Nasal Congestion: Causes, Treatments, and When to See a Doctor
Nasal congestion (stuffy nose) results from inflamed, swollen nasal mucosa obstructing airflow.
Common Causes
- Allergic rhinitis: Pollen, dust mites, pet dander, mold → histamine release
- Infections: Viral (cold, flu), bacterial (sinusitis)
- Structural: Deviated septum, nasal polyps, enlarged turbinates
- Vasomotor rhinitis: Non-allergic, triggered by temperature, odors, stress
- Medication rebound: Topical decongestant overuse (>3 days) → rhinitis medicamentosa
- Environmental irritants: Smoke, pollution, chemicals
- Pregnancy: Hormonal vascular engorgement
Treatment by Cause
- Allergies: Oral/nasal antihistamines, nasal corticosteroids (first-line chronic)
- Viral: Supportive (saline irrigation, hydration, time)
- Bacterial sinusitis: Antibiotics if criteria met
- Structural: Surgery (septoplasty, polypectomy, turbinate reduction)
- Rebound: Stop topical decongestants; bridge with nasal steroid
When to See a Clinician
Symptoms >10 days, high fever, severe facial pain, unilateral purulent discharge, blood, or OTC failure.
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