Page 95 - LCNL Diwali Magazine 2022

i
l
Happy Diwali RAGHUVANSHI 2022 - 2023 91
Happy Diwa

Why is my nose blocked?

Nasal blockage, congestion or stuffiness is an extremely common problem that affects all of us
at some time. The commonest cause of course is the common cold as a result of viral upper
respiratory tract infection and this is a self-limiting condition that resolves within days. This

article will cover the more persistent conditions that cause difficulty in breathing through the
nose.
Nasal blockage has an impact on the quality of life. It results in mouth breathing which causes
dryness in your throat and can interfere with sleep too.
Anatomical factors are usually due to trauma to the nose or may be an inherited phenomenon.
Depending on the degree of trauma incurred, the problem may be blatantly obvious externally in that the nasal
framework is distorted but more often than not the external appearance may be satisfactory with the internal
problem resulting from a deviated nasal septum. The nasal septum is the partition between the right and left nostril
and theoretically should be in the midline but often can be twisted or deviated compromising the nasal passage and

hence causing nasal blockage. In conjunction with this if the lining of the nose is inflamed then the nasal blockage
would be further aggravated. Simple solution for this would be to use saline nasal douche (available over the counter
such as Sterimar or NeilMed sinus rinse) with intranasal steroid sprays (some available on prescription only but
some used for hay fever are available over the counter). The more significantly compromised nose may require nasal

surgery in the form of septoplasty or septo-rhinoplasty.
Physiological factors generally cause rhinitis which is inflammation of the nasal mucosa or lining. This may be due

to allergic or non-allergic causes. The non-allergic causes are generally due to common cold like infections or due
to vasomotor rhinitis (where the blood vessels within the nasal cavity dilate) that can cause sneezing, runny nose and
nasal congestion. Various factors can trigger of vasomotor rhinitis and include changes in humidity, temperature,
perfumes, smoke, alcohol and some foods (dairy products, gluten, and bananas). Treatment of this condition is by
avoiding trigger factors and using saline douche and intranasal steroid sprays. Allergic rhinitis may be seasonal due
to grass or tree pollen as in hay fever season or may be perineal due to allergens such as house dust mite, pets, foods
such as nuts, some fruits, egg, milk or wheat. Allergy can be identified either by a blood test or skin prick test which

can be arranged by your GP. Treatment for allergic rhinitis is by avoiding allergens (in allergies due to house dust
mite, it may be useful to invest in anti-allergy bedding) and taking medication such as antihistamine in conjunction
with nasal steroid sprays. In severe cases it may be worth being considered for immunotherapy which is usually
delivered in the hospital under close supervision.

Pathological factors causing nasal blockage may be due to nasal polyps or sinusitis. Sinusitis is an infection affecting
the nasal sinuses and in addition to nasal blockage can cause mucus or catarrh dripping at the back of the nose,
facial pain and headaches as well as disturbed sense of smell. Sinusitis can occur with or without nasal polyps. Nasal
polyps (Figure 1a &b) are painless growths within the nasal cavity. Generally speaking antibiotics may be sufficient

for milder sinusitis but more stubborn problems would require investigations with CT scan of sinuses and then
perhaps surgery.
Long-term use of nasal sprays such as Otrivine and Sudafed is very harmful and can worsen nasal blockage.
Wishing you all a very happy and peaceful Diwali and a healthy and prosperous New Year!

Figure 1a Nasal polyps Figure 1b nasal polyps
inside the nose removed surgically

Professor Bhikhu Kotecha
Consultant Ear, Nose & Throat Surgeon