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| {{Infobox_Disease |
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| | {{Nasal Congestion}} |
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| | '''For patient information, click [[Nasal Congestion (patient information)|here]]''' |
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| ICD9 = {{ICD9|478.19}} |
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| | {{CMG}}; '''Associate Editor-In-Chief:'''{{SM}} |
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| | ==[[Nasal Congestion overview|Overview]]== |
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| ==Overview== | | ==[[Nasal Congestion historical perspective|Historical Perspective]]== |
| '''Nasal congestion''' is the blockage of the [[nose|nasal]] passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels. It is also known as '''nasal blockage''', '''nasal obstruction''', '''blocked nose''', '''runny nose''', and '''stuffy nose'''.
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| ==Natural history== | | ==[[Nasal Congestion classification|Classification]]== |
| Nasal congestion has many causes and can range from a mild annoyance to a life-threatening condition. The newborn [[infant]] is an obligate nose breather and must breathe through the nose. Nasal congestion in an infant in the first few months of life can interfere with nursing and cause life-threatening respiratory distress. Nasal congestion in older children and [[adolescent]]s is often just an annoyance but can cause other difficulties.
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| Nasal congestion can interfere with the ears, hearing, and speech development. Significant congestion may interfere with sleep, cause snoring, and can be associated with [[sleep apnea]]. In children, nasal congestion from enlarged [[adenoids]] has caused chronic sleep apnea with insufficient [[oxygen]] levels and [[Hypoxia (medical)|hypoxia]], as well as right-sided heart failure. The problem usually resolves after surgery to remove the [[adenoids]] and [[tonsils]].
| | ==[[Nasal Congestion pathophysiology|Pathophysiology]]== |
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| A blocked nose can also cause mild facial and head [[Pain and nociception|pain]], and a degree of discomfort.
| | ==[[Nasal Congestion causes|Causes]]== |
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| == Common causes == | | ==[[Nasal Congestion differential diagnosis|Differentiating Nasal Congestion from other Diseases]]== |
| * Allergic reaction
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| * [[Common cold]] or [[influenza]]
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| * [[Hay_fever|Hay fever]], allergic reaction to pollen or grass
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| * [[Sinusitis]] or sinus infection
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| * Many women suffer from nasal congestion during pregnancy due to the increased amount of blood flowing through the body.
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| == Differential diagnosis of causes of nasal congestion==
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| In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
| | ==[[Nasal Congestion epidemiology and demographics|Epidemiology and Demographics]]== |
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| * Congenital abnormality
| | ==[[Nasal Congestion risk factors|Risk Factors]]== |
| * [[Cystic Fibrosis]]
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| * [[Folliculitis]] of nasal hair
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| * Foreign body in nose
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| * Idiopathic rhinitis
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| * Intranasal [[cocaine]] use
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| * Medication side effects
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| * NARES
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| * [[Nasal polyps]]
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| * Perennial [[allergic rhinitis]]
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| * Rhinitis medicamentosa
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| * [[Sarcoidosis]]
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| * Seasonal allergic rhinitis
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| * [[Sinusitis]]
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| * [[Upper respiratory infection]]
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| * [[Vasomotor rhinitis]]
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| * [[Wegener's Granulomatosis]]
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| == History and Symptoms == | | ==[[Nasal Congestion screening|Screening]]== |
| * Duration
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| * Onset
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| * Recurrence pattern
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| * Medications/illicit drug use
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| * Associated symptoms
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| === Physical Examination === | | ==[[Nasal Congestion natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| * Examination should include the following exams:
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| *:* Ears
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| *:* Sinuses
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| *:* Eyes
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| *:* Nares
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| *:* Oral mucosa
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| *:* Posterior pharynx
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| *:* Tongue
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| *:* Neck
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| *:* Chest
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| *:* Heart
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| == Laboratory Findings ==
