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A Chronically Stuffy Nose May be a Sign of
Allergies

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Dear Dr. Paul: When my daughter
gets a common cold, she also gets a stuffy nose that seems to lasts for a
long time. It usually turns into a sinus infection or something requiring
antibiotics. Isn't there something that she can take that will curb the
stuffiness and help clear things up? Thank you.
Dr. Paul Answers: A stuffy nose is very common in young children.
The most usual reason for this is that the nasal passages are quite small
in children, and it doesn't take very much to block them.
However, in situations where this is recurrent, like in your daughter, one
has to consider allergies. Allergens (something that causes an allergy) such
as dust mites, cat or other animal dander, can irritate the nose resulting
in chronic nasal congestion, and sometimes a chronically runny nose. This
is referred to as "allergic rhinitis". Typically, the symptoms are worse
during the winter months when everyone tends to spend more time indoors.
Additionally, there is usually a history of allergies in the family.
Another typical feature of the allergy symptoms which you describe in your
daughter, is that colds may last longer than usual and often turn into sinus
infections. This happens because the normal drainage of the sinuses into
the nose is blocked by the nasal irritation. This leads to a build-up of
fluid in the sinuses which then get infected. To treat allergic rhinitis
in children we focus primarily on identifying the specific allergen. We do
this by performing an allergy test. Once we have identified what is causing
the allergy, we can proceed to allergic precautions.
Dust mites, which are microscopic insects that live in dust, are commonly
identified allergens. They like humidity and can be found in upholstered
furniture and bedding. Dust mite precautions include, removing the carpet
and stuffed toys from the child's room, washing the bed sheets weekly in
hot water, covering the mattress and pillow with specially-made dust-mite
covers and maintaining the humidity level at 40%.
If a pet, such as a dog or (especially) a cat is causing the allergy, then
we usually recommend removing that pet from the household. Of course, second-hand
smoke is a major risk factor for all children. Smoking should be avoided
in the home and in the car at all times. In terms of medications, inhaled
nasal (steroid) treatments are available. These work by decreasing the nasal
irritation, which in turn decreases the symptoms. However, medications should
not replace the most basic treatment in these situations - the identification
and subsequent removal of any indoor allergens or irritants in the environment
that may be causing the problem or making it worse.
Although an allergy is an important cause of a chronically stuffy nose in
children, it is not the only cause. Chronic nasal congestion can also be
caused by enlarged adenoids, the treatment of which is different than that
of allergic rhinitis.
About the Author
One of the most satisfying aspects of being a pediatrician is answering parents
questions and concerns..as I feel that the more you know about your child's
health and wellness (in terms of illness, normal growth/development and
importantly prevention), the more comfortable you can be with your kids!
Visit Dr. Paul's website.
The information provided in this column is designed to be an educational
aid only. It is not intended to replace the advice and care of your child's
physician, nor is it intended to be used for medical diagnosis or treatment.
If you suspect that your child has a medical condition, always consult a
physician.
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