Can sinus congestion be caused by allergic (hypersensitivity) reactions?

From the Guidelines

Yes, sinus congestion can definitely be caused by allergic reactions, as evidenced by the clinical practice guideline for allergic rhinitis, which lists nasal congestion as a symptom consistent with an allergic cause 1. When allergens like pollen, dust mites, pet dander, or mold spores enter the body, the immune system may overreact in sensitive individuals, releasing chemicals like histamine that cause inflammation of the nasal passages and sinuses. This inflammation leads to increased mucus production and swelling of the sinus tissues, resulting in congestion. For allergy-related sinus congestion, treatment options include:

• Antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) at standard adult doses of 10mg, 10mg, and 180mg daily respectively, as recommended for patients with allergic rhinitis and primary complaints of sneezing and itching 1.
• Nasal corticosteroid sprays such as fluticasone (Flonase) or triamcinolone (Nasacort), used as 1-2 sprays per nostril daily, can reduce inflammation, and are recommended for patients with a clinical diagnosis of allergic rhinitis whose symptoms affect their quality of life (QOL) 1.
• Saline nasal irrigation using a neti pot or squeeze bottle can help flush out allergens and thin mucus.
• For immediate relief, decongestants like pseudoephedrine may help, but shouldn't be used for more than 3 days to avoid rebound congestion. Identifying and avoiding specific allergen triggers is also crucial for long-term management, and clinicians may advise avoidance of known allergens or environmental controls, such as removal of pets, the use of air filtration systems, bed covers, and acaricides, in allergic rhinitis patients who have identified allergens that correlate with clinical symptoms 1. If over-the-counter remedies don't provide relief, a healthcare provider might recommend allergy testing or prescription medications, and clinicians should perform and interpret, or refer to a clinician who can perform and interpret, specific IgE (skin or blood) allergy testing for patients with a clinical diagnosis of allergic rhinitis who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is needed to target therapy 1.

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP relieves allergy symptoms caused by pollen, mold, dust and pets. Fluticasone Propionate Nasal Spray, USP not only relieves sneezing, itchy nose, runny nose and itchy, watery eyes, but also relieves nasal congestion. Allergies can cause uncomfortable symptoms like congestion and itchy eyes. These symptoms can be triggered by allergens like pollen, mold, dust or pet dander

Yes, sinus congestion can be caused by allergic (hypersensitivity) reactions 2.

• Key points:
  • Allergic reactions can trigger sinus congestion
  • Fluticasone Propionate Nasal Spray, USP is used to relieve allergy symptoms, including nasal congestion
  • The drug works by blocking allergic reactions in the nose
  • It is effective against a broad range of allergens, including pollen, mold, dust, and pet dander

From the Research

Sinus Congestion and Allergic Reactions

• Sinus congestion can be caused by allergic (hypersensitivity) reactions, as evidenced by studies on allergic rhinitis 3, 4, 5, 6, 7
• Allergic rhinitis is a common condition that affects an estimated 15% of the US population and is associated with symptoms of nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 4
• Nasal congestion is considered the most bothersome of allergic rhinitis symptoms and can significantly impair ability to function at work, home, and school 6

Treatment of Sinus Congestion

• Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe allergic rhinitis and also when nasal congestion is a prominent symptom 6
• Combination therapy of an antihistamine and a decongestant, such as desloratadine and pseudoephedrine, can be an effective treatment for allergic rhinitis symptoms, particularly nasal congestion 3
• Mometasone furoate nasal spray has been shown to be effective in relieving moderate-to-severe nasal congestion in patients with seasonal allergic rhinitis 7

Symptoms and Diagnosis

• Patients with allergic rhinitis typically present with symptoms of nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 4
• Nasal congestion can lead to sequelae such as sinusitis, otitis media, and the onset or worsening of mild to severe sleep disturbances, including obstructive sleep apnea 5
• Accurate diagnosis and appropriate treatment of nasal congestion depend on identifying the underlying cause, which can be allergic or non-allergic in nature 4, 6