Nasal congestion is a difficulty in nasal breathing. The symptom is often accompanied by nasal discharge, headaches, and sleep disturbances. Unpleasant manifestations can be due to both physiological causes and various diseases of the nasal cavity, allergic reactions, pathologies of anatomical structures. To identify the cause of congestion, rhinoscopy, radiography of the paranasal sinuses, laboratory tests and allergy tests are performed. Non-drug methods, nasal drops, are used as symptomatic treatment until a diagnosis is established.
Regardless of the cause, nasal congestion often develops gradually: a person notices difficulty in nasal breathing, there is a subjective feeling of lack of air. The condition is accompanied by discomfort in the forehead and bridge of the nose, dryness of the nasal epithelium. With a pronounced difficulty in the passage of the air flow, patients breathe through an open mouth, their sense of smell decreases. Often there is a combination of congestion with sleep disturbances - in a horizontal position, the symptoms intensify, so people have to sleep half-sitting, leaning on high pillows.
A few hours after the onset of nasal breathing disorders, other symptoms often join - mucous discharge, itching, sneezing. Sometimes breathing is disturbed only on one side, and when lying on one side, a feeling of congestion in the nostril located below is typical. With a chronically stuffy nose, insufficient oxygen enters the body, which is manifested by persistent headaches. If the difficulty in nasal breathing persists for 3-4 days, violations of the general condition increase, insomnia worries, it is necessary to consult a specialist.
The nasal epithelium is in contact with all external stimuli that are in the atmospheric air. The impact of adverse factors causes swelling of the mucous membrane, which in healthy people is short-lived. The appearance of congestion is more often caused by low humidity in the room: in apartments, especially in winter when central heating is in operation, the moisture content does not exceed 40% (the normal level is 50-60%). There are other causes of nasal breathing difficulties: exposure to cold air, tobacco smoke, strong odors.
Allergic diseases rank first among the causes of nasal congestion (18-38% of all cases). A symptom can occur when inhaling dust, pungent odors, flower aromas. Violations develop within a few minutes. Congestion is preceded by a feeling of discomfort and itching, lacrimation. Upon contact with the allergen, the mucous membrane of the nasal passages swells, and in severe cases it completely closes. Breathing through the nose, as a rule, recovers on its own after the cause is eliminated (the termination of contact with the trigger factor).
Allergic rhinitis is characterized by an increase in symptoms in spring and early summer - during the flowering period of trees and shrubs. Patients complain of severe breathing difficulties, which are aggravated when leaving the room. When congestion is combined with abundant serous discharge, lacrimation and redness of the eyes, they speak of hay fever. Such manifestations significantly worsen the quality of life, the symptoms are poorly stopped by vasoconstrictor nasal drops.
Difficulty inhaling through the nose is one of the first signs of viral rhinitis, moderate congestion persists throughout the entire treatment period. Typical complaints of severe dryness of the nasal mucosa, causing discomfort. The sense of smell is sharply reduced, and its recovery is delayed up to a week or more. Swelling of the epithelium in viral infections is accompanied by weakness, severe headaches, fever. Most often, such symptoms are caused by a rhinovirus infection, influenza.
Difficulties in nasal breathing that last more than 1 month are characteristic of chronic inflammatory processes in the nasal cavity. There is a constant presence of pathological symptoms, the relationship between exacerbations and exposure to external factors is often not traced. Nasal congestion is most severe in hypertrophic rhinitis: significant growths of nasal conchas create a mechanical obstacle to the passage of air. In pregnant women, the disorder is usually associated with vasomotor rhinitis.
Any inflammation in the upper respiratory tract is accompanied by reactive swelling of the nasal mucosa, making it difficult to inhale air through the nose. Symptoms worsen in the evening and at night. The symptom occurs against the background of pain in the frontal region, bridge of the nose, sore throat, coughing, fever. Congestion is due to the following reasons:
The appearance of nasal congestion is characteristic of the early stages of growth, when there are no other symptoms. Patients feel discomfort in the region of the nose, nasal breathing disorders are most pronounced in the morning, immediately after waking up. For polyps, difficulty in exhaling is typical - patients inhale quite freely, and on exhalation, the polyposis tissue plays the role of a damper. When the disease changes mucociliary clearance and outflow of mucus, so the discharge of the nasal cavity flows down the back of the pharynx, causing sore throat and discomfort.
