It is estimated that 35 million people in the U.S. alone suffer from sinusitis and it can have a major impact on their quality of life.

Acute Sinusitis

Definition

Acute sinusitis (inflammation of the sinuses) also called 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 amoxicillin 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 the blood vessels in the sinuses. These can only be used short term, have side effects and can be addictive. Pharmaceutical nasal sprays can cause a condition called ‘Rhinitis Medicamentosa’ which actually makes the nasal congestion worse. They do not treat any infection present.

4. Over the counter pain relievers - Aspirin and Ibuprofen can 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 which relieve inflammation, nasal congestion, sinus pain, headaches, remove airborne irritants etc. SinuSoothe is anti-bacterial and anti-fungal and can therefore help get rid of any infection present. In addition it contains natural anti-histamines that relieve a runny, itchy nose and sneezing etc. Natural nasal sprays can be used long term, are non addictive and have 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 nasal congestion. They can be either isotonic or hypertonic solutions. These can be used long term, have no side effects and are non-addictive. They may 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 may help reduce inflammation and relieve nasal congestion. It is a good practice for keeping your sinuses clean and removing irritants. It is completely safe provided you use the correct saline solution.

8. Over the counter anti-histamines - These are available as tablets or syrups such as Benadryl and are useful for sinusitis caused by allergies. They reduce histamine thereby reducing allergy symptoms such as nasal congestion. However they can cause various side effects such as drowsiness.

Chronic Sinusitis

Definition

Chronic sinusitis 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 membranes 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 may make chronic sinusitis worse.

2. Nasal corticosteroids - Steroid nasal sprays such as Beconase can reduce inflammation for chronic sinusitis and allergies 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 - OTC decongestants such as Sudafed can relieve nasal congestion to help you breathe more easily. Like any medication they have side effects.

5. Over the counter decongestant nasal sprays - OTC nasal sprays such as Vicks Sinex can relieve inflammation and nasal congestion by shrinking the blood vessels in the sinuses. These can only be used short term, have side effects and can be addictive. Pharmaceutical nasal sprays can cause a condition called ‘Rhinitis Medicamentosa’ which actually makes the nasal congestion worse. They do not treat any infection present.

6. Over the counter pain relievers - Aspirin and Ibuprofen can be used to relieve pain and inflammation. However they can cause side effects such as slowing down the digestive system and internal bleeding.

7. Natural nasal sprays - Natural nasal sprays such as SinuSoothe contain natural ingredients which relieve inflammation, nasal congestion, sinus pain, headaches, remove airborne irritants etc. SinuSoothe is anti-bacterial and anti-fungal and can therefore help get rid of any infection present. In addition it contains natural anti-histamines that relieve a runny, itchy nose and sneezing etc. Natural nasal sprays can be used long term, are non addictive and have no side effects.

8. Saline nasal sprays - Saline nasal sprays such as Sterimar are useful for moisturising the nasal passages, removing airborne irritants and relieving nasal congestion. They can be either isotonic or hypertonic solutions. These can be used long term, have no side effects and are non-addictive. They may help reduce inflammation.

9. 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 may help reduce inflammation and relieve nasal congestion. It is a good practice for keeping your sinuses clean and removing irritants. It is completely safe provided you use the correct saline solution.

10. 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 by either blowing your nose or using a decongestant nasal spray. This type of nasal spray can cause side effects such as headaches, drying of nasal tissue, swelling of face etc.

11. Over the counter anti-histamines - These are available as tablets or syrups such as Benadryl and are useful for sinusitis caused by allergies. They reduce histamine thereby reducing allergy symptoms such as nasal congestion. However they can cause various side effects such as drowsiness.

12. Natural anti-histamines - Chronic sinusitis caused by allergies would benefit from these. Quercetin and butterbur can be just as effective as OTC anti-histamines but without their side effects. Your local health food store should be able to advise you on these and others. It usually takes about 4 weeks for these to start taking effect.

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 minimised whenever possible. It reduces immune function and causes ‘flare ups’. Vitamin B complex assists the body during stressful times and magnesium, 5htp etc. can help to relax you. There are also plenty of other supplements that can relieve stress and help you to cope with it better. 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 supplementing with good quality vitamins etc. will improve immune system function and your ability to fight infection. Vitamin C, vitamin B complex, garlic and a multi-vitamin & mineral would help boost your immune system. Your local health food store should be able to advise you.

17. Natural anti-inflammatories- Since the symptoms of chronic sinusitis are caused by inflammation it follows that by reducing inflammation you will reduce the severity of 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. Pollen barriers - Pollen barriers such as petroleum jelly or special barrier gel inside the nostrils can catch pollen before it enters the nasal passages thus relieving hay fever symptoms.

19. Red light phototherapy - This involves inserting two narrow red light probes in to your nostrils. The light reduces inflammation.

20. Immunotherapy - This is often a last option. 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 desensitise your immune system to the allergen. You have to be referred to an allergy clinic in order to receive this treatment.

21. 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 in some cases it does not work and as with any surgery it carries with it it’s own risks.

22. Balloon Sinuplasty - This uses a small, flexible, sinus balloon catheter to open up blocked sinus passages, restoring normal sinus drainage. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

As with all medical conditions you should consult your doctor before undertaking new treatments.