Why does the nose swell

Hypersensitive nose, vasomotor rhinitis

If the nasal mucous membrane overreacts, there are many causes. Special forms of cold are also hormone-related colds and non-allergic eosinophilic rhinitis

An overly sensitive nose reacts immediately with a cold

If the nasal mucous membrane reacts excessively sensitive to external and internal stimuli, doctors also speak of nasal hyperreactivity or hyperreactivity. Depending on the experts, the term includes allergic rhinitis. Mostly, however, it refers to forms of colds that are not triggered by allergies or infections. This includes, for example vasomotor rhinitis or hyperreflective rhinopathy. Certain neurotransmitters, hormones, proteins and other factors act on the vessels and control elements of the mucous membrane cells in the nose. As a result, they defend themselves immediately and violently against very different, sometimes harmless influences.

The triggers Environmental factors such as air pollution, ozone, fine dust, exhaust gases, tobacco smoke or irritants, e.g. from cleaning agents, can be responsible for nasal hyperreactivity. Some sufferers also get complaints when they change their physical position, for example turning over in bed. In hyperreflective rhinopathy, the overly sensitive mucous membranes respond strongly to smells, alcohol, hot drinks and spicy foods. Direct reactions to temperature changes and physical activity in cold air, such as skiing, are often typical. Stress and emotional stress also play a role.

Symptoms: The stimuli make the nasal mucous membrane swell, trigger sneezing and a flowing nose. The nose is often itchy and it is difficult to breathe through the nose. If the nasal secretions flow inwards, coughing can occur.

It is not uncommon for acute reactions to develop into a chronic runny nose, which favors other diseases such as chronic sinusitis or chronic bronchitis.

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Also repeated, runny nose caused by viruses can make the nasal mucous membrane overly sensitive. Sometimes, however, no clear triggers can be identified (idiopathic rhinitis).

If the mucous membranes become too dry, for example due to cold, dry air or other influences, they also react irritated. The constant use of plays a special role here decongestant nasal drops and sprays (see chapter "Medicines as a cause"). This can lead to a chronic runny nose, odor disorders and under certain circumstances also to a so-called rhinitis sicca or atrophic rhinitis to lead. Here the mucous membranes dry out strongly, crusts and crusts form. If the changes progress and germs settle, an unpleasant smell arises from the nose ("smelly nose"; see also the guide "bad breath").

Diagnosis and therapy: First, the doctor checks whether the symptoms are not due to an allergic or infectious cause. The chronic complaints, the medical history and an inspection of the nose often give him the first clues (see also chapter "Diagnosis"). Allergy tests, blood tests and an endoscopy of the nose and laboratory tests of nasal secretions may follow.

If the results suggest non-allergic and non-infectious nasal hyperreactivity, the treatment consists of avoiding triggering factors as far as possible, for example nasal drops that cause swelling. It is important to moisten and care for the nasal mucosa. Often, nasal rinsing with saline solutions also makes sense. Ear, nose and throat doctors may also prescribe medication, primarily cortisone nasal sprays.

Hormonal rhinitis

If the balance of certain hormones, such as estrogens, changes, the nasal mucous membranes sometimes swell. A very typical example is the "pregnancy runny nose". Pregnant women complain of a blocked nose, especially in the last months of pregnancy, which makes breathing difficult, especially at night. This form of rhinitis disappears after the birth. However, pregnant women should avoid decongestant nasal drops. Natural measures bring relief here (see also the common cold disease guide).

In addition, a hormone-related runny nose can occur in connection with an overactive thyroid gland (hyperthyroidism). Key symptoms for an overproduction of thyroid hormones are, for example, sensitivity to heat, tendency to perspire, weight loss despite increased appetite, increased excitability.

Non-allergic eosinophilic rhinitis (NARE syndrome)

Cold symptoms exist here all year round. They are similar to allergic symptoms, but the doctor cannot determine an allergy. A laboratory examination of mucous membrane and secretion samples, however, shows an increased number of certain white blood cells (eosinophilic granulocytes), as in allergic diseases. Often those affected have nasal polyps at the same time and some react with sometimes severe symptoms to certain painkillers, in particular to analgesics such as acetylsalicylic acid (ASA intolerance syndrome, see chapter "Medicines").

Symptoms: The nasal mucous membranes are generally hypersensitive, and certain triggering stimuli are often not discernible. Are typical Sneezing attacks, nasal congestion and nasal discharge, itching in the nose and throat. Often there are pronounced odor disorders that impair the sense of taste. Asthmatic cough can also occur.

For the therapy For NARE syndrome, ENT doctors usually use cortisone, especially in the form of nasal sprays. These have also proven effective for nasal polyps. In special cases, doctors also consider surgery or long-term treatment with cortisone and, if necessary, antibiotics.