A congested, stuffy nose is a nuisance that can affect your ability to smell, taste and breathe. It is one of the most common complaints, especially when it persists or is accompanied by nasal discharge.
What Causes Nasal Congestion?
Congestion (or nasal obstruction) occurs when air flow through the nose is restricted. This can be due to changes in anatomy or to swelling and inflammation of nasal tissues and blood vessels. It has little to do with excess mucus, as many people believe.
Anything that irritates the nasal tissues can cause congestion. The list of possible causes is lengthy and includes infections (colds, influenza and acute or chronic sinusitis), allergies, structural abnormalities (deviated septum, enlarged adenoids/tonsils, nasal polyps or tumors), non-allergic rhinitis, dry air, cold temperatures, bright lights, cluster headaches, hormonal changes, medications, thyroid problems, spicy foods, tobacco smoke and stress.
Decongestants: For occasional congestion, decongestants are a good short term choice. They constrict blood vessels, decreasing blood flow to the lining of the nose and diminishing the thickness of that lining. This leaves more room for air to flow. Decongestants come in pill form and topical sprays, and they are very effective. They do have some side effects, though. Decongestants commonly cause a rapid heart rate and can raise blood pressure. If you have a history of coronary heart disease or heart attack, you should avoid them. They can also give you the jitters and make it difficult to sleep. Also, topical decongestant sprays are notorious for being habit forming. For that reason, it is recommended that you use these sprays for only a few days at a time. Some people who use decongestant sprays can become dependent on them, and may find that they can’t breath well through their nose without them.
Antihistamines: Antihistamines can reduce swelling and mucus production. They are most effective when your congestion is due to allergies. . Well known antihistamines are Benadryl (diphenhydramine), Zyrtec (cetitirizine), Allegra (fexofenadine) and Claritin (loratidine). The last 3 in this list have the advantage of not having as much sedating side effect that Benadryl has.
Topical Nasal Steroids: These can be very effective, especially with allergies. They have a general local anti-inflammatory effect, but the exact way they work is not completely understood. Commonly used nasal steroids include Flonase (fluticasone) and Nasonex (mometasone). These meds can have a drying effect, and if you are prone to nose bleeds, you might want to choose other options to treat your nasal congestion.
Anti-Leukotrienes: These meds first were used for asthma, but because they help allergies, they are also used for allergic nasal congestion. If polyps are part of the cause of your congestion, then this class of medications may be very helpful. The best known anti-leukotriene is Singulair (montelukast).
Nasal Saline: Saline can come as a spray (in a bottle) or as an irrigation (basically salt water that is used to flush out the nose). Some people even make their own saline irrigation recipes.