Dr. Nikhil Mali
Nasal congestion is the blockage of
the 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, stuffy nose,
or stuffed up nose.
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.
Nasal congestion can also cause mild
facial and head pain, and a degree of
discomfort.
Nasal blockage can be seen in the
following Diseases
Common cold
The onset is acute, with a scratchy sore
throat and cough. The nasal mucosa
will appear red, boggy, and glassy. The
nasal drainage will initially be clear but
will later become
colored (yellow-green).
Allergic rhinitis
Acute allergic rhinitis is often associated
with eye irritation, paroyxms of sneezing,
itching of the eyes, nose, or palate, and
postnasal drip with cough.
The nasal mucosa is bluishand pale.
Seasonal rhinitis is usually caused by
inhaled pollens. Perennial rhinitis is caused
byallergy to animals, dust, mites, or mold.
Vasomotorrhinitis
Congestion is prominent, but
rhinorrhea, sneezing, and itching are
not.
Rhinitis medicamentosa occurs after 3
to 4 days of continuous use of a topical
vasoconstrictor.
There will be initial relief with its use
that is then followed by rebound with
worsened congestion.
Vasomotor rhinitis may also be
precipitated by cold, emotion, or sexual
arousal. The turbinates are red and
boggy.
Nasalpolyp
Unilateral airflow will be obstructed and a
polyp will be visible deep inside, beyond the
turbinate, as a gray structure with the
appearance of a skinned grape.
There is an associationbetween aspirin use,
nasal polyps, and asthma, but the most
common cause is chronic allergic
rhinitis.
Sinusitis
Drainage, if present, will be purulent,
although colored drainage can be found
in otherconditions.
There will be a sensation of facial
fullness that worsens with bending
forward, oftenaccompanied by fever
and a headache.
On physical examination, there will be
tenderness toconcussion and pressure,
overlying warmth, and fever. The affected
sinus will not transilluminate.
Drugs
Cocaine, beta-blockers, reserpine, and
hydralazine can each cause nasal
obstruction
Deviated septum
Deviation causes chronic unilateral
obstruction, which is readily observed
with a
nasal speculum.
Intranasal foreign body
There will be nasal obstruction
associated with a chronic unilateral
mucopurulent discharge with a foul
odour.
SarcoidosisSarcoidosis
presents with bilateral nasal congestion in as
many as 20% of cases. Systemic symptoms
such as fever, fatigue, or weight loss;
pulmonary symptoms such as cough
ordyspnea; or skin manifestations such as
erythema nodosum or purple, waxy plaques
are clues tothe underlying diagnosis.
Cerebrospinal fluid leak
Head trauma with a basilar skull fracture
may go unrecognized.
Clear nasal drainage tests positive for
glucose using a urine dipstick.
Wegener granulomatosis
Its earliest manifestation may be nasal
obstruction, rhinorrhea, crusting,and
chronic sinusitis with a fetid drainage.
Development of a septal ulceration is
present
Causes of Nasal blockage
oAllergic reaction
oCommon cold or influenza
oDeviated septum
oHay fever, allergic reaction to pollen or
grass
oReaction to medication (e.g. Flomax)
oSinusitis or sinus infection
Treatment
The treatment of nasal congestion
frequently depends on the underlying
cause.
Both influenza and the common cold
are self limiting conditions that
improve with time; however, drugs such
as acetaminophen (paracetamol) and
ibuprofen may help with the
discomfort.
A cause of nasal congestion may also be due to
an allergic reaction caused by hay fever, so
avoiding allergens 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.
Topical decongestants 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
The use of nasal irrigation may help reduce
nasal congestion. It involves rinsing the
nasal cavity with salty water, however, this
may cause further irritation.
Vaporisers
These are obtainable in ointment and oil
form and have scented constituents that
could assist in allaying a dripping nose or
finding relief from the ‘stuffed or suffocated
feeling’ by de-clogging the inflammation in
the air passages.
Eucalyptus and oils like peppermint,
menthol, camphor act on the nasal
receptors, constrict the flow of blood and
hence lower inflammation.
