Advice to relieve nasal congestion, sinus pressure or runny nose

Advice to relieve nasal congestion, sinus pressure or runny nose

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Maybe you still have a cold you had a month ago. Or your head and nose feel like they are full of cotton. Maybe you’re not sure what’s causing your sinus problems: In addition to respiratory infections and allergies, environmental irritants may trigger these problems.

Sometimes the reason is a bit mysterious.

But sinus problems such as runny nose, congestion, sneezing, or postnasal drip are common. Other problems may include facial pressure, decreased sense of smell or taste, nasal crusting and frequently feeling the need to clear the throat. Older people are more susceptible to problems with these air-filled cavities behind the nose, cheekbones and forehead.

“Your nose changes as you age,” says Kevin Hoare, MD, assistant professor of clinical otolaryngology at Keck Medicine of the University of Southern California in Los Angeles. As we age, the nose becomes less efficient at expelling mucus, trapping it there and in the sinuses – allowing congestion and other unpleasant symptoms to persist.

Here are some common sinus triggers and how to deal with them.

Respiratory diseases and allergies

Up to 30 percent of adults have a stuffy or runny nose due to allergies to substances such as tree, grass or weed pollen, as well as mold, pets, dust mites and cockroaches, says allergist Zachary Rubin, MD, a spokesman for the American College of Pediatrics. . Allergies, asthma and immunity.

Older people tend to have less strong immune systems, making them more susceptible to colds and flu, says Hiten Patel, MD, a family medicine specialist at Ohio State University Wexner Medical Center in Columbus. Both can cause sinus problems.

what should be done: Over-the-counter saline nose drops or salt water washes are your best bet either way, says Hoare. When you feel full, use it several times daily to help expel mucus. “It’s like taking a shower, you can’t do that too often,” he says. You can also do this preventatively, such as once or twice daily during cold and flu season. “It helps keep them (sinuses) moist and healthy, and may help get rid of any viruses that can cause colds,” he says.

For a respiratory virus causing sinus problems, you can also use an over-the-counter steroid nasal spray such as fluticasone (Flonase) or triamcinolone (Nasacort) for a few weeks. This can help reduce nasal inflammation caused by the virus, Hoare says.

For allergies, an over-the-counter antihistamine nasal spray such as Azelastine is a better option, Rubin says, and can relieve congestion quickly. If that doesn’t help, ask your doctor about prescription Dymista, which combines a nasal antihistamine with a steroid.

For both, an over-the-counter nasal decongestant spray such as oxymetazoline (Afrin) may provide some relief. But using these things for more than three days increases your risk of rebound congestion, Hoare says. And be careful about oral decongestants, which may contain ingredients like phenylephrine that can raise blood pressure, Patel says.

If the above strategies don’t help after about 10 days of a respiratory infection, or you start feeling better and then worse, consider asking your doctor to check for a bacterial sinus infection, especially if you also have facial pain and pressure, a cough, and a low-grade fever. . You may need an antibiotic, Hoare says. For allergy-related sinus symptoms, ask about immunotherapy (given as shots or, for some allergens, under the tongue, also known as sublingual).

When the cause is less clear

Nonallergic rhinitis — caused by irritants such as cigarette or fireplace smoke, traffic fumes, strong odors, and weather changes — can also cause sinus problems. “This is due to a misregulation of the nerves in your nose that produce mucus,” Hoare says.

Stuffiness accompanied by a dry, crusty nose or even nosebleeds may indicate so-called atrophic rhinitis. “As you age, nasal tissue weakens and atrophies, due to decreased blood flow to the nasal cavity,” says Peter Maness, an ear, nose and throat specialist at Yale University School of Medicine in New Haven, Connecticut. “The cartilage also weakens,” which can change the shape of your nose.

what should be done: If you suspect you may have non-allergic rhinitis, avoid potential triggers and use a saline nasal spray several times daily to flush out mucus and irritants. Do you want more help? Prescription nasal spray ipratropium (Atrovent), which reduces the amount of mucus you produce, is primarily good for runny noses, Maness says.

To treat a stuffy nose, antihistamine nasal sprays are often very effective. “This is likely because it has some kind of anti-inflammatory effect, and may also calm the nerve endings in the nose,” says Maness. Treatment for atrophic rhinitis usually involves repeatedly spraying your nose with a saline nasal spray.

Sinus problem still won’t stop?

If you don’t feel better within a few weeks after trying some of the above treatments, it may be helpful to have your ear, nose and throat specialist examine your nose with an endoscope.

“This allows us to look for mucus that could indicate infection, as well as swelling or even nasal polyps, which are benign growths on the lining of the nasal passages,” says Gregory Levitin, MD, an otolaryngologist at New York Eye and Ear Infirmary at Mount Sinai. New York. Sometimes, the solution is simple. For nasal polyps, for example, the prescription injectable drug dupilumab (Dupixent) may help shrink them.

But if the cause of your persistent nasal symptoms isn’t clear, you may need a CT scan of your sinuses. “Sometimes, years of untreated inflammation damage sinus tissue,” Levitin says. “This can lead to chronic inflammation and swelling.”

A small amount of this tissue can be removed in your doctor’s office, but more extensive sinus disease may require surgery under general anesthesia. This is considered relatively safe for older people: In a 2022 study published in the American Journal of Rhinology and Allergy, the surgical complication rate was 3.9% for adults 70 and older, but it was higher — 8% — for younger patients.

  • Steam shower: The warm, humid air will help drain the mucus, Manis says. You can also wrap a towel over your head and inhale the steam from a bowl of hot water.
  • Stay hydrated: Hot, room-temperature beverages help relieve nasal symptoms, an older study in the journal Rhinology found. But people reported greater relief when sipping a hot beverage than when sipping a room temperature beverage. Another older study found that chicken soup and hot water relieved cold symptoms such as nasal congestion more than cold water.
  • Chili pepper: They are rich in capsaicin, which may help relieve nasal congestion, according to a 2015 Cochrane review.
  • Moisturizer: Dry air can lead to irritation and inflammation of the nasal lining. A humidifier (choose a cool mist) set at 30 to 50 percent humidity will increase the humidity in your home appropriately, Maness says.
  • Chronic heartburn: In gastroesophageal reflux disease (GERD), stomach acid regularly backs up into the esophagus and mouth, damaging the lining of the esophagus. The most common advice is for a sore throat or persistent cough, Hoare says. But in a study published in BMC Pulmonary Medicine in 2021, GERD was also associated with a four-fold increase in non-allergic rhinitis. “We tend to see this in patients with severe GERD” who may not realize that the condition also affects their sinuses, says Hoare. A gastroenterologist can help.
  • Sleep Apnea: People with this condition (in which breathing stops briefly several times during sleep) who also reported nasal congestion during the night were more likely to have severe sleep apnea, according to a 2022 study. They were also more likely to have high blood pressure. Or not controlling it. Addressing problems that may get in the way of treating sleep apnea — such as a deviated septum or other structural obstructions in the nose — can also help your sinuses, Hoare says.
  • Side effects of medications: Beta blockers, antidepressants, and erectile dysfunction medications may worsen nasal congestion. If you doubt this, talk to your doctor. You may be able to switch to a different class of medication.

Copyright 2024, Consumer Reports Inc.

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