Dr. Nikhil Mali

Nasal congestion is the blockage of the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels

It is also known as nasal blockage, nasal obstruction, blocked nose, stuffy nose, or stuffed up nose.

Nasal congestion can interfere with the ears, hearing, and speech development. Significant congestion may interfere with sleep, cause snoring, and can be associated with sleep apnea.

Nasal congestion can also cause mild facial and head pain, and a degree of discomfort.

Nasal blockage can be seen in the following Diseases

Common cold The onset is acute, with a scratchy sore throat and cough. The nasal mucosa will appear red, boggy, and glassy. The nasal drainage will initially be clear but will later becomecolored (yellow-green). 

Allergic rhinitis

Acute allergic rhinitis is often associated with eye irritation, paroyxms of sneezing,itching of the eyes, nose, or palate, and postnasal drip with cough.

The nasal mucosa is bluishand pale. Seasonal rhinitis is usually caused by inhaled pollens. Perennial rhinitis is caused byallergy to animals, dust, mites, or mold.

VasomotorrhinitisCongestion is prominent, but rhinorrhea, sneezing, and itching are not.

Rhinitis medicamentosa occurs after 3 to 4 days of continuous use of a topical vasoconstrictor.

There will be initial relief with its use that is then followed by rebound with worsened congestion.

Vasomotor rhinitis may also be precipitated by cold, emotion, or sexual arousal. The turbinates are red andboggy.

 

Nasalpolyp

Unilateral airflow will be obstructed and a polyp will be visible deep inside, beyond theturbinate, as a gray structure with the appearance of a skinned grape.There is an associationbetween aspirin use, nasal polyps, and asthma, but the most common cause is chronic allergicrhinitis.

Sinusitis

Drainage, if present, will be purulent, although colored drainage can be found in otherconditions.

There will be a sensation of facial fullness that worsens with bending forward, oftenaccompanied by fever and a headache.

On physical examination, there will be tenderness toconcussion and pressure, overlying warmth, and fever. The affected sinus will not transilluminate.

Drugs

Cocaine, beta-blockers, reserpine, and hydralazine can each cause nasal obstruction

Deviated septum

Deviation causes chronic unilateral obstruction, which is readily observed with anasal speculum.

Intranasal foreign body

There will be nasal obstruction associated with a chronic

unilateralmucopurulent discharge with a

foul odour.

SarcoidosisSarcoidosis

presents with bilateral nasal congestion in as many as 20% of cases. Systemic symptoms such as fever, fatigue, or weight loss;

pulmonary symptoms such as cough ordyspnea; or skin manifestations such as erythema nodosum or purple, waxy plaques are clues tothe underlying diagnosis.

Cerebrospinal fluid leak

Head trauma with a basilar skull fracture may go unrecognized.

Clear nasal drainage tests positive for glucose using a urine dipstick.

 

Wegener granulomatosis

Its earliest manifestation may be nasal obstruction, rhinorrhea, crusting,and chronic sinusitis with a fetid drainage. Development of a septal ulceration is present

Causes of Nasal blockage

oAllergic reactionoCommon cold or influenzaoDeviated septumoHay fever, allergic reaction to pollen or grassoReaction to medication (e.g. Flomax)oSinusitis or sinus infection

Treatment

The treatment of nasal congestion frequently depends on the underlying cause.

Both influenza and the common cold are self limiting conditions that improve with time; however, drugs such as acetaminophen (paracetamol) and ibuprofen may help with the discomfort.

A cause of nasal congestion may also be due to an allergic reaction caused by hay fever, so avoiding allergens is a common remedy if this becomes a confirmed diagnosis.

Antihistamines and decongestants can provide significant symptom relief although they do not cure hay fever.

Topical decongestants should only be used by patients for a maximum of 3 days in a row, because rebound congestion may occur in the form of rhinitis medicamentosa

The use of nasal irrigation may help reduce nasal congestion. It involves rinsing the nasal cavity with salty water, however, this may cause further irritation.

VaporisersThese are obtainable in ointment and oil form and have scented constituents that could assist in allaying a dripping nose or finding relief from the ‘stuffed or suffocated feeling’ by de-clogging the inflammation in the air passages. Eucalyptus and oils like peppermint, menthol, camphor act on the nasal receptors, constrict the flow of blood and hence lower inflammation.