Menthol-based nasal strips
The placing of these strips is done below the
nasal bridge for allaying obstruction as it
lifts open the nostrils.
The menthol helps to relieve inflammation
in the air passages.. Their strong-smelling
nature helps to infiltrate the mucus
obstruction, thus help to provisionally open
the nasal passages.
Nasal Sprays
These sprays have decongestants like
oxymetazoline or xylometazoline that
contract the blood vessels.
They additionally aid in stopping
mucous formation
list of surgical procedures is shown below.
•Turbinectomy
•Partial turbinectomy
•Submucosal resection of the turbinates
•Surface "scoring" techniques
•Less invasive techniques
•"Hot poker" methods (electrocautery,
radiofrequency, laser)
•Powered/submucous inferior turbinoplasty
•FESS (Functional Endoscopic Sinus Surgery)
Septoplasty
According to Ayurveda
नासावरोध
नासाप्रतीनाह
Samprapti:
कफव्रत
ु ो वायरु
ु दानसंद्न्यो यदा स्वमार्गे ववर्गण
ु ः
स्स्ितःस्यात ्।
घ्राणं व्रण
ु ोतीव तदा स रोर्गो नासाप्रतीनाह इती प्रददष्टः॥
स.ु उ.२२/१५
Laxanas
नासावरोध
 सकष्टश्वसन
मख
ु ेन श्वसन
 तालश
ु ष्ु कता
स्नेहपान
Chikitsa
स्स्नग्ध धम
ू
शशरोबस्स्त
स्नेहन
स्वेदनादद उपचार ्
अपीनस
Samprapti:
कफपरवरधदो नaसायां रुध्दद्नवा
स्रोतांस्यपीनसम।्
कुयाात्सघुघुरा ं ् श्वासं पीनसाधधकवेदनम॥्
नासावरोध,
 घघ
ु रुा ं
 श्वास,
 वपस्छिल पीत पक्व स्राव
Chikitsa
स्नेहन,
 स्वेदन,
वमन,
 ववरे चन,
 धम
ू पान,
 अवपीडन नस्य
नासाशोष
Samprapti:
शोषये्नाशसकास्रोतः् कफं च कुरुते अननलः।
शक
ा नासात्वं.........॥
ु पण
ु भ
वा.स.ु १९/१६
Laxanas
नासावरोध
नासाशष्ु कता
सकष्टश्वसन,
 नासाववदारण
शुकपुणभ
ा नासत्वं
Chikitsa
स्नेहपान,
स्स्नग्ध धम
ू
 स्वेदनादद उपचार ्
पट
ु क
Samprapti:
वपत्तश्लेष्मावरुधः अतनाासायां शोषये्मरुत।्
कफं सशष्ु कपट
ु ताम ् प्राप्नोनत पट
ु कं ् तु तत ् ॥
वा. उ. १९/२५
Laxanas
पट
ु कोत्पस्त्त
 नासावरोध
नासाशष्ु कता
 सकष्टश्वसन
Chikitsa
स्नहपन
 सनर्गध धम
ू
 प्रधमन नस्य
नाडीस्वेद
नासाशा
Samprapti:
दोषैस्स्िशभस्तैः प्रि
ु कश्च ब्रय
ु ात्तिः अशााशस
तिैव शोफाम।्
सु.उ.२२/१८
Laxanas
नासावरोध
 सकष्टश्वसन
 शशरःशल
ू
सानन
ु ाशसकउछचार
Chikitsa
शस्िकमा
प्रनतश्याय
Samprapti:
चयं र्गता मध
ू ाानन मारुतादयः प्रि
ु कसमस्ताश्च
तिैव शोणणतम ्।
प्रकोप्यमाणां ववववधैः प्रकोपणैन्रण
ु ां
प्रनतश्यायकरा भवस््त दह॥
स.ु उ.२४/४
Chikitsa
स्नेहन
 स्वेदन
वमन
 धम
ू
 र्गण्डूष
Dr. Nikhil Mali