The sneezing, the watery eyes, the back and forth between your nose running uncontrollably and being so stuffed up you can’t breathe, it’s probably not a cold that’s lasted for weeks or months on end. It may be nasal allergies that have you feeling clogged up.1

Seasonal allergic rhinitis (rhinitis means inflammation of the nose) and perennial allergic rhinitis are two different types of nasal allergies that can be the cause of your congestion.1

Seasonal allergic rhinitis is also called hay fever. It is an allergic reaction from allergens such as pollen from trees, grasses and weeds. This type of rhinitis occurs mainly in the spring and fall when pollen from trees, grasses and weeds are in the air. 1 Perennial allergic rhinitis is caused by allergens that are present all year long. The primary causes of this type of rhinitis are allergies to dust mites, mold, animal dander and cockroach debris.1

Congestion is one of the most common symptoms of nasal allergies. Other symptoms that can occur are sneezing, a runny nose and mucous (phlegm) in the throat (postnasal drip).1,2

Congestion is caused when the airflow in your nose is obstructed. There can be many different reasons, one of them is when the blood vessels inside your nose become inflamed and swell because of allergens that irritate your nose.3,4

Decongestant nasal sprays provide relief by shrinking the swollen blood vessels in your nasal passages which allows you to breathe easier again.3

Decongestant nasal sprays are supposed to be used for a maximum of three days. If you use them longer than that, your nasal passages can develop a dependence, and this can cause rebound congestion. Doctors call this rhinitis medicamentosa. It means congestion caused by medication.3,5

The reasons why rebound congestion occurs are complicated and not well understood. This is thought to be related to two possible causes:5

  1. Use of a nasal decongestant causes inadequate blood supply (because of the constriction of blood vessels) which causes swelling to occur in your nasal passages.
  2. Use of nasal decongestants causes nasal receptors that respond to decongestants to down-regulate (reduce in numbers) which leads to congestion.

When evaluating you for rebound congestion, your doctor will take a thorough medication usage history as well as perform a nasal exam. Typically, with rebound congestion, your nasal passages will appear to be red with a thicker than the normal nasal mucous membrane.5

If rebound congestion continues untreated it can actually lead to other conditions including chronic sinusitis, atrophic rhinitis (your nasal lining wastes away because of thick crusts that forms inside your nasal cavity) and enlarged turbinates (small structures inside the nose that cleanse and humidify air that passes through the nostrils into the lungs).5,6,7

If you are already addicted to a nasal spray, talk to your doctor. Some doctors may recommend a gradual decrease in the use of the medication until you are completely weaned off it. This may be preferable than trying to quit the medication outright, which may result in severe congestion for a number of days.5

The best way to treat nasal congestion is to treat the cause. Avoid your allergy triggers if you know what they are, if you don’t your doctor can help you to identify them.2

Go to www.gotallergies.co.za for more information about allergies and how to treat them.

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

Name and business address of the holder of the certificate of registration: iNova Pharmaceuticals (Pty) Ltd,. Co. Reg. No. 1952/001640/07, 15e Riley Road, Bedfordview. Tel. No. 011 087 0000. www.inovapharma.co.za. For further information, speak to your healthcare professional. Further information is available on request from iNova Pharmaceuticals. IN2978/18

References:

  1. Asthma and Allergy Foundation of America. Rhinitis (Nasal Allergies). [online] October 2015 [cited April 0219]; Available from URL: https://www.aafa.org/rhinitis-nasal-allergy-hayfever/
  2. 5 Nasal Allergy Symptoms You Shouldn’t Ignore. [online] February 2011 [cited April 2019]; Available from URL: https://www.webmd.com/allergies/features/allergy-symptoms?print=true
  3. Can You Become Addicted to Nasal Spray? [online] December 2017 [cited April 2019]; Available from URL: https://www.healthline.com/health/nasal-spray-addiction#correct-usage
  4. Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med 2010;3:47-57.
  5. Verywell Health. What Is Rebound Congestion? [online] March 2019 [cited April 2019]; Available from URL: https://www.verywellhealth.com/everything-you-need-to-know-about-rebound-congestion-1192177?print
  6. Standford Health Care. Turbinate Reduction. [online] [cited April 2019]; Available from URL: https://stanfordhealthcare.org/medical-treatments/n/nasal-surgery/types/turbinate-reduction.html
  7. Interventions for atrophic rhinitis. [online] February 2012 [cited April 2019]; Available from URL: https://www.cochrane.org/CD008280/ENT_interventions-for-atrophic-rhinitis