Nasal Congestion Management in Allergic Rhinitis

Allergic rhinitis is characterised by an immunoglobulin E-mediated inflammatory response of the nasal mucosa to environmental allergens, leading to vasodilation, increased vascular permeability and mucus hypersecretion. Nasal congestion is the hallmark symptom, often impairing sleep, school or work performance and quality of life. Management strategies combine avoidance of known triggers, saline irrigation to promote mucociliary clearance and pharmacotherapy. Topical intranasal corticosteroids remain the cornerstone of treatment for moderate to severe congestion, as they directly suppress local inflammation and reduce tissue oedema. Oral and topical decongestants acting as α-adrenergic agonists offer rapid but short-lived relief through vasoconstriction; their prolonged use can result in rebound congestion and rhinitis medicamentosa. Second-generation antihistamines relieve associated sneezing and rhinorrhoea, while leukotriene receptor antagonists are considered when nasal congestion coexists with asthma. Emerging approaches include biologic agents targeting key cytokines in the allergic cascade and novel barrier-forming sprays that reinforce mucosal defence. An integrated, patient-centred approach maximises symptom control, minimises adverse effects and addresses the global burden of allergic rhinitis.

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Nasal Congestion Management in Allergic Rhinitis publication trend

The graph below shows the total number of articles in nasal congestion management in allergic rhinitis across all publications each year (not limited to Nature Index journals).

Technical terms

Allergic rhinitis: Immunoglobulin E–mediated inflammation of the nasal mucosa triggered by environmental allergens.

Alpha-adrenergic agonist: Agent that binds to α-adrenergic receptors in nasal blood vessels to induce vasoconstriction and reduce congestion.

Intranasal corticosteroid: Topical steroid spray that suppresses mucosal inflammation and decreases nasal obstruction.

Rhinitis medicamentosa: Rebound nasal congestion resulting from prolonged overuse of topical decongestants.

Mucociliary clearance: Self-cleaning mechanism of the nasal epithelium that removes mucus and trapped particles.

References

1. The Use and Efficacy of Oral Phenylephrine Versus Placebo Treating Nasal Congestion Over the Years on Adults: A Systematic Review. Cureus (2023).
2. Efficacy and Safety Assessment of Nasal Spray Containing Sodium Hyaluronate and Methylsulfonylmethane (MSM) in Otolaryngological Disorders. Applied Sciences (2023).
3. Intranasal alpha-adrenergic receptor agonists and corticosteroids as medical treatments for nasal congestion. Theoretical and Natural Science (2023).