A B C D E F G H I J K L M N O P R S T U V W

BLOCKED NOSE

What is a Blocked Nose ?

From time to time, every person has a blocked nose. Often this is the result of a common cold (acute rhinitis). A longer-lasting blockage of the nose due to swelling of its lining occurs quite often. Hay fever is a seasonal type of rhinitis, and is due to allergy to grass and tree pollens. Patients react to the pollen which causes a swelling of the lining of the nose. They also have a marked watery nasal discharge and sneezing. Often the normally white conjunctiva of the eyes is inflamed and red. This is one form of nasal allergy.

Other substances can also cause nasal allergies: the symptoms are then present all year round. This type of rhinitis is called perennial rhinitis. In some patients, swellings form inside the nose, often in response to allergy and infection. Because of the shape of the inside of the nose, these swellings become pear-shaped, and gradually get bigger. They are called polyps. The nose is divided into left and right sides by the nasal septum. This septum is not always in the midline. If it is over to one side, it is referred to as a deviated septum. This problem can either cause or make worse any blockage of the nose.

How does a Blocked Nose occur ?

True allergy of the nose occurs in hay fever. Nasal symptoms may also occur with allergy to a mite, present in house dust. Hay fever occurs in spring and early summer and is worse when pollen counts are high. The substances which cause the allergic response are called allergens. These allergens stimulate the body to produce antibodies. The antibodies combine with the allergen on the surface of the lining of the nose. When the two combine there is a release of certain chemicals which include histamine. Other non-allergic conditions of the nose can also result in these chemicals being made. The chemicals directly cause the inflammation, with swelling, watery discharge and blockage.

Why does a Blocked Nose occur ?

We do not really know why some people become allergic to things. However, allergies tend to run in the family: there is often a family history of hay fever, asthma or eczema. The deviation of the septum may be due to some previous injury, or simply the way in which the nose has grown.

Treatment Involved for a Blocked Nose

If you have HAY FEVER, you can try to avoid particular trees or grasses which are known to upset you. When pollen counts are high, make sure that you are taking the right treatment. If you have YEAR-ROUND NASAL SYMPTOMS, you can do a variety of things to help. The home conditions may be improved by a number of simple measures. Vacuum clean the bedroom carpets daily, the bed sheets on alternate days, and the mattress weekly. This is to reduce exposure to dust and the house dust mite. Wooden floors rather than carpets are helpful. Avoid feathers by using man-made fibres in the bedding. Animal fur should be avoided. Pets must not be allowed in the bedroom and should only be played with outdoors. The home should generally be kept as dust-free as possible and well humidified. Bedroom heating should be turned off before going to bed. Smoking should be avoided.

In some patients, a food allergy may be suspected. The suspected food should be excluded from the diet for six weeks. This should only be done after advice from your doctor or a dietitian about avoiding possible food allergens. Desensitization is now almost never carried out. Very serious side-effects have occurred, although only in a very small number of people. Fortunately there are a number of effective medical treatments which can control the symptoms.

Antihistamines are drugs which counteract the effects of histamine and related substances. There are many available, and the right one is often found by trial and error. The main side effects of some older antihistamine drugs are dryness of the throat and drowsiness. Modern antihistamine drugs have very little in the way of side-effects. It is usually possible to find an antihistamine which is both effective and comparatively free of side-effects. Decongestant drugs act on the blood vessels in the nasal lining and make it shrink. Decongestant drugs can also be put directly in the nose as drops or sprays. They constrict the blood vessels and reduce the swelling. Steroid (cortisone-like) sprays and drops may be used with good effect in many patients. Another type of nasal spray uses a drug called sodium cromoglycate. This preparation blocks the chemical reaction between the allergen and its antibody, and so prevents the formation of histamine. Like the steroid spray, to be effective, it should be applied regularly. It can also be used as eye drops.

Nasal symptoms present all year round may sometimes be due to an allergy. However, the lining of the nose can react to many different irritants without a true allergy being present. This type of stuffy nose responds in most patients to the above types of treatment. In a few patients, medical treatment alone is not enough. Surgical treatment may be considered. A deviated septum which is contributing to the blockage may be straightened out. This operation is called a SEPTOPLASTY or septal repositioning. Turbinates are structures on the side wall of the nose which can swell up with prolonged rhinitis. These turbinates may be reduced in size. Partial removal and diathermy (a type of cautery) are often used. If nasal polyps cannot be controlled by use of antihistamines and steroid drops and sprays, they may be removed too. The operation is most often done through the nose. It may be performed under local or general anaesthetic. Sometimes the surgeon will suggest an operation to clear the sinuses as well. This may include endoscopic (keyhole) sinus surgery. Surgery cannot offer a cure for polyps. There is a marked tendency for them to recur. Despite this, surgery can offer great relief.

During Treatment of a Blocked Nose

Many of the drugs used have side effects. Very occasionally, the sedative effect of antihistamines may make driving (especially long distance) dangerous. Decongestants can cause agitation, a fast heart beat and sleep disturbance. Older men may have difficulty in passing urine. Decongestant nasal drops and sprays are readily bought over the counter and so tend to be over-used. They can actually worsen the problem if used for more than a week at a time. Prolonged steroid sprays can produce nose bleeds. If this occurs, they need to be stopped for 2 weeks in every 8. This is very much less likley with current steroid nasal sprays.

If a Blocked Nose is Left Untreated

A blocked nose is very uncomfortable and lowers the quality of life. Patients with a blocked nose are more liable to chest and throat infections. They are also more likely to have infections of the nose and sinuses, which can very occasionally have serious complications.