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| * Nasal cultures
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| === MRI and CT ===
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| * CT scan of sinuses
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| === Other Diagnostic Studies ===
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| * Rhinoscopic exam/nasopharyngolaryngoscopy
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| * Nasal lavage
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| * Allergy testing
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| == Treatment ==
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| In general:
| | ==Diagnosis== |
| | [[Nasal Congestion history and symptoms|History and Symptoms]] | [[Nasal Congestion physical examination|Physical Examination]] | [[Nasal Congestion laboratory findings|Laboratory Findings]] | [[Nasal Congestion x ray|X Ray]] | [[Nasal Congestion CT|CT]] | [[Nasal Congestion MRI|MRI]] | [[Nasal Congestion other imaging findings|Other Imaging Findings]] | [[Nasal Congestion other diagnostic studies|Other Diagnostic Studies]] |
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| * Intranasal saline lavage
| | ==Treatment== |
| * Avoid allergens
| | [[Nasal Congestion medical therapy|Medical Therapy]] | [[Nasal Congestion surgery|Surgery]] | [[Nasal Congestion primary prevention|Primary Prevention]] | [[Nasal Congestion secondary prevention|Secondary Prevention]] | [[Nasal Congestion cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Nasal Congestion future or investigational therapies|Future or Investigational Therapies]] |
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| Drinking plenty of fluids, more than usual, aids the body in expelling the irritant and clearing congestion. [[Water]], fruit juice, [[tea]]s and [[mayonnaise]] are recommended by medical experts to resolve congestion, and rest and [[sleep]] are also suggested remedies in a case of nasal congestion. Carbonated beverages also can help to alleviate nasal congestion. Increasing air moisture with a humidifier or a steamy bath or shower usually helps relieve the congestion and accompanying discomfort.
| | ==Case Studies== |
| | [[Nasal Congestion case study one|Case #1]] |
| | {{WH}} |
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| Neither influenza nor the common cold can be cured with medication; however, drugs such as [[acetaminophen]], [[decongestants]], [[nasal spray]]s or drops, cough remedies and throat lozenges may provide some [[symptom]] relief. Furthermore, medications have recently been approved which, when started shortly after the onset of symptoms, may shorten the duration of influenza.
| | {{WS}} |
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| A cause of nasal congestion may also be due to an allergic reaction caused by [[hay fever]], so avoiding [[allergen]]s is a common remedy if this becomes a confirmed diagnosis. [[Antihistamines]] and decongestants can provide significant symptom relief although they do not cure hay fever. Antihistamines may be given continuously during pollen season for optimum control of symptoms.
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| [[Topical decongestant]]s should only be used by patients for a maximum of 3 days in a row, because rebound congestion may occur in the form of [[rhinitis medicamentosa]].
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| Insertion of cotton swabs into a child's nostrils as a remedy is generally discouraged. An alternative solution is for the discharge to be caught outside the nostril on a tissue or swab, be rolled around, and have the discharge pulled out of the nose. [[Petroleum jelly]] applied to the nasal openings can assist in providing protection against [[irritation]], though it is important to ensure that the nostrils are not blocked by the jelly.
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| The ancient use of [[nasal irrigation]], which originated from the [[Yoga]] practice of jala neti, is also said to help reduce nasal congestions. It involves rinsing the [[nasal cavity]] regularly with salty water.
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| Alternately thrusting the tongue against the roof of the mouth and pressing between the eyebrows with a finger for approximately thirty seconds can loosen congestion. This method causes the [[vomer bone]], which runs through the nasal passages to the mouth, to rock back and forth, forcing sinuses to drain.<ref>http://health.msn.com/menshealth/articlepage.aspx?cp-documentid=100119940>1=7538</ref>
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| === Acute Pharmacotherapies ===
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| * Intranasal or oral decongestants
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| * [[Amoxicillin]]
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| * [[Trimethoprim sulfamethoxazole]]
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| * [[Doxycycline]]
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| * Intranasal steroids
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| * [[Antihistamines]]
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| * [[Cromolyn sodium]]
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| ==References==
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| <references/>
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| ==External links ==
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| * [http://www.mayoclinic.com/health/runny-nose/ID00006 Runny nose and stuffy nose: Self-care]
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| * Unblock a [http://www.buteykoscotland.co.uk/nose.htm Stuffy Nose: self help]
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| [[zh:鼻塞]]
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| [[Category:Rhinology]] | | [[Category:Rhinology]] |
| | [[Category:Symptoms]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
| | [[Category:Medical signs]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Primary care]]
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