A chronic disease or structural problem can block breathing. Here’s what you can do about it.
If your nose feels permanently stuffed up for more than two months, it’s probably not due to a cold you caught. It’s perhaps due to a chronic condition or a blockage that reduces the air passing through your nose. This makes breathing difficult and can affect sleep and quality of life.
Why are you blocked?
The following problems can block the passages or airways on one or both sides of the nose.
Allergies or chronic sinus problems. The inside of the nose is lined with a layer of sensitive tissue called the mucosa. Allergies can cause chronic inflammation of the lining, reducing the airflow space.
Enlarged turbinates. Turbinates are structures inside the nose that heat and filter the air as it passes through. Environmental irritants (such as smoke), hormonal changes, allergies, and chronic sinus problems can inflame the mucosa lining the turbinates: as they swell, the nostrils narrow.
It compromised nasal valves. This is a structural narrowing in some regions of the nasal passages. It may be due to injury, the nasal structure you were born with, a nose job, or simply aging.
“Everything sags with age, including the tissue of the nose. It loses elasticity; without that support, the nostrils can narrow, even if you’ve breathed through your nose without problems. “Suddenly, there’s a new symptom,” says Robin Lindsay, MD, facial plastic and reconstructive surgeon at Harvard-affiliated Massachusetts Eye and Ear.
Deviated septum. The septum is the wall separating the nose’s left and right sides. You may have been born with a crooked septum, or it may have been deformed in an accident. “As a result, it can become more difficult to breathe through one or both sides of the nose, even at low levels of activity,” Dr. Lindsay explains. “A deviated septum that has never been a problem before can cause symptoms if there is a compromise of the nasal valves and loss of supporting tissue.”
Nasal polyps. These non-cancerous (benign) tumors grow along the mucosa or sinuses and can block airflow.
Getting help
The cause of a blocked nose may not be as apparent as the nose on your face. You will need to see an ear, nose, and throat (ENT) specialist to determine the nature of the problem.
The ENT specialist will ask you about your medical history and symptoms and then examine the inside of your nose to see what is blocking airflow. The specialist may also order allergy tests (these involve pricking your skin with small amounts of allergens by pricking your arm or back. A skin reaction to a particular allergen indicates that you are allergic to it).
Treatment
Strategies for regaining space in the nasal passages depend on the cause of the blockage. If you have allergies, sinus problems, or enlarged turbinates, you may need a steroidal nasal spray or other medications to control the inflammation. If the turbinates don’t shrink with nasal sprays, you may need an office procedure or surgery to shrink them. Polyps are removed with a polyp-reducing medication or surgery.
Nasal narrowing due to altered nasal valves can be treated with surgery or (in some cases) with non-invasive, in-office procedures that involve injecting supportive implants into the nose or reshaping the nose with radio frequency energy. But these procedures are not the first line of defense. “We’ll try steroid sprays if mucosal inflammation contributes to symptoms,” Dr. Lindsay says. “And you can try opening the nostrils with nasal dilators, either a tape worn in the nose to gently spread the nostrils or small cone-shaped devices inserted into the nostrils. If either of these methods improves symptoms, nasal valve correction surgery will likely be helpful.”
According to Dr. Lindsay, the only way to straighten a deviated septum is through a surgical procedure called septoplasty. The methods are performed together on people with a deviated septum and nasal valve damage. “Most people return to normal activity in about two weeks, but this can vary depending on their health and the extent of the surgery,” says Dr. Lindsay.
However, don’t let the potential prospect of surgery deter you from seeking treatment. “Find the cause of the problem first,” Dr. Lindsay says. “The solution can be simple, and it can provide you with great relief.”
