Breathing easy: Tackling nasal congestion

Written by: Mr Matt Lechner
Edited by: Kate Forristal

A blocked nose, medically known as nasal congestion, is a common ailment that can disrupt our daily lives and leave us feeling frustrated. Whether it's caused by a cold, allergies, or other factors, such as an array of structural abnormalities (e.g. a deviated nasal septum or enlargement of the sidewall structures of the nose called the turbinates), the sensation of struggling to breathe through your nostrils can be both uncomfortable and irritating. In his latest online article, Mr Matt Lechner delves into the causes of a blocked nose and explores effective ways to alleviate the symptoms.

Causes of a blocked nose:

Common cold and respiratory infections: The most frequent culprit behind a blocked nose is the common cold. When we catch a cold, the nasal passages become inflamed, swollen and produce excess mucus, causing congestion. Respiratory infections, such as sinusitis and bronchitis, can also lead to nasal congestion.


Allergies: Allergic reactions to pollen, dust, pet dander, or other environmental factors can trigger the release of histamines, leading to swelling and congestion in the nasal passages.


Environmental irritants: Exposure to irritants like smoke, pollution, or strong odours can irritate the nasal lining, causing temporary congestion.


Deviated septum: A deviated septum, a condition where the wall between the nostrils is crooked, can hinder proper airflow and result in chronic nasal congestion. This can be diagnosed with a camera test, a so-called endoscopy and can be diagnosed in the clinic.


Enlargement of the sidewall structures of the nose: We all have turbinates which are sidewall structures of the nose and they warm and humidify the air which we breathe through the nose. They can enlarge as a result of a variety of conditions and diagnosis is key. There are a number of treatment options.


Nasal polyps: Non-cancerous growths in the nasal passages, known as nasal polyps, can obstruct normal breathing and cause congestion.


Hypertrophy of the adenoids: Adenoids are often enlarged in children and can also be found to be enlarged in some adults. In such cases, this enlargement at the back of the nose can impair nasal breathing, even in the absence of any other cause of nasal obstruction.


Nasal trauma: Nasal trauma at any stage of life can lead to a nasal deformity which is often associated with impaired breathing through the nose, as the bones and structures inside the nose also get shifted. This can be corrected surgically.


Alleviating a blocked nose:

Hydration: Maintaining proper hydration assists in thinning mucus, making it easier to expel. 


Steam therapy and nasal saline rinses: Steam inhalation proves to be an efficient method for alleviating nasal congestion temporarily, but nasal saline sprays or neti pots are often a lot more effective with helping flush out excess mucus and reduce congestion. These solutions also moisturise the nasal passages, providing relief. It is important to always add the recommended amount of salt to such a solution and by no means the nose should only be rinsed with water.


Over-the-counter medications: Decongestant nasal sprays only provide temporary relief, but continued use can have the opposite effect and can cause chronic nasal obstruction (so called Rhinitis medicamentosa). In patients with hay fever oral antihistamines can provide temporary relief from nasal congestion. Nevertheless, it is crucial to follow the provided instructions and seek advice from a healthcare professional if symptoms persist.


While a blocked nose can be a nuisance, understanding its causes and implementing effective remedies can make a significant difference in your comfort and well-being. Whether it's a temporary annoyance due to a cold or a more persistent issue, taking proactive steps to address nasal congestion can help you breathe easy and get back to enjoying your daily activities. Full assessment with the use of a camera to visualise the inside of your nose and the use of other tests allows for an accurate diagnosis and a more personalised approach to relief, with a number of treatment options available for each condition.


Mr Matt Lechner is an esteemed consultant rhinologist and ENT surgeon. You can schedule an appointment with Mr Lechner on his Top Doctors profile.

By Mr Matt Lechner
Otolaryngology / ENT

Mr Matt Lechner is a consultant rhinologist and ENT surgeon who specialises in nasal blockage, rhinitis, sinusitis, smell losssnoring, sleep apnoea, and rhinoplasty surgery. He is currently practising at the HCA UK at The Shard as well as The London Independent Hospital.

Mr Lechner, who is also an associate professor of surgery at University College London, previously held the role as clinical instructor in rhinology, advanced endoscopic sinus surgery, and skull base surgery at Stanford University School of Medicine. In his current role as associate professor of surgery, Mr Lechner is directly responsible for leading a research programme with a specific focus on rhinology, loss of smell, strategies for early cancer drug development, and precision medicine.

Mr Lechner has published more than 100 peer-reviewed articles on topics such as rhinology, smell disorders, and tumour biology. He was awarded a prestigious Hunterian Professorship by the Royal College of Surgeons of England in 2020 and regularly lectures internationally. He is the co-director at the London Nose Clinic.

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