If you suffer from constant nasal stuffiness, you’re not alone. Nasal stuffiness is an incredibly common symptom with various potential causes. The good news is you don’t need to suffer. Learn about common causes of stuffiness and what can be done to help alleviate the symptoms and the underlying condition(s).
Among the most common causes for nasal stuffiness are allergic rhinitis and chronic rhinosinusitis. These diagnoses are becoming increasingly prevalent and can cause similar symptoms. However, the causes of allergic rhinitis and chronic rhinosinusitis are distinct, and determining the appropriate diagnosis is essential to starting the correct treatment.
What Is Allergic Rhinitis?
Allergic rhinitis is a condition caused by the inhalation of allergens — substances such as pollen, dust and animal dander — and the subsequent reaction of the immune system to these allergens. The result: inflammation of the lining on the inside of the nose and sinuses.
Allergic rhinitis affects 10 to 30 percent of children and adults in the U.S., with the numbers continuing to grow. One in every 50 visits to a doctor are for the management of allergic rhinitis, and this condition accounts for 2 million lost school days and 6 million lost work days every year.
There are a number of factors that increase the chance of developing allergic rhinitis, including a family history of allergies, regular exposure to common allergy triggers such as household dust mite and even being born during pollen season.
[See: What’s the Healthiest Month to Be Born In?]
Common Signs and Symptoms of Allergic Rhinitis
The symptoms of allergic rhinitis include:
— Bouts of sneezing
— Runny nose
— Postnasal drip (the sensation that mucus is draining from the nose to the back of the throat)
— Nasal congestion or stuffiness
— Coughing
— Itching in the nose, ears or roof of mouth
In children who tend not to blow their nose, symptoms will often consist of sniffing, snorting, coughing and a clicking sound caused by rubbing an itchy palate with the tongue. Over time, untreated allergic rhinitis can disturb sleep, leading to fatigue and low levels of energy. In children, this can lead to poor concentration, lower exam scores and lower self-esteem.
Is Allergic Rhinitis Seasonal?
The symptoms of allergic rhinitis can be mild or severe, and can occur throughout the year — called perennial allergic rhinitis — or only during specific seasons, termed seasonal allergic rhinitis. Some sufferers will have a mixture of both types, with symptoms all year round that then worsen during certain seasons.
Usually, the perennial form of allergic rhinitis is caused by the body’s reaction to indoor allergens such as dust mites, cockroaches, mold or cat/dog dander. Seasonal allergic rhinitis, on the other hand, occurs due to inhalation of pollen from trees, grasses and weeds. Over time, with continued exposure to allergens, the lining of the nose becomes increasingly sensitized and reacts to smaller amounts of the allergic trigger, resulting in worsening severity of symptoms.
Could My Symptoms Be Due to Another Condition?
In more severe forms of allergic rhinitis, inflammation of the nasal lining can block the drainage of the sinuses leading to bacterial infection and sinusitis. However, it’s possible a condition called chronic rhinosinusitis could be the issue.
CRS refers to inflammation of the lining of the paranasal sinuses (which drain into the nasal cavity) and nasal passages that has been present for three months or longer.
The underlying cause of CRS is not completely understood and likely involves the complex interplay between the immune system and microbes, such as bacteria and fungi. Fifty to 84 percent of people with CRS also suffer from allergic rhinitis. The prevalence of CRS in the United States ranges from 2 to 12 percent, which is equivalent to the number of people with asthma or chronic back pain. It can affect both adults and children, though it is far more common in adults in their 30s and 40s.
Like allergic rhinitis, CRS creates an economic burden in the United States, with treatment costs ranging from $10 to $13 billion per year. CRS is associated with depression, poor sleep and poor mental performance.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
What Are the Symptoms of Chronic Rhinosinusitis?
The symptoms of CRS can be similar to those of allergic rhinitis, and the two conditions can be confused. The four cardinal signs and symptoms of CRS used to make a diagnosis are:
— Opaque white, yellow or green nasal drainage from the nostrils or into the back of the throat
— Nasal obstruction or congestion
— Facial pain or pressure
— Decreased sense of smell in adults or cough in children
Other symptoms include fatigue, sleep disturbance, bad breath, dental pain and throat irritation.
Because of overlap between the symptoms of CRS and other conditions, including allergic rhinitis, the diagnosis of CRS requires objective findings of inflammation. This objective evidence is usually obtained through an office procedure called nasal endoscopy, where a narrow endoscope is passed into the nasal passages by an otolaryngologist — an ear, nose and throat specialist — so that the lining within the nasal passages can be directly observed. Often, the diagnosis is confirmed using a computed tomography scan, which accurately maps sinus inflammation and infection.
Many otolaryngologists will refer patients with or without CRS to an allergy specialist to determine whether allergic rhinitis might be contributing to the symptoms.
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Can I Be Treated?
Whether you have allergic rhinitis, CRS or both, the good news is that there are effective treatments. In the case of allergic rhinitis, treatment often begins with simple measures to control your environment and reduce exposure to allergens. Medical therapies consisting of nasal sprays and allergy tablets are also started. “Allergy shots,” termed immunotherapy, can also be highly effective in reducing the severity and frequency of allergy symptoms over the long term.
Chronic rhinosinusitis is typically managed with a combination of medical therapies that include nasal saline rinses, nasal steroid sprays and courses of antibiotics and steroid tablets, as appropriate. Those who fail to improve with medical therapy are often candidates for endoscopic sinus surgery, which is highly effective at controlling symptoms. Newer treatments, including monoclonal antibodies — which serve to regulate the immune response underlying CRS — are also increasingly used for patients with severe disease.
If you’re suffering from any of the symptoms related to allergic rhinitis, CRS or both, speak to your health care provider to discuss what treatments may be best for you.
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My Nose Is Stuffy All the Time. What Can I Do? originally appeared on usnews.com
