It is estimated that 35 million people in the U.S. suffer from sinusitis. It is a major source of misery for the sufferers and can lead to depression, anxiety and mood disorders.
Acute Sinusitis
Definition
Acute sinusitis (inflammation of the sinuses) also known as acute rhinosinusitis does not last for more than 12 weeks.
Causes
The mucous membranes of the nasal passages become swollen and inflamed, the openings get blocked and proper sinus drainage is inhibited leading to a mucous build up. These blocked, inflamed sinuses create a moist environment that makes it easier for bacterial infection to occur and take hold. Usually a cold/flue or allergies cause the nasal congestion to occur.
Symptoms
Sinus/facial pain, sinus/facial tenderness, sinus/facial pressure, headaches, pain in teeth, pain in jaw, pain in ears, pain through and around eyes, fatigue, dizziness, drainage of a thick yellow or green discharge from the nose or down the back of the throat (post nasal drip), nasal congestion and difficulty breathing, reduced sense of smell and taste, cough (which may be worse at night), nausea, sore throat and halitosis (bad breath).
Treatments
1. Anti-biotics - A course of anti-biotics such as amoxicillan prescribed by a doctor usually gets rid of acute sinusitis.
2. Over the counter decongestant tablets and liquids - OTC decongestants such as Sudafed can relieve nasal congestion to help you breathe more easily. Like any medication they have side effects.
3. Over the counter decongestant nasal sprays - OTC nasal sprays such as Vicks Sinex can relieve inflammation and nasal congestion by shrinking blood vessels in the sinuses. These can cause side effects and should only be used short term (see manufacturers instructions) otherwise you can get rebound congestion (when you stop using it the congestion is worse than before) leading to dependency. Also prolonged use can lead to permanent damage of the delicate linings of the nasal passages and a condition called 'Rhinitis Medicamentosa'.
4. Over the counter pain relievers - OTC pain relievers such as Aspirin and Ibuprofen can be used to relieve inflammation and pain. However they can cause side effects such as slowing down the digestive system and internal bleeding.
5. Natural nasal sprays - Natural nasal sprays such as SinuSoothe contain natural ingredients that relieve inflammation, sinus pain, headaches, nasal congestion, remove airborne irritants etc. It is also ant-bacterial and anti-fungal so can therefore help get rid of any infection present. For allergy sufferers it contains natural anti-histamines to relieve a runny, itchy nose and sneezing. It can be used long term, is non-addictive and has no side effects.
6. Saline nasal sprays - Saline nasal sprays such as Sterimar are useful for moisturising the nasal passages, removing airborne irritants and relieving congestion. These can be either isotonic or hypertonic solutions.These can be used long term and are non-addictive. They can help reduce inflammation.
7. Nasal irrigation - A neti pot is used to irrigate the sinuses with either an isotonic or hypertonic solution. An isotonic solution has the same salt concentration as your body. A hypertonic solution has a higher salt content and may be more useful at drawing moisture and mucous from the sinuses. This can help relieve nasal congestion and may reduce inflammation. This is a good practice for keeping the sinuses clean and many people have benefited from daily nasal irrigation.
Chronic Sinusitis
Definition
Chronic sinusitis, also known as chronic rhinosinusitis, lasts longer than twelve weeks or keeps coming back and people have been known to suffer from it for over fifty years. This can really have a profound affect on peoples quality of life.
Causes
The mucous membranes of the nasal passages become swollen and inflamed, the openings get blocked and proper sinus drainage is inhibited leading to a mucous build up. These blocked, inflamed sinuses create a moist environment that makes it easier for bacterial infection to occur and take hold.
It is caused by;
1. recurring bouts of acute sinusitis combined with a low immune system.
2. allergies.
3. fungal infections.
4. nasal polyps (growth in the sinuses) or tumours.
5. deviated nasal septum.
6. trauma to the face (a fractured or broken bone may obstruct the sinuses).
7. Medical conditions such as cystic fibrosis, gastroesophageal reflux, HIV and other immune system diseases.
8. Immune system cells (with certain health conditions immune cells called eosinophils can cause inflammation).
9. Regular exposure to pollutants such as cigarette smoke.
Symptoms
Sinus/facial pain, sinus/facial tenderness, sinus/facial pressure, headaches, pain in teeth, pain in jaw, pain in ears, pain through and around eyes, fatigue, dizziness, drainage of a thick yellow or green discharge from the nose or down the back of the throat (post nasal drip), nasal congestion and difficulty breathing, reduced sense of smell and taste, cough (which may be worse at night), nausea, sore throat and halitosis (bad breath). The fatigue is worse in chronic sinusitis than acute sinusitis.
