Probably the most common cause of longstanding (chronic) nasal stuffiness (congestion) is swollen nasal membranes (medically known as hypertrophied turbinates). These membranes line the nose and are designed to warm and humidify the air as it passes through the nose. The membranes alternately shrink and swell on one side and then the other to regulate air flow. This is why you might notice at times you breathe a bit better through one side of your nose, and a little while later you are breathing better through the other side of your nose. You may also notice when you are sleeping the lower side of the nose becomes more congested than the upper. If you have allergies or a crooked internal nasal wall (deviated septum) the swelling can become permanent, causing chronic nasal stuffiness.
Nasal congestion can also be caused by nasal polyps, which occur when a small portion of the membrane lining the nose becomes abnormally swollen. The exact cause is unkown, though allergy sometimes plays a role. If the polyps swell enough then they can block your breathing.
What are the treatments for nasal congestion?
The first line of treatment for nasal congestion is intranasal steroid sprays such as Flonase®, Nasacort AQ®, and Rhinocort Aqua®. These sprays typically reduce the swelling associated with allergies and nasal inflammation. They are quite safe and are available over-the-counter. Many patients do not realize that the sprays need to be used for several weeks to become fully effective. Saline nasal rinses may also help.
If you have allergies (we can test you for this) your congestion may respond to antihistamines or even allergy shots (desensitization therapy).
If the medications do not work well then the swollen membranes can be surgically reduced (turbinate reduction). If the internal nasal wall is crooked (deviated septum) then it can also be straightened (septoplasty). If you have nasal polyps which do not respond to steroid therapy then they can be surgically removed (nasal polypectomy).
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