Symptoms
The possible symptoms of a stuffy nose include difficult nasal breathing, swelling of the mucous membrane, a feeling of fullness, secretions, crusting, rhinitis, itching, and sneezing. The stuffy nose often occurs at night while lying down and also triggers insomnia, sore throat and headache.
Causes
A stuffy nose restricts the flow of air through the nose and reduces the space in the nasal cavity. Often, the cause is mucosal impairment, such as an inflammatory reaction that leads to vasodilatation, secretions, and swelling. The inflammation can be allergic, infectious and traumatic in nature. Irritants, emotions and temperature differences can also trigger the symptoms (vasomotor rhinitis). The symptoms can be acute, chronic, and chronic-recurrent. Causes (selection):
- Common cold, bacterial infections.
- Sinusitis
- Dry nasal mucosa
- Allergic rhinitis, e.g. hay fever, year-round allergy such as dust mite allergy.
- Rhinitis medicamentosa due to the excessive use of decongestant nasal sprays.
- Nasal polyps
- Vasomotor rhinitis, e.g., due to odors, smoke, pollutants, or temperature changes.
- Pregnancy rhinitis
- Drugs: phosphodiesterase inhibitors, NSAIDs, acetylsalicylic acid, antihypertensives (eg, beta-blockers), estrogens and antidepressants.
- Intoxicants such as alcohol and cocaine
- Foreign bodies in the nose, especially in young children
- Anatomical narrowing, for example, due to a deviation of the nasal septum (septal deviation).
- Cancers
- Injuries, nosebleeds
Diagnosis
Diagnosis is made in medical or specialist treatment based on the patient’s history, physical examination, laboratory methods, nasal endoscopy (rhinoscopy), nasal endoscopy, imaging techniques and nasal flow measurement. Specialists in the diseases are otolaryngologists.
Nonpharmacologic treatment
- Increasing the humidity of the air
- Operative intervention
- Reduction of allergens and pollutants, avoidance of triggers.
- Raise the head end of the bed
- Nasal aspirator to remove secretions
- Removal of foreign bodies
- Sufficient drinking
Drug treatment
Decongestant nasal sprays:
- With active ingredients such as xylometazoline or oxymetazoline belong to the group of sympathomimetics. They have vasoconstrictor and mucosal decongestant properties and usually show a rapid effect. However, they may only be used for a maximum of 5 to 7 days, because they can lead to habituation and a so-called rhinitis medicamentosa.
Oral sympathomimetics:
- Such as pseudoephedrine and phenylephrine are commercially available, for example, in the form of capsules and cold remedies. Like nasal decongestants, they have vasoconstrictive properties. Because of the systemic administration, more adverse effects are to be expected. The oral sympathomimetics are also not suitable for long-term therapy.
Glucocorticoid nasal sprays:
- With active ingredients such as mometasone furoate or fluticasone are usually characterized by good efficacy. They have antiallergic, anti-inflammatory, decongestant, and immunosuppressant properties and can be used for longer periods. The sprays are significantly better tolerated than cortisone tablets. Because the active ingredients are suspended, the sprays must be shaken immediately before use.
Antihistamine nasal sprays:
- For example, with azelastine or levocabastine are anti-allergic, antihistamine, anti-inflammatory and mast cell stabilizing. They are mainly used for rhinitis of allergic origin. Another indication is vasomotor rhinitis.
Antihistamines:
- Such as cetirizine, bilastine, loratadine and fexofenadine are also taken perorally in the form of tablets, solutions or drops for allergic causes.
Humidifying nasal sprays:
- With sea water, Emser salt, plant extracts, hyaluronic acid, dexpanthenol, ectoin or saline cleanse, moisturize and nourish the nasal mucosa.They can be used daily and for a longer period of time. Appropriate nasal rinses are also available.
Other medicines:
- Inhalations, for example with essential oils.
- Nose sticks, cold baths with essential oils.
- Cold balms
- Nasal ointments
- Herbal extracts, such as nasturtium and horseradish root.
- Mast cell stabilizers such as cromoglicic acid.
- Leukotriene antagonists such as montelukast
- Parasympatholytics: Ipratropium bromide nasal spray
- Sprays, which form a “protective layer” on the mucous membrane with gel formers
- Antibiotics against bacterial infections
