.

- You experience recurrent visual disturbances, especially if they are accompanied by headaches.

- You develop additional symptoms such as fever, severe headache, or neurological signs (e.g., weakness, numbness, difficulty speaking).

- The headache becomes more severe or does not respond to over-the-counter pain relief.

Recommended Actions
1. Monitor Symptoms: Keep track of any recurring symptoms, their duration, and any associated factors (such as stress, dietary changes, or environmental exposures).

2. Consult a Specialist: If symptoms persist or worsen, consider consulting an ENT specialist for a thorough examination of your nasal passages and sinuses. Additionally, a neurologist may be warranted if you continue to experience visual disturbances or headaches.

3. Lifestyle Adjustments: Ensure you are staying hydrated, managing stress, and avoiding known allergens or irritants that could exacerbate nasal congestion.

4. Follow-Up: If you experience any new or concerning symptoms, do not hesitate to seek medical attention promptly.

In conclusion, while your symptoms may not indicate a serious condition at this moment, remaining vigilant and proactive about your health is essential. If you have any doubts or if symptoms change, consulting a healthcare professional is always the best course of action.

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