Waxman

Waxman

Nasal congestion, stuffiness or obstruction to nasal breathing is one our most common problems.

For some it may only be a nuisance, for others it can be a source of considerable discomfort. The nose and sinuses are often misunderstood and wrongly used interchangeably. The nose is like a hallway with air going back and forth. The sinuses are rooms off to the sides and play little part in the flow of air. The nasal passage is divided by the septum, a wall, and is lined with a spongey type tissue that regulates air flow and produces mucus.

What are the causes of nasal congestion?

Infection

The average child suffers a common cold 5-6 times per year. They occur less often in adults because immunity strengthens with age. Once a virus is absorbed by the nose, it causes the body to release histamine, a chemical, which causes the nasal tissue to swell, produce excessive amounts of mucus which in turn stuffs up the nasal airway. Antihistamines and decongestants will help relieve the symptoms of a cold but not cure it.

During a viral infection, (or allergies) the nose has poor resistance to bacteria. This is why worse infections of the nose and sinuses will often follow. When the mucus turns from clear to yellow or green, it usually means a bacterial infection has set in. Acute sinus infections produce nasal congestion and a thick discharge. Patients often complain of fever and chills. Pain may occur in the cheeks and upper teeth, around the eyes and in the forehead, depending on which sinuses are involved. In this case, a physician should be consulted.

Structural abnormalities

These include deformities of the nose and nasal septum. The septum is made up of thin, flat cartilage and bone. Deviations are often the result of an injury, sometimes having occurred in childhood. Symptomatic blockage may develop later as the nose grows. If there is obstructed breathing, surgical correction may be helpful.

One of the more common causes of nasal obstruction in young children is enlargement of the adenoids. This is tonsil-like tissue located in the back of the nose. Children may experience noisy breathing at night and snore. Chronic mouth breathing plays a strong part in developing dental deformities and in sleep disturbances. Surgery to remove the adenoids and possibly the tonsils may be advisable.

Other causes in this category may include nasal tumors, foreign bodies and nasal polyps. Polyps are benign growths usually from allergies or infection coming out of the natural opening of the sinuses into the nose. Children are often known to insert small objects into their noses.

Allergies

Allergy is an exaggerated inflammatory response to a substance which, in the case of a stuffy nose, is usually pollens, mold, animal dander or house dust. Pollens are usually seasonal whereas the others can be year round. In the allergic patient, histamine as well as other substances results in the congestion and production of thin mucus and swelling of the nasal tissue. Antihistamines and other medications can help relieve the sneezing and runny nose of allergy. Allergy shots are a specific and successful treatment method. Skin or blood tests are used to determine the specific allergens and to design the best treatment plan.

Vasomotor rhinitis

Rhinitis means inflammation of the nose and nasal membranes. Vasomotor refers to the nerves that control the blood vessels of the membranes. Normal breathing is to breathe through one side of the nose at a time. It will change several times throughout the day and then, when lying down the up side should open while the lower side becomes congested. When both sides are blocked, we are more symptomatic.

In addition to allergies and infection, other circumstances can cause the nasal blood vessels to expand. These may include exercise, pregnancy, low thyroid function, other medications and exposure to irritants such as chemicals and smoke. Fortunately, many of these conditions are temporary and reversible.

Treatment considerations

Many of the antihistamines, though effective, cause drowsiness. This can be a problem for school children as well those who need to drive or operate dangerous machinery. Decongestants cause an increase in blood pressure and pulse rate. These may need to be avoided in those with high blood pressure or irregular heartbeat.

The decongestant nasal sprays can become habit forming. Saline nasal washes have been shown to offer good temporary relief. Intranasal steroid therapy is very effective for nasal allergies. The instructions need to be followed closely to obtain optimal benefit. Surgical intervention to correct a deformity, remove a growth or to reduce the sponge like tissue may be an option when medical management fails. A thorough ear, nose and throat exam can help determine which and how these problems need be addressed.

For further information, schedule an appointment at 343-2376.

—Shape Up, Emporia!, is a weekly fitness and health column aimed at readers of all ages to get off the couch and get into shape. Each week will feature a fitness, health or nutrition professional from around the area who will share some friendly tips on how to improve your overall health. Our goal is to make getting in shape fun and easy to fit into your existing lifestyle and daily routine.

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