Chronic nasal congestion can be caused by allergies, irritants, or infections, and may require testing to identify the cause. Treatment options include medication, lifestyle changes, and surgery if structural problems are present.
Chronic nasal congestion, or simply a blocked or stuffy nose, is a condition that often results in other conditions such as snoring or sinus headaches, and has a constellation of causes. It is differentiated from the stuffy/runny nose that occurs when people have colds or allergies, called acute nasal congestion. This usually resolves a few weeks after symptoms appear; with chronic nasal congestion, symptoms may last for several months with few signs of disappearing.
Some of the causes of chronic congestion include ongoing allergies, response to irritants, or chronic fungal or bacterial infections of the sinuses. Some more unusual causes include diseases such as gastroesophageal reflux disease (GERD) or certain hormone treatments or naturally high levels of hormones, such as in pregnancy. Some of these conditions are fairly easy to spot at first, and others may require some testing to identify. It is important to distinguish between chronic fungal and bacterial sinusitis, as antibacterial treatment for fungal sinusitis can only make the problem worse.
Of these causes, one of the clear culprits of chronic nasal congestion is allergies. Many people get seasonal allergic rhinitis, and while congestion is chronic during the season, it may only be present during a particular season. Others seem to have chronic congestion all the time, and this can suggest allergies to things found in the home like dust mites, pet dander, or mold. Doctors might suggest people get allergy testing to determine what things are creating congestion, and as part of treatment, they might recommend trying to minimize exposure to those things in living environments.
Chronic nasal congestion could also be a response to things that irritate the nose and cause it to become inflamed. Tobacco smoke and some other chemicals may be more appropriate in these cases. People may not have an allergy but instead have a sensitivity response and symptoms may be reduced, as with allergies, by minimizing exposure
Long-lasting congestion can suggest an infection and this could be bacterial or fungal in origin. When sinus infections don’t clear up, and especially don’t clear up after antibiotics, you might try other treatments. It should be noted that people may have chronic nasal congestion caused by more than one source. It is possible to have allergies, sensitivities and infections at the same time.
Treatment of chronic congestion begins with identifying the cause. If GERD is identified, treatment focuses on acid reduction. For other causes, doctors might suggest decongestants, antihistamines, corticosteroids, antifungals, or antibacterials. Additionally, they may recommend lifestyle changes that could help alleviate some of the problem, and may recommend at-home treatments such as daily sinus rinses.
Sometimes additional help may be needed, particularly if structural problems with the nose are causing chronic nasal congestion. Some doctors might recommend things like removing the adenoids or aligning certain nasal structures to promote better breathing. There are many possible surgical approaches to addressing the problems of a congested nose, particularly when the cause appears to be rooted in nasal form or function.
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