Enlarged adenoid vegetations in children create significant obstacles to the passage of air masses through the nose through the respiratory tract. Congestion is very pronounced, especially at night. The child breathes through the mouth, which causes a characteristic appearance - a constantly open mouth, smoothed nasolabial folds, dry lips with cracks. Due to the impossibility of normal inhalation of air, sleep is disturbed, loud snoring is noted. The disease is combined with frequent and prolonged rhinitis, which further exacerbate respiratory disorders.
Violation of the anatomical structures of the nasal cavity is more often manifested by unilateral congestion. Complaints are made of difficulty or complete inability to inhale air through one nostril, while the symptom is constant and does not change in the position on the side. Vasoconstrictor drops used for treatment have no effect. With strong curvatures, the shape of the nose noticeably changes. The most common causes of impaired nasal breathing due to deformation of the bone part are congenital defects of the septum or trauma to the bones of the facial skull.
The occurrence of drug-induced rhinitis is most often associated with prolonged uncontrolled use for the treatment of topical decongestants (vasoconstrictor nasal drops with adrenergic agonists). The use of these drugs for 7-1 days causes a "ricochet" obstruction - a strong swelling of the mucous layer, which does not decrease with further instillation of adrenomimetics. Among other drugs, tamsulosin, a drug for the treatment of prostatic hyperplasia in men, has the greatest effect on nasal breathing.
An otolaryngologist is engaged in examining the patient and establishing the cause of the sensation of nasal congestion. Diagnostic search involves an instrumental study of the nasal cavity and nearby parts of the respiratory tract. In order to clarify the diagnosis, laboratory tests are prescribed. The most valuable and informative are:
To quickly establish the cause of difficult nasal breathing, instrumental methods of examination are shown - pharyngoscopy and laryngoscopy. In order to confirm the allergic nature of nasal congestion in the period of exacerbation of symptoms, an extended immunogram is performed, after the clinical manifestations subside, allergy tests with the most common antigens are recommended. In difficult cases, other specialists are involved in the examination.
Rhinoscopy - instrumental examination of the nasal cavity
Unpleasant symptoms can be reduced with non-drug treatments. It is recommended to increase the humidity in the room. To do this, it is better to purchase a special humidifier. The patient must avoid strong odors, a sharp change of cold and warm air. You need to sleep on a high pillow so that the head is always in an elevated position - this reduces the swelling of the mucosa. Persistent breathing problems through the nose are more often a sign of illness, therefore, to determine the cause of the disorder, it is necessary to seek qualified medical help.
The choice of treatment tactics depends on the cause of the disease. Symptomatic therapy in the form of nasal drops with adrenomimetics is recommended for short-term use during the period of the greatest severity of discomfort, but it does not affect the causes of congestion. The basis of the treatment regimen in patients with impaired nasal breathing is usually drug methods. As etiotropic and pathogenetic therapy use:
Washing the nasal cavity with saline solutions helps eliminate dryness of the mucous membrane. In patients with chronic diseases of the nasal cavity, along with drugs, methods of physiotherapy are actively used - galvanotherapy, darsonvalization, microwave therapy, which stimulate blood circulation and improve immune defense processes. To enhance the effect of drugs, they are injected directly into the affected area using electrophoresis.
To eliminate nasal congestion caused by a deviated septum, surgery is indicated - septoplasty. Surgical methods are also used to treat polyposis: most often, endoscopic removal of the volumetric formation is performed, after which nasal breathing is restored. Advanced variants of hypertrophic rhinitis are subject to surgical correction: during the intervention, the specialist performs a conchotomy, removing part of the turbinate to eliminate the mechanical obstruction to the passage of air.