Treatments
1. Anti-biotics - Unfortunately anti-biotics do not get rid of chronic sinusitis. The Mayo Clinic in the U.S. have conducted clinical trial and discovered that 96% of people with chronic sinusitis have a fungal infection. There is a theory that this fungal infection irritates the sinus passages and they become inflamed. That is why anti-biotics prescribed to treat chronic sinusitis do not work since they cannot kill the fungal infection. In fact since anti-biotics themselves are a mold, they can make fungal infection worse (which may make chronic sinusitis worse).
2. Nasal corticosteroids - Steroid nasal sprays such as Beconase can reduce inflammation for sinusitis and allergy sufferers, usually start to work within a few hours, and are used twice a day at most. They are particularly useful at reducing nasal polyps. However they can cause side effects such as nasal ulcers, cataracts, headaches, sore throat etc. and they do not treat any underlying infection.
3. Oral or injected corticosteroids - These are used for severe sinusitis. They can cause severe side effects and do not treat underlying infection.
4. Over the counter decongestant tablets and liquids - see acute sinusitis.
5. Over the counter pain relievers - see acute sinusitis.
6. Natural nasal sprays - see acute sinusitis.
7. Saline sprays - see acute sinusitis.
8. Nasal irrigation. see acute sinusitis.
9. Over the counter decongestant nasal sprays - These are not suitable for chronic sinusitis since they should not be used on a long term basis.
10. Over the counter pain relievers - see acute sinusitis.
11. Non-steroid nasal sprays - Non-steroid nasal sprays such as NasalCrom can relieve allergies by reducing histamine production in the nasal tissue. If nasal congestion is present the sinuses have to be cleared before using it by either blowing your nose or or using a decongestant nasal spray. This type of nasal spray is not always successful and can have side effects such as headaches, drying of nasal tissue, swelling of face etc.
12. Over the counter anti-histamines - These are available as tablets or syrups such as Benadryl. They can reduce the amount of histamine produced during an allergic reaction thereby reducing the symptoms such as nasal congestion. However they can cause various side effects such as drowsiness.
13. Nasal anti-histamines - Nasal anti-histamines such as Astelin are steroid free and help patients to be symptom free from their allergies for up to 12 hours. They can however cause side effects such as headaches, drowsiness etc.
14. Reducing stress levels - Stress contributes to ill health and should be avoided whenever possible. It reduces immune function and can aggravate any medical condition. Vitamin B complex assists the body during stressful times and magnesium can relax you. There are also plenty of other herbs and supplements that can relieve stress. Your local health food store should be able to advise you. Pressure is healthy, stress is not.
15. Exercise - Exercise has been known to reduce chronic sinusitis symptoms since the endorphins released during exercise act as natural painkillers. It can also improve immune function provided it is not over strenuous.
16. Boosting immune system - Eating a balanced diet and supplementation with vitamins and minerals will improve the immune function and the ability to fight off infection. Vitamins; vitamin C, B complex, multi-vitamin and garlic.
17. Natural anti-inflammatories - Since inflammation causes the symptoms of sinusitis it is logical that anti-inflammatories will reduce inflammation therefore relieve the symptoms. Omega 3,6 & 9 oils, vitamin C, turmeric and ginger are all excellent natural anti-inflammatories. There are plenty of others and your local health food store should be able to advise you on these. It usually takes about 4 weeks for these to start taking effect.
18. Natural anti-histamines - For chronic sinusitis caused by allergies, quercetin and butterbur etc. can be just as effective as OTC anti-histamines but they do not have their undesirable side effects. It usually takes about 4 weeks for these to start taking effect.
19. Pollen barriers - For sinusitis caused by hayfever, pollen barriers such as petroleum jelly or special barrier gels inside the nostrils can catch pollen before it enters the nasal passages.
20. Red light phototherapy - This involves inserting two narrow red light probes in to your nostrils. The light reduces inflammation in the nasal membranes.
21. Immunotherapy - This is often a last option for allergy sufferers. Very small amounts of the allergen you are allergic to is either injected in to your body or ingested in a tablet form, to gradually desensitize your immune system to the allergen. You have to be referred to an allergy clinic in order to receive this treatment.
22. Surgery - Surgery can be carried out to remove a nasal polyps, rectify deviated septum or remove infected unhealthy sinus tissue. Surgery should be considered as a last resort for chronic sinusitis as any form of surgery carries a risk and it is not always guaranteed to work.
As with all medical conditions you should consult your doctor and any specialist before embarking on new treatments.
