ear, nose, and throat disorders
Nasal Congestion and Discharge
Evaluation of Nasal Congestion and Discharge
Not all episodes of nasal congestion and discharge require immediate evaluation by a doctor. The following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation. In people with nasal congestion and discharge, certain symptoms and characteristics are cause for concern. They include Discharge from only one side of the nose, particularly if it contains pus or blood Face pain, tenderness, or both People should see a doctor right away if either of the following occurs: They have Warning signs . Their caregiver thinks they may have put something in their nose. People who have nasal congestion and discharge but no warning signs should call their doctor. They may not need to be seen, particularly if they have typical cold symptoms and are otherwise healthy. Doctors first ask questions about the person's symptoms and medical history and then do a physical examination. What doctors find during the history and physical examination often suggests aand the tests that may need to be done. During the medical history, doctors ask about the following: The nature of the discharge (such as whether it is watery, sticky, pus-filled, or bloody) and whether it is present most or all of the time (chronic) or comes and goes Symptoms of possible causes, including fever and face pain (sinusitis); watery, itchy eyes (allergies); and sore throat, a general feeling of illness (malaise), fever, and cough (viral upper respiratory infection) Whether people have allergies, diabetes, or a weakened immune system and whether they have been using decongestant sprays If the discharge comes and goes, doctors try to determine whether it relates to where the person lives, the season, or exposure to potential triggers (such as pets or dust). During the physical examination, doctors look at the following: The face for redness over the sinuses just above the eyebrows (frontal sinuses) and the sinuses in the cheekbones (maxillary sinuses) The membranes lining the nose (nasal mucosa) for color (whether they are red or pale), swelling, color and nature of the discharge, and (particularly in children) whether there is any foreign object Doctors may also tap their finger over the sinuses to check for tenderness. Testing is usually not needed for nasal symptoms unless severe sinusitis is suspected in a person with diabetes or a weakened immune system or with symptoms that do not resolve after treatment. In such cases, Computed Tomography (CT) (CT) is usually done. 