Patient Education - Sinusitis
Background for Nasal and Sinus Discomfort
The body's nasal and sinus membranes have similar responses to viruses, allergic insults, and common bacterial infections. Membranes become swollen and congested. This congestion causes pain and pressure; mucus production increases during inflammation, resulting in a drippy, runny nose. These secretions may thicken over time, may slow in their drainage, and may predispose to future bacterial infection of the sinuses. Congestion of the nasal membranes may even block the Eustachian tube leading to the ear, resulting in a feeling of blockage in the ear or fluid behind the eardrum. Additionally, nasal airway congestion causes the individual to breathe through the mouth.
Each year, more than 37 million Americans suffer from sinusitis, which typically includes nasal congestion, thick yellow-green nasal discharge, facial pain, and pressure. Many do not understand the nature of their illness or what produces their symptoms. Consequently, before visiting a physician, they seek relief for their nasal and sinus discomfort by taking non-prescription or over-the-counter (OTC) medications.
You're coughing, sneezing, tired and achy. You think that you might be getting a cold. Later, when the medicines you've been taking to relieve the symptoms of the common cold are not working and you've now got a terrible headache, you finally drag yourself to Dr. Zimm. After listening to your history of symptoms, examining your face and forehead, and perhaps doing a sinus x-ray, the Dr. Zimm says you have sinusitis. Sinusitis simply means your sinuses are infected or inflamed, but this gives little indication of the misery and pain this condition can cause.
Types of Sinusitis
- Acute sinusitis - which lasts for 3 weeks or less.
- Chronic sinusitis - which usually lasts for 3 to 8 weeks but can continue for months or even years.
- Recurrent sinusitis - which is several acute attacks within a year.
Causes of Acute Sinusitis
Most cases of acute sinusitis start with a common cold, which is caused by a virus. These viral colds do not cause symptoms of sinusitis, but they do inflame the sinuses. Both the cold and the sinus inflammation usually go away without treatment within 2 weeks time. The inflammation, however, might explain why having a cold increases your likelihood of developing acute sinusitis. For example, your nose reacts to an invasion by viruses that cause infections such as the common cold or flu by producing mucus and sending white blood cells to the lining of the nose, which congest and swell the nasal passages. Most healthy people harbor bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae, in their upper respiratory tracts with no problems until the body's defenses are weakened or drainage from the sinuses is blocked. Acute sinusitis is much more common in some people than in the general population. For example, sinusitis occurs more often in people who have reduced immune function (such as those with immune deficiency diseases or HIV infection) and with abnormality of mucus secretion or mucus movement (such as those with cystic fibrosis).
Causes of Chronic Sinusitis
If you have asthma, an allergic disease, you may have frequent episodes of chronic sinusitis. If you are allergic to airborne allergens, such as dust, mold, and pollen, which trigger allergic rhinitis, you may develop chronic sinusitis. In addition, people who are allergic to fungi can develop a condition called 'allergic fungal sinusitis.' If you are subject to getting chronic sinusitis, damp weather, especially in northern temperate climates, or pollutants in the air and in buildings also can affect you. Like acute sinusitis, you might develop chronic sinusitis if you have an immune deficiency disease or an abnormality in the way mucus moves through and from your respiratory system (e.g., immune deficiency, HIV infection, and cystic fibrosis). In addition, if you have severe asthma, nasal polyps (small growths in the nose), or a severe asthmatic response to aspirin and aspirin-like medicines such as ibuprofen, you might have chronic sinusitis often.
How is Sinusitis Treated?
Sinusitis is generally first treated with antibiotics, decongestants and/or anti-inflammatory drugs. If medication is not effective, or if there is a blockage, surgery is generally recommended. Your sinus specialist will prescribe medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) and procedures (flushing) for treating acute sinusitis.