The Do’s And Dont’s of Sinusitis
16 Aug 2004
I must confess I’ve been putting off writing this column for a long time. Sinusitis seems to be such a dull, boring, uninteresting topic compared to most medical troubles. But nevertheless this condition affects millions of people and it’s a damn annoying condition when it strikes. There are also some important do’s and dont’s in treating sinusitis.
Dr. Ron Fenton, Otolaryngologist-in-Chief at St. Michael’s Hospital in Toronto, reports in the University of Toronto Health News that one in 200 colds will be complicated by an attack of sinusitis. And the number of cases is increasing.
Sinusitis normally starts as a viral infection which causes inflammation and blocks the sinusues. Patients then often get a bacterial infection on top of the viral infection.Dr Fention says it’s not clear why some people are more prone to sinusitis. But it tends to occur more often in patients suffering from asthma, weak immune systems and those with cystic fibrosis. Other cases may be related to a deviated nasal septum and allergies may also play a role.
A full-blown case of acute sinusitis is associated with facial pain, a plugged nose , fever, swelling around the eyes, general malaise, a feeling your head is about to explode and copious amounts of thick, yellow, green or white discharge. Acute sinusitis usually lasts for less than three weeks. Chronic sinusitis can persist for months or recur after several months. This condition is often accompanied by headaches, throbbing in the head, cough, sore throat, low grade fever and a feeling that mucus is constantly dripping down the back of the nose and throat.
Dr. Fenton says "not every sinus infection requires treatment." This a refreshing remark, that we don’t have to run to the doctor or pharmacy for drugs and antibiotics. People forget that our immune systems can normally fight non-lethal infections without help. Unfortunately this advice too often goes in one ear and out the other.
Luckily, saying no to treatment is rarely a life-threatening decision. But the frontal sinuses are close to the eyes and brain. So, on rare occasions, infection can spread to the bones in the face and head causing meningitis or brain abscess with serious complications.
If it is decided that treatment is prudent there are several options. Some doctors prescribe a 10 day course of the antibiotic, amoxicillin. But if it’s being used to treat chronic sinusitis it may be needed for several weeks. And remember don’t stop taking antibiotics when you start feeling better. You may get a relapse, make it harder to treat later infection and contribute to drug-resistant bacteria.
In any pharmacy you’ll find an arm full of decongestants, antihistamines, steroids and other agents to treat sinusitis. But never forget a basic rule of life. It’s an extremely rare situation when you get something for nothing, particularly when it concerns medication.
Dr. Fenton reports that decongestant nasal sprays initially ease breathing, but they also decrease blood flow and may cause "rebound stuffiness".
But if you pass up decongestants and decide on antihistamine medication hoping it will relieve the symptoms and decrease the flow of mucus think again. Dr. Fenton says antihistamines thicken mucus secretions making them pool, thus aggravating the situation. But they can be helpful if there’s an allergic component causing sinusitis. Topical nasal steroid sprays, can also reduce swelling of nasal mucous membranes if an allergy is present. Is there anything that can prevent a cold from developing into sinusitis? Keep in mind old fashioned remedies that are also free of complications. Drinking more fluids helps and breathing in steam in a steam-filled room acts to clear sinuses. Since dry air aggravates sinus membranes consider buying a humidifier. Some patients also find air-conditioning helpful. And if you ‘re suffering from repeated attacks of sinusitis and still smoking it’s time to see a psychiatrist.
Surgical procedures to treat sinusitis should be considered a last resort as any operation can lead to complications. Luckily most people do not suffer enough from sinusitis to warrant this approach.
I’m hoping this has been helpful and hasn’t put you to sleep.
