Most of us have experienced the annoyance of a blocked nose, leading to countless tissues being used. This is typically due to a cold or flu and usually clears up once the infection has passed.
However, there are instances when the symptoms seem to persist. Healthline experts suggest that this could be an indication of a more serious underlying health condition such as allergies or enlarged adenoids. They explain: “Congestion is when your nose becomes stuffed up and inflamed. Minor illnesses are the most common causes of nasal congestion. For instance, a cold, the flu, and sinus infections can all cause stuffy noses.”
“Illness-related congestion usually improves within 1-2 weeks. If it lasts longer than 10-14 days, it’s often a symptom of an underlying health issue,” reports Gloucestershire Live.
According to experts at Patient there are four common causes of nasal congestion and six less common ones. The most frequent causes include:
- Infections: such as the common cold, other respiratory tract infections including flu and sinusitis
- Allergies, including hay fever
- Persistent rhinitis
- Nasal polyps
The less common causes can include:
- Swollen adenoid glands
- Injuries to the nose
- Foreign bodies in the nose
- Rebound congestion after stopping decongestant medication
- Tumours of the sinuses or inside of the nose
- Side-effects of certain medications.
Expectant mums can also experience nasal congestion, often towards the end of the first trimester due to hormonal changes and increased blood flow. These shifts can inflame, dry out or cause bleeding in the nasal membranes.
Dr Pippa Vincent from Patient has provided guidance on how to identify different causes and when it’s time to consult a doctor.
A cold
Nasal congestion is a symptom of the common cold. The discharge can be clear, yellow or green, and may vary from watery to thick and sticky. Accompanying symptoms can include a headache, fatigue, general malaise or fever. A cough may also be present.
As the common cold is viral, antibiotics are ineffective. The symptoms of nasal congestion usually subside after a few days. Over-the-counter medications like paracetamol or ibuprofen can alleviate headaches or fever while waiting for the immune system to combat the germs. A decongestant can help with a blocked nose.
Flu (influenza)
Flu is a viral infection that triggers sneezing and nasal congestion. It generally makes people feel significantly worse than a common cold, with high fevers, extreme tiredness, and body aches. The treatment is typically similar to that for the common cold. Antibiotics are also not used.
However, those who are more vulnerable may require an antiviral treatment. These treatments are only used for individuals at risk of developing complications from the flu.
Sinusitis
The sinuses, air-filled spaces inside the cheekbones and forehead that drain into the nose, can become inflamed, leading to sinusitis. This condition is typically caused by an infection.
While most cases last between one to four weeks, some may develop into a more persistent (chronic) sinusitis. Symptoms of sinusitis primarily include nasal congestion and pain in the area of the affected sinus, usually in the forehead or cheeks on one or both sides of the nose.
The pain may worsen when bending down. Other potential symptoms include dizziness and fever.
Treatment for sinusitis usually involves painkillers and decongestants. In some cases, if symptoms persist for three weeks or more, antibiotics may be required.
Hay Fever
Hay fever, a common cause of nasal congestion or a stuffy nose, is triggered by an allergy to pollen. It can also lead to itchy, watery eyes and sneezing.
Depending on the specific pollen causing the allergy, symptoms of nasal congestion typically occur during a particular part of each year. In the UK, this is usually late spring to early summer.
Common treatments for hay fever include antihistamines, nasal sprays, and steroid drops or sprays.
Allergic Rhinitis
Rhinitis refers to the inflammation of the tissues lining the inside of the nose. This can be due to allergies (allergic rhinitis) or other causes (non-allergic rhinitis). Other allergies, not just pollen, can also result in a blocked nose.
The symptoms are similar to those experienced with hay fever. Tests may be available to identify the cause of the allergy.
The most effective treatment is to avoid the allergen if possible. If this isn’t feasible, the treatment would be similar to that for hay fever.
Nasal polyps
Nasal polyps are benign, fleshy swellings that develop inside the nose or sinuses. The most common symptom they cause is a stuffy, runny nose. Steroid nasal drops are often used to reduce the size of the polyps.
In some cases, surgery may be required. Nasal polyps frequently reappear after treatment, so steroid nasal sprays are sometimes used daily to prevent their return.
Other causes
There are several other factors that can cause a blocked nose. Swollen adenoid glands can lead to nasal congestion, particularly in children.
If the tissue dividing the two nostrils (nasal septum) is crooked (deviated septum), this can also result in a blocked nose. This could be due to an injury or simply the way the nose has grown since birth.
Other potential causes could be someone, usually a child, getting an object such as a bead or pea stuck up their nose. Rarely. it might be caused by a tumour in the airways around the nose or sinuses may cause congestion.
Treatment
Where possible, the cause of the nasal congestion will be treated. However, most will get better on their own without specific treatment.
There are some nasal congestion treatments which improve a blocked or runny orstuffy nose:
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Steam inhalation
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Salt water (saline solutions)
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Menthol vapours, rubs and pastilles
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Decongestant drops and sprays for nasal congestion
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Decongestant tablets and syrups
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Steroid sprays
However they only tend to work for a short time which means they need to be repeated regularly until the cause has cleared.
How to get a decent night’s sleep
A stuffy nose can be worse at night because the effect of gravity makes mucus pool at the back of the throat on lying down, says Dr Vincent. Studies have shown that the immune system is also more active at night.
People can also focus on the issue more at night when they try to sleep. It can help to sleep with the head propped up, if necessary using extra pillows.
Steam inhalations just before going to bed may also help. Keeping the bedroom temperature cool might also help and some find a humidifier in the bedroom improves things.
When to see a doctor
While nasal congestion often clears up on its own, there are instances when you should seek medical advice. These include:
- The nasal congestion is not getting better after two weeks despite trying suggested remedies
- There is no clear cause for your nasal congestion
- There is blood in the discharge coming from the nose
- Only one side of the nose is blocked
- A baby is having difficulties feeding or breathing due to nasal congestion. Babies have very small noses so often sound congested and make a lot of snuffling noises; however, if they are breathing faster than usual, if their chest wall is moving in and out more than normal, if they are using their tummy muscles whilst breathing or if they are not drinking as much as usual, these are all reasons to consult with a doctor.
- You are feeling very unwell.
