NASAL OBSTRUCTION: FREQUENT CAUSES AND EFFECTIVE SOLUTIONS

Nasal obstruction means difficulty breathing through the nose. It can be temporary, as with a common cold, or persistent enough to affect sleep, exercise and daily activities. Identifying the cause is essential because not all types of obstruction are treated in the same way.

What are the common causes?

• Allergic rhinitis: often causes congestion, sneezing, itching and watery discharge.
• Non-allergic rhinitis: symptoms may be triggered by irritants, strong odours or temperature changes.
• Deviated nasal septum: may restrict airflow, sometimes more noticeably on one side.
• Inferior turbinate enlargement: swollen turbinates narrow the nasal airway.
• Chronic rhinosinusitis, with or without polyps: may cause discharge and impaired sense of smell.
• Overuse of decongestant sprays: can cause rhinitis medicamentosa and worsening congestion.

What other symptoms may occur?

Mouth breathing, snoring, runny nose, postnasal discharge or reduced smell. Symptoms help guide assessment but do not always identify the underlying cause on their own.

How is nasal obstruction assessed?

An ENT specialist examines the nasal septum, turbinates and nasal lining. Nasal endoscopy can help identify polyps or other causes of obstruction. Allergy testing or a sinus CT scan is used selectively when clinically indicated.

Which treatments may help?

• Intranasal corticosteroids: commonly used for allergic rhinitis, inflammatory congestion and nasal polyps, according to the diagnosis.
• Antihistamines: particularly helpful when allergic symptoms are present.
• Saline sprays or irrigation: can ease symptoms and help clear the nose.
• Septoplasty: may be considered for a confirmed symptomatic deviated septum.
• Functional endoscopic sinus surgery (FESS): considered for selected patients with chronic rhinosinusitis, with or without polyps, when there is a clear indication.

A note about decongestant sprays

Sprays containing xylometazoline may provide short-term relief, but should not be used for more than 5 consecutive days without medical advice because longer use can worsen nasal blockage. Always check the instructions for the specific product.

When should you see an ENT specialist?

Assessment is appropriate for persistent or severe obstruction, or symptoms affecting sleep and everyday life. Persistent one-sided blockage, especially with bleeding or unusual one-sided discharge, needs timely examination to exclude less common causes.

Treatment should follow the underlying diagnosis and is not necessarily surgical.