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Guide Health: Take care of your nose. It’s nothing to sniff at

Abrupt loss of smell can be related to trauma, tumours, polyps or diseases like COVID-19

You probably take your nose for granted. You breathe through it and you don’t even need to think about it. Breathing is an autonomic nervous system function; it just happens.

And, of course you use your nose for smelling, which you do notice, even though sometimes you wish you didn’t have to!

Your nose is a structure of cartilage and bone separated into two chambers by your septum. The shape and appearance of your nose is genetically determined, and there’s also something else about its appearance that you don’t control.

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Cartilage is one part of your body that continues to grow during your lifetime. Your nose does get bigger as you age.

Your nose is lined with mucosal membranes, hairs and sensory cells. When you breathe through your nose, the hairs remove foreign substances like dust or pollen and the mucosal membranes warm and moisturize the air.

High in the back of your nose there is a small patch of sensory cells that detect molecules carried by air and senses them as smells. Either you breathe in these molecules such as the smell of a skunk. Or, when you chew, food molecules move up the back of your throat and are detected as part of the taste of your food.

Nerve cells then carry messages from these sensory cells to your olfactory cortex, which interprets the smells.

About 12 per cent of Canadians at any one time have a loss of smell, technically known as anosmia. Anyone who has had a “plugged” nose with a cold will be familiar with this inability to smell. Loss of smell can occur slowly over time and is usually associated with nasal inflammation, sinus infections, nervous system diseases such as Alzheimer’s disease, or even older age.

Abrupt loss of smell is usually related to trauma, tumours, polyps or diseases like COVID-19. Whether the inability to smell is permanent or temporary depends upon the cause; once an infection has cleared, your sense of smell usually returns, but nervous system damage, aging and trauma-related causes are often irreversible.

Some drugs have been implicated in loss of smell. Zinc supplements, phenothiazine drugs used in psychosis and some drugs used to treat cancer can cause loss of smell, which can be permanent. Other drugs that can change your ability to smell include ibuprofen, antihistamines, ranitidine, potassium, the blood pressure medication nifedipine, and even diuretics or water pills.

Even oral inhalers used for breathing problems can alter your ability to smell because, as we said, your throat and nose are closely connected.

If your nose is plugged or you have nasal symptoms, you may want to use a nasal spray. Treating the symptoms locally in your nose avoids adverse reactions throughout your body, and is even safe for pregnant women. Saline nasal sprays and drops help moisturize your nasal passages and are considered safe for children.

Decongestant products are marketed to unplug congested nasal passages, but should be used no longer than a week. After that period of time your nasal passages depend upon the decongestant to remain open and rebound congestion can be more severe than your original symptoms.

There are as well corticosteroid nasal sprays which reduce inflammation and are ideal for nasal symptoms of allergies like hay fever. Some of these corticosteroid products are available without a prescription, but remember you need about two weeks to experience the maximum effect.

To receive the most benefit from your nasal spray you need to use it properly. Blow your nose before you use it; if you blow afterward you expel the medication. Some bottles of nasal sprays need priming and/or shaking before using; reading the product information will tell you whether your nasal spray does or not.

Keep upright and don’t tilt your head back otherwise the nasal spray will run into your throat not stay in your nose. Instill into one nostril at a time, holding the other nostril closed with your finger. Aim the spray away from your septum to avoid irritation and the risk for bleeding.

And, make sure you can sniff air before using a nasal spray. Otherwise you are spraying into a plugged nose!

About the author

Contributor

Marie Berry is a lawyer/pharmacist interested in health and education.

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