Why am I congested all the time? – 03/06/2023 – Balance

It’s more than a sniff. Your nose gets stuffy, continues and whistles or wheezes when you breathe. Your face hurts. You use boxes and boxes of tissues. The situation is always the same.

Chronic congestion is common, says Mark Dykewicz, an allergist and immunologist at Saint Louis University School of Medicine, but treating it can be tricky — in part because there are so many potential causes. Here’s what you should know.

Why am I so stuffed?

There are many potential triggers for nasal congestion, including irritating products at home and work, allergies and upper respiratory infections.

The anatomy of the nose could also be to blame, adds Dykewicz. Some people are born with or develop a deviated septum, in which the thin wall of cartilage and bone that separates the left and right nostrils is off-center. This makes one nasal passage larger than the other, Dykewicz says, and the smaller side can get clogged easily.

Some people also get congested when the septum and nearby structures weaken and begin to sag over time, or when the turbinates — small bony plates inside the nose that clean, warm and humidify the air you breathe — get bigger, he adds. .

Seasonal allergies are an obvious source of congestion — especially if you have itchy, watery eyes and a runny nose and you’re also sneezing. But other types of environmental allergies can clog your nose year-round, points out Sarah Hochman, an assistant professor at New York University’s Grossman School of Medicine. Pet dander, dander, saliva, and urine can enlarge and inflame the soft tissues in your nose, causing congestion, just like dust mites. Everyday irritants, such as perfume, car exhaust and cigarette smoke, can also trigger reactions, adds Dykewicz.

Viral infections such as the common cold, flu, and Covid-19 can also lead to congestion, as can viral pneumonia. Other factors include changes in temperature and humidity, Dykewicz points out, although some people have chronic inflammation with no known cause.

If your nose is persistently stuffy for more than two weeks, and especially after a cold, you may have a sinus infection, or sinusitis, Hochman said, which is inflammation of the sinuses. Other telltale signs of a sinus infection include earache, fever, and pain when you touch your cheeks. If you have nasal congestion and your face or forehead also hurts from bending over to tie your shoes, for example, Hochman says, it could be another sign of a sinus infection and you should seek medical attention.

Congestion can also be a surprising by-product of some medications, including Viagra and some ACE inhibitors to lower blood pressure, points out Dykewicz. So if you’re experiencing chronic congestion, it’s important to look out for the possible side effects of any medication or supplement you’re taking and consult with the doctor who prescribed it.

how to reduce congestion

It may sound simple, but first try to clear your nose as much as possible by gently blowing your nose into a tissue, says Raj Sindwani, an otolaryngologist at the Cleveland Clinic. You can use an over-the-counter saline nasal spray to help irrigate your nasal passages two or three times a day, says Dykewicz.

It’s also important to stay hydrated, as fluids can help thin the mucus in your nose, allowing it to drain more easily. A steam bath can also help open up your nasal passages, Hochman points out.

Certain over-the-counter medications can help fight congestion, though many have caveats, says Dykewicz.

If allergies are the root cause of your congestion, your doctor may recommend an oral antihistamine such as cetirizine or fexofenadine for mild symptoms. Most antihistamines are safe in the long term, Hochman points out, but if you’re going to be using them for more than a week or two, consult a doctor.

For more severe symptoms, medicated nasal sprays can help, but some are safer for long-term use than others, says Dykewicz. Steroid nasal sprays that contain active ingredients like fluticasone, triamcinolone or budesonide are safe to use for as long as you need them, Sindwani points out. “No problem, you can use these as much as you like,” he says.

But nasal sprays that contain decongestants like oxymetazoline or phenylephrine shouldn’t be used for more than three to five days, as they risk what doctors call “rebound congestion,” says Dykewicz. These medications cause the blood vessels to constrict, opening the nose for a brief period of relief. But if used repeatedly, the mucous membranes in the nose can swell, says Hochman, and some people end up feeling worse than before. There is some risk that, after prolonged use of these nasal sprays, swelling may become persistent and require further treatment, for example with steroids, Dykewicz points out.

“The nose gets more and more clogged”, he says. “People become really addicted to it.”

If chronic nasal congestion is interfering with your daily life, Hochman points out, you should seek care from an otolaryngologist, who will investigate whether your nose has a structural problem or whether you have something like chronic sinusitis.

“Each person has a different threshold above which they can’t take it anymore,” she says.

Translated by Luiz Roberto M. Gonçalves