Menthol-based nasal strips

The placing of these strips is done below the nasal bridge for allaying obstruction as it lifts open the nostrils. The menthol helps to relieve inflammation in the air passages.. Their strong-smelling nature helps to infiltrate the mucus obstruction, thus help to provisionally open the nasal passages.

Nasal Sprays

These sprays have decongestants like oxymetazoline or xylometazoline that contract the blood vessels. They additionally aid in stopping mucous formation

list of surgical procedures is shown below. •Turbinectomy

•Partial turbinectomy

•Submucosal resection of the turbinates

•Surface "scoring" techniques

•Less invasive techniques

•"Hot poker" methods (electrocautery, radiofrequency, laser)

•Powered/submucous inferior turbinoplasty

•FESS (Functional Endoscopic Sinus Surgery)Septoplasty

According to Ayurveda

ना�सा�वरो�ध

ना�सा�प्रतीना�ह

Samprapti:

कफव्रु�ती� व�यु�रुदा�नासा�दा�न्यु� युदा� स्वमा�र्गे� विवर्गे�णः� स्थि�ती�स्यु�ती�।घ्रा�णः� व्रु�णः�तीव तीदा� सा रो�र्गे� ना�सा�प्रतीना�ह इती प्रदिदाष्टः�॥

सा�.उ.२२/१५

Laxanas

ना�सा�वरो�ध साकष्टःश्वसानामा�खे,ना श्वसाना ती�लु�शु�ष्कती�

Chikitsa स्ना,हपा�नास्निस्नाग्ध ध3माशिशुरो�बस्तिस्तीस्ना,हना स्व,दाना�दिदा उपाचा�रो�

अपानासा

Samprapti:

कफपारोवरोधदा� नाaसा�यु�� रुध्द्वा� स्रो�ती��स्युपानासामा�।क� यु�<त्साघु�घु�<रो� � श्व�सा� पानासा�धिधकव,दानामा�॥

 

ना�सा�वरो�ध, घु�घु�<रो� श्व�सा, विपास्थि@लु पाती पाक्व स्रो�व

 

Chikitsa

स्ना,हना, स्व,दाना, वमाना, विवरो,चाना, ध3मापा�ना, अवपाडना नास्यु

ना�सा�शु�ष

शु�षयु,न्ना�शिसाक�स्रो�ती�� कफ� चा क� रुती, अविनालु�।शु�कपा�णः<भना�सा�त्व�.........॥

व�.सा�.

१९/१६

Samprapti:

Laxanas

ना�सा�वरो�धना�सा�शु�ष्कती�साकष्टःश्वसाना, ना�सा�विवदा�रोणःशु�कपा�णः<भना�सात्व�

Chikitsa

स्ना,हपा�ना, स्निस्नाग्ध ध3मा स्व,दाना�दिदा उपाचा�रो�

 

पा�टक

Samprapti:

विपात्तश्ले,ष्मा�वरुध� अतीना�<सा�यु�� शु�षयु,न्मारुती�।कफ� साशु�ष्कपा�टती�मा� प्र�प्नो�विती पा�ट�क�� ती� तीती� ॥

व�. उ. १९/२५

Laxanas

पा�टक�त्पात्तित्त ना�सा�वरो�धना�सा�शु�ष्कती� साकष्टःश्वसाना

 

Chikitsa

स्नाहपाना सानार्गेध ध3मा प्रधमाना नास्युना�डस्व,दा

ना�सा�शु< 

Samprapti:

दा�षNस्निस्Oत्तिभस्तीN� प्र�थकश्च ब्रु�यु�त्तथ� अशु�<शिसा तीथNव शु�फ�मा�।

सा�.उ.२२/१८

Laxanas

ना�सा�वरो�ध साकष्टःश्वसाना शिशुरो�शु3लु सा�ना�ना�शिसाकउच्चा�रो

Chikitsa

शुस्Oकमा<

प्रवितीश्यु�यु

Samprapti:

चायु� र्गेती� मा3ध�<विना मा�रुती�दायु� प्र�थकसामास्ती�श्च तीथNव शु�त्तिणःतीमा�।

प्रक�प्युमा�णः�� विवविवधN� प्रक�पाणःNन्रु�णः�� प्रवितीश्यु�युकरो� भवन्तिन्ती विह॥

सा�.उ.२४/४

Chikitsa

स्ना,हना स्व,दानावमाना ध3मा र्गेण्ड3ष

Dr. Nikhil Mali