It is more than a sniffle. Your
nose gets clogged, stays clogged, and then whistles or hisses when you breathe.
Your face aches. You blow through box after box of tissues. It just will not go
away.
اضافة اعلان
Chronic congestion is common, says Dr Mark
Dykewicz, an allergist and immunologist at Saint Louis University School of
Medicine, but treating it can get complicated — in part because there are so
many potential causes. Here is what to know.
Why am I so stuffed up?There are many potential triggers for nasal
congestion, including household and workplace irritants, allergies, and upper
respiratory infections.
The anatomy of your nose could also be a
culprit, Dykewicz added. Some people are born with or develop a deviated
septum, in which the thin wall of cartilage and bone that separates the right
and left nasal passage is off-center. That makes one nasal passage larger than
the other, Dykewicz said, and the smaller side can get stuffed up easily.
Some people also become congested when the
septum and nearby structures weaken and start to cave in over time, or when the
turbinates — small, bony plates inside the nose that cleanse, heat, and
humidify the air you breathe in — become enlarged, he added.
Seasonal allergies are one obvious source of congestion — especially if you have watery, itchy eyes in addition to a runny nose, and you are also sneezing. But other kinds of environmental allergies can gunk up your nose year-round, too
Seasonal allergies are one obvious source
of congestion — especially if you have watery, itchy eyes in addition to a
runny nose, and you are also sneezing. But other kinds of environmental
allergies can gunk up your nose year-round, too, said Dr Sarah Hochman, an
assistant professor of medicine at NYU Grossman School of Medicine.
Pet hair, dander, saliva, and urine can
enlarge and inflame the soft tissues in your nose, causing congestion, as can
dust mites. And everyday irritants such as perfumes, car exhaust, and cigarette
smoke can cause our noses to react, Dykewicz added.
Viral infections such as the common cold,
flu and COVID-19 can also lead to congestion, as can viral pneumonia. Other
factors include temperature and humidity changes, Dykewicz said, although some
people have chronic inflammation with no known cause.
If your nose is persistently blocked for
longer than two weeks, and especially after you have had a cold, you may have a
sinus infection, Hochman said, which is an inflammation of the sinus tissue.
Other telltale signs of a sinus infection include earaches, fever, and pain
when you touch your cheeks. If you have sinus congestion and your face or
forehead also hurts when you lean over (to tie your shoes, for example),
Hochman said, that could be another sign of a sinus infection and you should
seek medical care.
Congestion can also be a surprising
byproduct of some medications, including Viagra and some blood
pressure-lowering ACE inhibitor drugs, Dykewicz said. So if you are grappling
with chronic congestion, it is important to look up the potential side effects
of any medications or supplements you may be taking and consult with your
prescribing doctor.
How to clear up congestionIt may sound simple, but first try clearing
out your nose as much as possible by gently blowing into a tissue, said Dr Raj
Sindwani, an otolaryngologist at the Cleveland Clinic. You can use an
over-the-counter saline nasal spray to help irrigate your nasal passages two or
three times a day, Dykewicz said. It is also important to stay hydrated, as
fluids can help thin the mucus in your nose, allowing it to drain more easily.
A steamy shower can help open up your nasal passages, too, Hochman said.
Certain over-the-counter medications may
help combat congestion, although many come with caveats, Dykewicz said.
If allergies are the root cause of your
congestion, your doctor may recommend an oral antihistamine such as cetirizine
(Zyrtec) or fexofenadine (Allegra) for mild symptoms. Most antihistamines are
safe to take in the long term, Hochman said, but if you are going to use them
for more than a week or two, you should consult a doctor.
If you are grappling with chronic congestion, it is important to look up the potential side effects of any medications or supplements you may be taking and consult with your prescribing doctor
For more severe symptoms, medicated nasal
sprays may help, but some are safer for long-term use than others, Dykewicz
said. Steroid nasal sprays that contain active ingredients such as fluticasone
(Flonase), triamcinolone (Nasacort), or budesonide are safe to use for as long
as you need them, Sindwani said. “No problem, you can use those ad infinitum,”
he said.
But nasal sprays that contain decongestants
such as oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine) should be used
for no longer than three to five days, or you risk what doctors call “rebound
congestion”, Dykewicz said. These medications cause your blood vessels to
constrict, opening up your nose for a brief period of relief — but then, if
used repeatedly, the mucosal surfaces in your nose could swell, Hochman said,
and some people end up feeling worse than before. There is some risk that,
after long-term use of these nasal sprays, swelling could become persistent and
require additional treatment such as with steroids, Dykewicz said.
“The nose gets stuffier and stuffier,”
Dykewicz said. “People become de facto addicted to it.”
If chronic congestion is interfering with
your daily life, Hochman said, you should seek care from an ear, nose, and
throat doctor who can investigate whether your nose has a structural issue or
whether you have something like a chronic sinus infection.
“Everyone has a different threshold above
which they can’t take it anymore,” she said.
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