Causes of Nasal Congestion

It is important to recognize that there are several factors that can lead to nasal congestion (also known as nasal obstruction). These factors may involve structural abnormalities or issues that affect the anatomical aspects of the nose or disrupt its normal functions. This article will detail some of these causes.

Health Conditions

Nasal congestion can often result from specific health issues. Below is an overview of these conditions:

Common Cold or Influenza

The common cold and influenza are well-known for causing the nasal cavity to fill with mucus, resulting in temporary nasal blockage. The type of mucus can vary among individuals, ranging from yellow, green, to clear, and its consistency can be watery or thick and sticky. In addition to nasal congestion, individuals may experience symptoms like fever, cough, malaise, fatigue, and headaches. Typically, these symptoms subside in a few days. Over-the-counter medications such as paracetamol and ibuprofen can be beneficial, and nasal decongestants are also available to alleviate obstruction. However, influenza often presents with more severe symptoms compared to a cold, as it results from a viral infection and includes symptoms such as nasal congestion, sneezing, fever, fatigue, and body aches.

Rhinitis

Inflammation of the nasal membranes can occur due to various factors, categorized into two main types:

Allergic Rhinitis: Exposure to allergens can lead to an elevated immune response mediated by Immunoglobulin E (IgE), causing inflammation of the nasal mucosa. Common allergens include pollen, dust mites, pet dander, and tobacco smoke.
Non-Allergic Rhinitis: In some cases, the causes of this condition remain unclear and are generally unrelated to allergies or infections. It may be triggered by irritants or medications that lead to nasal congestion, known as drug-induced rhinitis. Exposure to strong odors can also contribute to the condition, which may sometimes be associated with atrophic rhinitis.

Sinusitis

Sinuses are internal cavities within the face that drain into the nasal passages. When these cavities become filled with mucus due to infection, it results in sinusitis. Ongoing colds may sometimes lead to sinus infections, which can be either bacterial or viral. The body responds by increasing blood flow to the nasal area, resulting in swelling and obstruction. Excess mucus can block nasal passages, leading to postnasal drip and coughing.

Nasal Polyps

Nasal polyps are soft tissue growths located within the nasal passages and can become infected, particularly in children. This can lead to increased mucus production similar to that seen in sinus infections.

Environmental Irritants

Exposure to certain environmental triggers is a common cause of nasal congestion. These irritants include smoke, fumes from harsh weather conditions, and allergens like pollen, which can exacerbate symptoms in individuals with various allergy types, such as hay fever.

Anatomical Changes in the Nose

Various anatomical changes in the nose can also lead to obstruction. These include:

Deviated Nasal Septum

The nasal septum is the cartilage and bone structure dividing the two nostrils. A deviation in this septum can cause breathing difficulties and uneven nasal obstruction. Problems such as frequent nosebleeds, facial pain, headaches, and snoring may also arise. Deviations often occur during fetal development or may result from physical trauma, such as sports injuries or car accidents. Age-related degeneration of nasal cartilage can further exacerbate this condition.

Enlarged Inferior Turbinates

The inferior turbinates are bony structures located on both sides of the nasal cavity. They are covered with mucous membranes that help warm and humidify inhaled air. These structures can become irritated and swollen due to allergens or dust, contributing to respiratory problems. Additionally, normal physiological growth can lead to enlargement of the inferior turbinates, which can obstruct airflow.

Nasal Polyps

Nasal polyps are non-cancerous growths that develop on the lining of the nasal passages or sinuses, often resembling hanging grapes. They are soft and typically painless, with adults being more susceptible to their formation. However, they can occur in individuals of any age. Their development is often linked to chronic inflammation related to asthma, recurrent infections, allergies, or certain immune disorders. Smaller polyps may not produce symptoms, while larger or clustered polyps can lead to nasal obstruction, respiratory issues, a diminished sense of smell, and recurrent infections.

Nasal Valve Collapse

The nasal valve is the narrowest part of the nasal airway, located between the nasal cartilage and the inferior turbinate. While nasal valve collapse is a common yet overlooked cause of nasal obstruction, it is often misconstrued as a more general nasal blockage. Improvement in airflow using nasal strips can suggest this as a potential cause.

Enlarged Adenoids

Adenoids are soft tissue masses located at the back of the nasal cavity. They trap germs and help the body fight infections. Typically enlarged due to infection, adenoids may remain swollen even after the infection resolves and can lead to obstructive symptoms. Surgical removal may be necessary if enlargement causes significant issues, often performed alongside tonsillectomy. Initial symptoms may be absent; however, prolonged enlargement can lead to nasal obstruction, mouth breathing, sleep disturbances, snoring, nasal discharge, coughing, and halitosis.

Choanal Atresia

Choanal atresia is a congenital condition that results in partial or complete blockage of the nasal passages. The obstruction can occur in one or both nostrils due to excess tissue or bones obstructing the back of the nasal passage, leading to breathing difficulties. Diagnosis typically occurs shortly after birth if both nostrils are affected, and immediate surgical intervention is necessary for normal breathing. However, if only one nostril is obstructed, diagnosis may happen later in the child’s life. Endoscopic intervention might be used to treat this condition. Symptoms may include nasal discharge, unilateral congestion, and one-sided sinus infections.

Additional Causes of Nasal Congestion

Besides the previously mentioned causes, nasal congestion may arise from various other factors, including:

Pregnancy
Psychological stress
Thyroid disorders
Cigarette smoking
Certain medications, such as those used to treat hypertension, erectile dysfunction, depression, and seizures
Insertion of foreign objects, which is particularly common in children who may place items like beads or peanuts in their noses, leading to unpleasant odors and discharge. Removal typically requires clinical intervention and may necessitate general anesthesia for older obstructions.
Excessive use of nasal decongestant sprays
Cysts or tumors in the nasal passages, although rare, should be considered if symptoms persist unilaterally.
Pyriform aperture stenosis, a rare condition that some infants may be born with, which causes obstruction due to abnormal jawbone development and may lead to severe respiratory difficulties.

Understanding Nasal Congestion

Nasal congestion is defined as a partial or complete obstruction of the nasal passages, which extend from the nostrils to the back of the throat. While generally not classified as a serious condition, it can be uncomfortable and may affect an individual’s quality of life by hindering airflow. Additionally, it is a significant symptom of obstructive sleep apnea, which can severely impact sleep quality. For athletes, nasal congestion can detrimentally affect performance by restricting their respiratory efficiency.