Stuffy Nose

A "stuffy nose" is medically termed "nasal congestion". This is a symptoms where the air does not flow unimpeded 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 some common causes in tabular form (modified, Ref. 4, p. 308).

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.

Common causes of "stuffy nose"
Causes of nasal congestion:	Comments:
allergic rhinitis	IGE antibodies from inhalant allergies cause inflammation of nasal lining
cigarette smoke	irritates mucous membranes and often blocks sinus entrance
drugs (side-effects)	diuretics dry the mucous membranes; betablockers 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, adenoids or nasal septum deviation	mechanical obstruction may require surgery
sarcoidosis and Wegener's granulomatosis	nasal congestion and bloody nasal discharge; needs ENT specialist

Enlarged 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).

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

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.

Last Modified: Jan. 27, 2008