Consider the following causes:
- rhinitis, sinusitis, polyps
- deviated nasal septum
- granulomatous conditions
- sino-nasal malignancy
Treat rhinitis with a topical steroid spray. If confident that polyps are present, consider steroid drops or even short course oral prednisolone.
If there is unilateral obstruction and/or blood stained discharge, please send an urgent referral to ENT.
Consider routine referral to ENT if medical treatment fails.