A stuffy nose is medically termed “nasal congestion”.
This is a symptom where the air does not flow unimpededly through the nostrils into the back of the nose. It seems to be more effort to breathe through the nose and often people breathe through the mouth (mouth breather). Below are common causes of nasal congestion re listed (modified, Ref. 4, p. 308).
Common causes of “stuffy nose”
| Causes of nasal congestion: | Comments: |
| allergic rhinitis | IGE antibodies from inhalant allergies cause inflammation of nasal lining |
| the effects of cigarette smoke | irritates mucous membranes and often blocks sinus entrance |
| drugs (side-effects) | diuretics dry the mucous membranes; beta-blockers or reserpine enlarge turbinates inside nose |
| hormone changes | early pregnancy or estrogen replacement in menopause can lead to nasal congestion; even to turbinate enlargement, at times needing surgery |
| infectious | the common cold: 5 to 9 days of nasal congestion, self limiting |
| polyps, swollen adenoids or nasal septum deviation | mechanical obstruction may require surgery |
| sarcoidosis and Wegener’s granulomatosis | nasal congestion and bloody nasal discharge; needs ENT specialist |
Treatment
Therapy for a stuffy nose depends on the cause. You need to be examined first by your physician and depending on what the finding is, different modalities of treatment would be required. If there is a side-effect of medications or hormones, a change of medication may be necessary. Swollen adenoids or polyps may have to be taken out. Allergic rhinitis may have to be treated with steroid nasal drops or by allergy testing and desensitization injections. Smoking needs to be stopped. With sarcoidosis and Wegener’s granulomatosis the work-up is done by the ENT specialist who likely will do biopsies. This will usually establish the diagnosis. A rheumatologist needs to be involved as these systemic diseases are associated with autoimmune antibodies (particularly with Wegener’s granulomatosis) and systemic immune suppressant therapy and corticosteroids need to be administered for prolonged periods of time. Rheumatologists have most of the experience in this field (Ref. 4, p. 1752).
References:
1. James Chin et al., Editors: Control of Communicable Diseases Manual, 17th edition, 2000, American Public Health Association.
2. Behrman: Nelson Textbook of Pediatrics, 16th ed., 2000, W. B. Saunders Company
3. J M Hickner et al. Ann Emerg Med 37(6): 703-710. June 2001.
4. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001 Mosby, Inc.
5. Abeloff: Clinical Oncology, 2nd ed.,2000,Churchill Livingstone, Inc.
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
