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Chronic nasal congestion, or simply, a stuffy or stuffed up nose, is a condition that often results in other conditions like snoring or sinus headaches, and it has a constellation of causes. It is differentiated from the stuffy/runny nose that occurs when people get colds or allergies, called acute nasal congestion. This usually resolves a few weeks after symptoms emerge; with chronic nasal congestion, symptoms can last several months with little sign of going away.
Some of the causes of chronic congestion include ongoing allergies, response to irritants, or chronic fungal or bacterial infection of the sinuses. A few more unusual causes include illnesses like gastroesophageal reflux disease (GERD) or some hormone treatments or naturally high levels of hormones, as in pregnancy. Some of these conditions are fairly easy to spot in the beginning, and others may take some testing to identify. Differentiating between chronic fungal and bacterial sinusitis is important, since antibacterial treatment for fungal sinusitis may just make the problem worse.
Of these causes, one of the clear culprits in chronic nasal congestion is allergies. Many people get seasonal allergic rhinitis and while congestion is chronic during the season, it may only be present during a particular season. Others seem to have chronic congestion at all times, and this may suggest allergies to things found indoors like dust mites, pet dander, or molds. Doctors might suggest people have allergy testing to determine what things are creating congestion, and as part of treatment might recommend trying to minimize exposure to such things in living environments.
Chronic nasal congestion could also be a response to things that irritate the nose and cause it to become inflamed. Tobacco smoke and certain other chemicals may be most indicated in these instances. People may not have an allergy but instead they have a sensitivity response and symptoms might be reduced, as with allergies, through minimizing exposure
Long-lasting congestion may suggest infection, and this could be of bacterial or fungal origin. When sinus infections don’t clear, and especially don’t clear after antibiotics, other treatments might be tried. It should be noted that people might have chronic nasal congestion being caused by more than one source. It is possible to have allergies, sensitivities, and infections at the same time.
Treatment of chronic congestion begins with identifying cause. If GERD is identified, treatment focuses on acid reduction. For other causes, doctors might suggest decongestants, antihistamines, corticosteroids, anti-fungals or antibacterials. In addition, they may advise about lifestyle changes that could help relieve some of the problem, and they could recommend home treatments like daily sinus rinsing.
Sometimes additional help may be needed, particularly if structural problems in the nose are causing chronic nasal congestion. Some doctors might recommend things like adenoid removal, or aligning some nasal structures to promote better breathing. There are many possible surgical approaches to addressing the issues of a congested nose, particularly when cause seems oriented in nasal shape or function.
@Terrificli -- In my experience, the saltwater wash you mentioned is at least as critical as a good decongestant when dealing with nasal problems. That is because (as you said) the emphasis is on removing allergens instead of drying them up so they can show up later.
Decongestants fight the symptoms, but a saltwater nasal wash fights the cause, see?
People with allergies often suffer chronic nasal congestion as a nasty offshoot of that illness. Chronic sinus congestion, in fact, often goes hand in hand with bad allergies.
And that condition leads to a heck of a lot of sinus infections and those are miserable.
But there is hope. For one thing, get a good decongestant to help with the problem. For another, there are kits designed to allow people to rinse out their sinuses with salt water. That can help remove allergens and that should cause your chronic nasal congestion to end.