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When congestion is a frequent but not persistent problem, it is often from either allergic rhinitis, flare-ups of chronic sinusitis, or frequent viral infections. Let us consider the difference between these common causes of frequent sudden onset, brief duration nasal congestion.

Frequent Viral Infections

Some people are prone to frequent viral infections. The common cold is one group of viral infections. On most occasions, patients will be doing just fine and then suddenly develop nasal congestion, nasal airway obstruction, clear drainage, sometimes sore throat and sometimes a cough. In adults, there is usually no fever. There are hundreds of types of viruses and they can each product slightly different symptoms. The symptoms of viral infections almost always are on both sides of the nose. They are sometimes associated with a feeling of malaise or a general body-feeling of illness, and they rarely include significant facial pain. It is possible to have some nasal drainage or discharge that is slightly cloudy with viral infections, but more often the drainage is clear.

The average adult gets about two viral infections per year. They are more common in people who are exposed to young children. School teachers, daycare workers and parents with young children are at high risk. Sometimes, it is possible to have a run of "bad luck" and get more than one viral infection, one after the other. It can be hard to differentiate this fairly common situation from an isolated more long-term problem, such as a bacterial sinus infection. People who are at risk for frequent viral infections can benefit from considering just how such infections are spread and taking measures to reduce their spread.

Allergic Rhinitis

"Allergies" are a common cause of congestion and in some people this can be a frequent event. In addition to congestion, patients often have sneezing, itchy eyes, and clear drainage. Allergic rhinitis occurs when inhaled particles that you are allergic to cause an inflammatory reaction on the mucous membranes of your nasal passages. Those particular things that you are allergic to determine when you will have problems and how severe the problems will be. The incidence of allergic rhinitis has been estimated at somewhere between 20% and 40% of people. Not all patients with allergic rhinitis have severe or frequent symptoms. Reactions to cigarette smoke, fumes and odors do not usually represent true allergic reactions, but they can cause similar symptoms by direct irritation or by stimulating certain nerves in the nasal passages. These exposures are usually obvious to the patient.

If you are allergic to mold spore or dust mite, you can have reactions anytime of the year. Sudden flare-ups can occur when you are exposed to large amounts of the agent that you are allergic to. Dust mites are especially dense in carpets, bedding and draperies. Mold spores are especially dense in house plants, flower beds, old magazines and books, objects stored in humid conditions, and anywhere that is frequently damp and where the air does not circulate well.

If the congestion is frequent and comes at the same time(S) every year, consider seasonal allergies. Seasonal allergy flare-ups occur when people have an allergy to a specific pollen and when that pollen blooms, suddenly. Ragweed is one of the most common blooms, but other pollens can also be responsible. Sudden allergy flare-ups from pollen are called "hay fever." Hay fever is not usually caused from hay, and there is usually no fever associated with it. The term hay fever refers to a sudden onset of nasal congestion, itchy eyes, sometimes cough and throat symptoms and is associated with a specific sudden pollen bloom.

Chronic Sinusitis

Chronic sinusitis is one of the most common problems of frequent constant nasal congestion, but it can also be a cause of congestion that flares up and cools down. It is not always clear why people with chronic sinusitis have the flare-ups and periods of cool-down. The actual process is termed acute exacerbations of chronic sinusitis. Patients with acute flare-ups of chronic sinusitis, will often have one side of their nose or sinuses more affected than the other. Sinus pain is frequent, and sinus headaches are common. Chronic sinusitis can be from low grade bacterial infections, inflammatory reactions to mold spore, or from physical obstruction of good drainage from polyps, cysts, or other anatomic problems.

What to do now?

It can be hard to distinguish between the three possibilities suggested above. If you have young children or work around children it is quite possible that at least some of these events represent acute viral infections. Consider treating them as viral infections. If you are pretty sure that it's not a cold(s), try OTC allergy medicines, use them consistently for a week or so, if they work some are indicated for long term use. Also see the section on treating chronic problems with OTC medicines. If that doesn't help, a visit to the doctor may be in order. If your problem is frequent and hasn't responded well to OTC medicines, it is time to find out what is going on.

Tips to avoiding viral infections

Viral infections spread when microscopic amounts of nasal secretions or saliva are passed from one person to another. Droplets in the air from sneezes or coughs are one of the ways such secretions can be spread. It is likely that a more common way that viral infections are passed is when you touch the surface that someone with a virus has touched and then later spread the virus to yourself by touching your mouth, your nostril, or rubbing your eyes.

There are some important issues to consider that can help reduce the frequently of catching viral infections, especially when surrounded by persons who are sick, when in crowds where it is likely that there are persons who are sick, or during those times of the year when viral infections are quite common. You should avoid touching your face with your hands unless you have just washed your hands or if you need to scratch or rub your face, use a Kleenex, a cloth. Washing your hands frequently or using the newly available antiseptic/alcohol gels can be very helpful. It is surprisingly common for people to rub or scratch their eyes. When this becomes necessary, you should either use a Kleenex or the inside surface of your shirt or other garment instead of your hands. It is surprising that for some patients, taking simple precautions such as this, can dramatically reduce their frequency of infections. This is especially the case in school teachers, parents of young children, and those in contact with the public.

Your Congestion...

Is it swelling from allergy?
Viruses are very common.
Is it seasonal?

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your congestion.
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