Nasal Congestion (Stuffy Nose)

Nasal congestion occurs due to inflammation of the blood vessels in the nasal cavity, leading to swelling of the nasal mucosa. Several triggers can cause nasal congestion, including:

• Common cold

• Allergies (e.g., dust mites, pollen, animal dander)

• Sinus infections

• Influenza (flu)

• Overuse of nasal decongestants

Proper identification and management of the underlying cause are crucial, especially in young children. In newborns (under 3 months), who cannot breathe effectively through the mouth, nasal congestion can interfere with feeding and may become life-threatening. Nasal congestion can also cause:

• Sleep disturbances

• Snoring

• Sleep apnea

Patient Advice

• Steam inhalation: Boil 4–6 cups of water, cover the head with a towel over the steam, and inhale for about 10–15 minutes per session.

• Stay hydrated: Drink sufficient water to thin nasal mucus. Avoid caffeinated beverages, as they can worsen dehydration.

• Maintain humidity: Rest in a humid environment; use a vaporizer or air humidifier if necessary.

• Avoid allergens: Especially important if nasal congestion is allergy-related.

• For infants: Use a nasal aspirator after softening mucus with 2–3 drops of saline solution in each nostril.

• Saline nasal sprays: Effective for relieving congestion safely.

When to See a Doctor

Nasal Congestion:

• Symptoms last longer than one week or worsen despite appropriate medication.

• Unilateral congestion with foul-smelling, greenish-yellow mucus.

• Presence of bloody mucus.

• Fever.

Influenza (Flu):

• Symptoms persist beyond one week or worsen despite medication.

• Severe symptoms, especially in:
  • Pregnant women
  • Young children (<5 years)
  • Elderly (>65 years)
  • Patients with chronic illnesses (asthma, diabetes, HIV/AIDS, heart disease)

• Persistent high fever for more than three days.

• Chest pain, difficulty breathing, wheezing.

• Lethargy, confusion.

• Severe or continuous vomiting.

Treatment Options

1. Nasal Decongestants and Other Nasal Preparations

• Nasal decongestants (e.g., naphazoline, oxymetazoline) constrict blood vessels in the nasal mucosa to reduce swelling.

• Precautions: Use with caution in patients with:
  • Uncontrolled hypertension
  • Heart disease
  • Hyperthyroidism
  • Glaucoma
  • Urinary retention
  • Diabetes
  • Those taking monoamine oxidase inhibitors (MAOIs)

Important: Short-acting nasal sprays should not be used for more than 5 consecutive days to avoid rebound congestion.

• Saline solutions (drops or sprays) can soothe irritated or dry nasal tissues, safe for long-term use, especially in children and pregnant women.

• Sea water nasal sprays Help relieve nasal and sinus congestion from allergies or infections.

• Carragelose nasal sprays Help moisturize and create a protective barrier against pathogens (e.g., cold viruses, pollutants, dry air).

2. Cough & Cold Preparations

These products often combine multiple active ingredients to relieve various symptoms:

• Analgesics: e.g., paracetamol, for headache, body aches, and fever.

• Antihistamines: e.g., chlorpheniramine, loratadine, brompheniramine, diphenhydramine, triprolidine, to reduce runny nose and congestion.

• Cough suppressants: e.g., dextromethorphan, for cough relief (regulated due to abuse potential).

• Decongestants: e.g., phenylpropanolamine, pseudoephedrine, phenylephrine.

Cautions:

• Decongestants can elevate blood pressure and must be used carefully in patients with cardiovascular disease or uncontrolled hypertension.

• Some antihistamines can cause drowsiness; caution is advised for those operating vehicles or machinery.