Nasal congestion, stuffiness, or obstruction to nasal breathing is may be a mere nuisance to some people, to others it is a source of considerable discomfort, and it affects the quality of their lives. The causes of nasal obstruction is divided into five types, that overlap exists between these types and that it is not unusual for a patient to have more than one factor involved in his particular case.
Deformities of the nose and the nasal septum, which is the thin, flat cartilage and bone that separates the nose into its two sides(Right side and Left side). These deformities are usually due to an injury at some time in one's life. The injury may have been many years earlier and may even have been in childhood and long since forgotten. It is a fact that newborn babies suffer significant nasal injury just from the birth process. Therefore, deformities of the nose and the deviated septum should be fairly common problems - and they are. If they create obstruction to breathing, they can be corrected with surgery.
One of the most common causes for nasal obstruction in children is enlargement of the adenoids: tonsil-like tissues which fill the back of the nose up behind the palate. Children with this problem breath noisily at night and even snore. They also are chronic mouth breathers, and sometimes dental deformities. Surgery to remove the adenoids and sometimes the tonsils may be advisable.
An average adult suffers a common "cold" two to three times per year, more often in childhood and less often the older he gets as he develops more immunity. The common "cold" is caused by any number of different viruses, some of which are transmitted through the air, but most are transmitted from hand-to-nose contact. Once the virus gets established in the nose, it causes release of the body chemical histamine, which dramatically increases the blood flow to the nose - causing swelling and congestion of nasal tissues - and which stimulates the nasal membranes to produce excessive amounts of mucus. Antihistamines and decongestants help relieve the symptoms of a "cold," but time alone cures it.
During a virus infection, the nose has poor resistance against bacterial infections, which explains why bacterial infections of the nose and sinuses so often follow a "cold." When the nasal mucus turns from watery clear to thick yellowish or green, it usually means that a bacterial infection has taken over and a ENT specialist to be consulted.
Acute sinus infections produce nasal congestion, thick discharge, and pain and tenderness in the cheeks and upper teeth, between and behind the eyes, or above the eyes and in the forehead, depending on which sinuses are involved.
Chronic sinus infections may or may not cause pain, but nasal obstruction and offensive nasal or postnasal discharge is often present. Some people develop polyps (fleshy growths in the nose) from sinus infections, and the infection can spread down into the lower airways leading to chronic cough, bronchitis, and asthma.
Allergy is an exaggerated inflammatory response to a foreign substance which, in the case of a stuffy nose, is usually that is in the air like Dust – Pollution, Smoke, pollen, mold,Pet animal fur, or house dust. Foods very rarely play a role. House dust allergies are often most evident in the winter. Molds may cause symptoms year-round. Ideally the best treatment is avoidance of these substances, but that is impractical in most cases.
In the allergic patient, the release of histamine and similar substances results in congestion and excess production of watery nasal mucus. Antihistamines help relieve the sneezing and runny nose of allergy. Many antihistamines are now available without a prescription.. Combinations of antihistamines with decongestants are also available.
Steroid nasal spays are the most specific treatment available, and they are highly successful in allergic patients. Skin tests or at times blood tests are used to make up treatment vials of substances to which the patient is allergic.This is called Immunotherapy. The doctor determines the best concentration for initiating the treatment. These treatments are given by injection. They work by forming blocking antibodies in the patient's blood stream, which then interfere with the allergic reaction. Injections are typically given for a period of three to five years. Decongestant nasal drops like Oxy / Xylometazolline should be avoided in nasal allegy.
"Rhinitis" means inflammation of the nose and nasal membranes. "Vasomotor" means blood vessel forces. The membranes of the nose have an abundant supply of arteries, veins, and capillaries, which have a great capacity for both expansion and constriction. Normally these blood vessels are in a half constricted, half-open state. But when a person exercises vigorously, his hormones of stimulation (i.e., adrenaline) increase. The adrenaline causes construction or squeezing of the nasal blood vessels, which shrinks the nasal membranes so that the air passages open up and the person breaths more freely.
The opposite takes place when an allergic attack or a "cold" develops. The blood vessels expand, the membranes become congested (full of excess blood), and the nose becomes stuffy or blocked.
In addition to allergies and infections, other events can also cause nasal blood vessels to expand, leading to vasomotor rhinitis. These include psychological stress, inadequate thyroid function, pregnancy, certain anti-high blood pressure drugs, overuse or prolonged use of decongestants nasal drops, and irritants such as perfumes and tobacco smoke.
In the early stages of each of these disorders, the nasal stuffiness is temporary and reversible. That is, it will improve if the primary cause is corrected. However, if the condition persists for a long enough period, the blood vessels lose their capacity to constrict. They become somewhat like varicose veins. They fill up when the patient lies down and when he lies on one side, the lower side becomes congested. The congestion often interferes with sleep. So it is helpful for stuffy patients to sleep with the head of the bed elevated . Steroid nasal spray helps to some extent. Surgery (Turbinectomy) may offer dramatic and long time relief in chronic cases.