Stuffy Noses And COPD: What’s The Deal?
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Many people with breathing disorders — like COPD — also suffer from medical conditions that may make it hard to breathe through your nose. Here’s all you need to know.

Some statistics

A 2007 study showed that up to 75% of COPDers also suffered from some form of nasal inflammation, and about a third of people diagnosed with sinusitis also had lower airway inflammation, which would be either asthma or COPD. So, there is quite a prevalence of nasal inflammation caused by sinusitis or rhinitis among the COPD community. (1)

What causes a stuffy nose?

The most common cause in COPD patients is inflammation of the blood vessels in your nose and sinuses. This inflammation may cause symptoms — such as a stuffy nose — resulting in a diagnosis of sinusitis or rhinitis.

Why does COPD cause a stuffy nose?  

Most cases of COPD result from long-term exposure to airway irritants, such as chemicals in cigarette smoke or in the air at work. These irritants cause damage to cells and genes resulting in an abnormal immune response that causes inflammation of the lower airway (bronchioles) and lung tissue. This is what causes chronic bronchitis and emphysema. COPD flare-ups may be caused by airway irritants, respiratory viruses, and allergens. That said since your upper airway (nose and sinuses) is exposed to these same irritants, it only makes sense that they may also be affected with inflammation. (1-2)

What is the purpose of this inflammation?

The purpose of this inflammation is to trap airway irritants (like microscopic particles) and pathogens (like viruses) to keep them out of your lungs. This inflammation irritates goblet cells to make them produce more sputum. Airway irritants or pathogens are balled up inside the sputum and then brought to your upper airway so you can swallow it or spit it up.

Why does nasal inflammation cause a stuffy nose?

The increased sputum in your nasal passages can become dry or thick and clog your nose and sinuses. Along with irritating goblet cells, it also irritates nerve endings in the area. This is what causes that annoying itchy or scratchy feeling in your nose when you suffer from rhinitis or sinusitis.

What is rhinitis?

Also commonly referred to as hay fever. It is inflammation of the mucous membrane lining your nasal passages. It can be caused by a normal immune response to respiratory viruses that cause the common cold. In these cases, it’s diagnosed as non-allergic rhinitis. It may also be caused by an abnormal immune response to common allergens, such as dust mites, pollen, mold spores, and animal dander. In these cases, it’s diagnosed as allergic rhinitis. Common symptoms include nasal irritation and sneezing, along with a stuffy and runny nose.

What is the treatment for rhinitis?

The best treatment may be avoidance of allergens and respiratory viruses, although since allergens and viruses are so ubiquitous, they are often hard to avoid. Allergy medicines such as antihistamines, leukotriene antagonists such as Singulair,  and nasal sprays that contain corticosteroids are common treatments. Sometimes rinsing your nose with salt water solutions may prove helpful. Your doctor may also have other suggestions, such as desensitization or allergy shots.

What is sinusitis?

It’s nasal inflammation and nasal stuffiness that may result in sinus infections that are usually bacterial in origin. Other symptoms include post nasal drip, trouble breathing through your nose, pain, and loss of the ability to taste or smell things. It can be acute, lasting a short time, such as what might occur with the common cold. It may also be chronic, lasting a long time, such as might occur with allergies, asthma, COPD. They can also be caused by nasal polyps and deviated septums. It may also be associated with rhinitis, in which case it may be called rhinosinusitis.  (3)

How is sinusitis treated?

It can be treated with medicine, such as saline rinses and sprays, nasal steroids, or antibiotics. Treatment may also involve treating the underlying condition, such as allergies, deviated septum, nasal polyps, etc. (3)

What are nasal anomalies?

There are many different anomalies that can occur inside your sinuses and nasal passages that can cause a stuffy nose, the most common of which are nasal polyps. A common cause of nasal polyps is chronic inflammation, such as that caused by chronic sinusitis. Another one is a deviated septum, where your nasal septum is deviated to one side, making one nasal passage narrow. Airflow may be further obstructed by swelling. Nasal anomalies can either be treated with medicine or surgery. (4-5)

How do you get a proper diagnosis and treatment?

If you have a diagnosis of COPD, it should be suspected that you also might have or develop at some point nasal inflammation. So, inspecting your nose should be a part of your regular screening at your doctor’s appointments. Your doctor may try to treat you medically. However, if your symptoms persist, you may be referred to a specialty doctor called an otorhinolaryngologist, or an Ear, Nose, and Throat doctor (ENT).

What are the advantages of nasal breathing?

Derek Cummings, an excellent writer who also has COPD, wrote a nice post on this subject called “Learning To Breathe Right Is The Hardest Of All.” He spells out all the wonderful benefits of breathing properly, meaning through your nose.  If you have trouble breathing through your nose, then you have no choice but to breathe through your mouth — it’s the path of least resistance. But, you will also miss out on all the benefits of breathing through your nose.

What does this mean for you?

I think a lot of people chalk up stuffy noses as just something they have to deal with, while in reality, it is quite often quite treatable. If you suffer from a stuffy nose, make sure you talk to your COPD doctor about this so that you can get the proper treatment you deserve so you can breathe easier and live better with COPD

 

view references
  1. Kim, JS., “Nasal and sinus inflammation in chronic obstructive pulmonary disease,” COPD, 2007, https://www.ncbi.nlm.nih.gov/pubmed/17530509, accessed 6/15/17
  2. Piotrowska, et al., "Rhinosinusitis in COPD: symptoms, mucous changes, nasal lavage cells and eicosanoids," international Journal of Chronic Obstructive Pulmonary Disease, 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898086/, 6/30/17
  3. Chronic Sinusitis, Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/dxc-20211170, accessed 6/20/17
  4. Nasal Polyps, Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/nasal-polyps/symptoms-causes/dxc-20267326, accessed 6/230/17
  5. Deviated Septum. Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/deviated-septum/home/ovc-20200967. Accessed 6/20/17
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