Chronic Sinusitis

What causes sinus headaches?

A headache is the characteristic feature of sinusitis, a painful inflammation of the sinuses usually caused by bacteria. The sinuses are air-filled cavities in the skull, lined with mucous membranes similar to those lining the nasal passages and the mouth. The sinuses warm and moisten the air you breathe.

Sinusitis is often a secondary bacterial infection that accompanies a cold. Allergies, polyps, and even tooth decay can cause an infection in the sinuses. The symptoms include pain around the upper cheeks, forehead, and eyes that sometimes get worse when you bend forward; dizziness or lightheadedness; and a thick yellow-green nasal discharge.

How can sinusitis be treated?

Breathing moist air helps to loosen the mucus and permit drainage, the goal of treatment. Put a towel over your head and breathe the steam from a sink or pan filled with hot water. Repeat this procedure 3 to 6 times a day for 5 to 10 minutes. It also helps to increase the humidity in your environment with a vaporizer, humidifier, or even a pan of water simmering on the stove. A warm, moist compress placed over the sinuses can make you more comfortable. Try above for temporary relief.

Never travel to a high altitude (greater than 5,000 feet) location or in an airplane when you have sinusitis. The pressure in the sinuses may be transmitted to the inner ear and eardrum, causing an ear infection and possibly perforating the eardrum.

If your sinusitis lasts for more than 2 or 3 days after a cold, you should see a doctor. You may require an antibiotic, and the doctor may take X rays for an accurate diagnosis.

How can acute sinusitis and chronic sinusitis sinus infections be prevented?

Proper rest, good nutrition, and regular exercise can help prevent this and many other infections. If you are susceptible to sinus infections, keeping the air you breathe moist with a humidifier is a preventive measure. Arid, desert air or heated air can dry and crack the sensitive sinus tissue, leaving it vulnerable to infection.

Avoid using a nasal spray. It may dry the external nasal passages temporarily but usually causes a rebound swelling of the sinuses when you stop its use. Also, you can become resistant to it in 3 to 4 days, and it will lose its effectiveness. If you use a spray, do so for only 1 or 2 days.

Decongestants used for more than a day or two can also overdry the mucous membranes and leave thick mucus that is unable to drain.

Avoid blowing your nose, and in particular blowing one nostril at a time. This may force an infection up into the opposite nasal passage and the inner ear.

Helpful Herbal Treatment for Chronic and Acute Sinusitis

Sinusitis Helpful Herb: Eucalyptus

Family: Myrtaceae

Species: Eucalyptus globulus (NOTE: There are over 700 different species of eucalyptus, with over 500 of those producing essential oil.)

Infection Control: antibacterial, antiviral, and antifungal

Actions: analgesic, antineuralgic, antirheumatic, antiseptic, antispasmodic, antiviral, balsamic, cicatrisant, decongestant, deodorant, depurative, diuretic, expectorant, febrifuge, hypoglycaemic, parasiticide, prophylactic, rubefacient, stimulant, vermifuge, vulnerary

Uses: Eucalyptus essential oil is used for respiratory illness including asthma, bronchitis, catarrh, colds, croup, flu, sinusitis, and tuberculosis. It is also used for feverish conditions including malaria, typhoid, cholera, and skin problems such as burns, ulcers, and wounds.

Safety: Eucalyptus oil is toxic if taken internally; but non-toxic used externally. Sensitization may occur in some individuals.

HOME REMEDIES:

If you're clogged, it's important to try to clear out your sinuses to prevent infection. Techniques include using Alkalol or Alkalol-like ingredients in a nose spray, neti pot, or bulb irrigator; using a steam inhaler; taking a hot shower with water running over your head; applying a hot compress to your nose and cheeks; dabbing eucalyptus oil on the outside of your nose; drinking hot tea and lots of liquids in general; and eating hot chicken broth with garlic.

Some people find that spicy foods (seasoned with garlic, cayenne pepper, ginger, wasabi, etc.) help open up their sinuses, while others find them sinus irritants. One trick is to carry wasabi (Japanese horseradish mustard) with you. It's available in small toothpaste-type tubes from many Asian grocery stores. Just place a dab on your tongue when you're congested.

Some sufferers use a vaporizer/humidifier at night to decongest, though you need to keep it clean as well as keep the humidity in the room from rising above 50 percent to prevent mold and dust-mite growth.

Another technique is nasal massage, which can soothe your sinuses, reduce swelling, and encourage blood flow to the area. Gently rub the sides of your nose and your cheeks with your fingers or knuckles.

A recent sinus article in the Mayo Clinic Proceedings, however, has brought candida more into the mainstream by reporting that the vast majority of sinusitis patients studied by the Mayo Clinic have fungal growth in their sinuses.

Some doctors still dispute the importance of candida and other fungi for sinus patients because the criteria the Mayo researchers used for measuring fungal growth were less stringent than is commonly used and because small amounts of fungi are commonly present even in people not suffering from sinusitis or any other health condition.

The Mayo doctors contend that it's not the fungi itself in the sinuses that causes problems but the allergic response to it by some individuals.

Researchers at the Mayo Clinic are further investigating, including developing possible new treatments.

In the meantime, antifungal drugs such as Sporanox and Amphotericin B are available, though they don't penetrate the sinuses particularly well and frequently have side effects. Also available are antifungal diets, such as the one described in Dr. Ivker's book.

The special anti-sinusitis diet consists primarily of vegetables and non-red-meat sources of protein, eliminating refined sugar, bread and other foods made with yeast, dairy, mushrooms, fried foods, grapes and some other fruit, alcohol, and a number of other foods and drinks.

Substances that are thought to have anti-fungal properties include garlic, the herbs barberry and oregano, and the bacteria Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus bulgaricus (in some yogurts or available in pill form in health food stores).

Sinusitis: Sinus Pain, Drainage & Infection

Did you know... sinus problems affect an estimated 35 million Americans, making sinusitis conditions one of the most common complaints of patients seeking medical attention There are four pairs of sinuses in the head that control the temperature and humidity of the air reaching the lungs no matter how hot, cold, or dry the weather.

Sinuses begin as pea-sized pouches in the newborn, extending outward from the inside of the nose into the bones of the face and skull. They expand and grow through childhood into young adulthood.

They are air pockets: cavities that are lined with the same kind of membranes lining the nose, and are connected to the inside of the nose through small openings about the size 'of a pencil lead.

Normally, the nose and sinuses produce between a pint and a quart of mucus secretions per day. This passes into and through the nose, picking up dust particles, bacteria and other air pollutants along the way. The mucus is swept to the back of the throat by millions of tiny hair-like structures (cilia), which line the nasal cavity; and is swallowed. In the stomach acids destroy any dangerous bacteria. Most people do not notice this mucus flow because it is just a normal bodily function.

Sinusitis Symptoms: Sinus infection can be divided into two types, acute sinusitis, which is frequently a temporary condition. Whereas Chronic sinusitis is an ongoing condition.

Acute Sinusitis: If a cold becomes worse, acute sinusitis may develop and may eventually lead to an even worse sinus problem known as chronic sinus condition. You should see a doctor if you experience the following: 1.) Green / yellow nasal discharge. 2.) Facial pressure around the cheeks, eyes, and forehead, especially with swelling, 3.) High fever (102" F and above), or 4.) Upper molar tooth pain.

Chronic Sinusitis: Patients with chronic sinus infections probably have had sinusitis for some time and had prior episodes of acute sinus infection, which failed to go away or be cured. They may also complain of having a continuous cold. Common symptoms include:

• 1. Low grade fever (less than 101 F),
• 2. Nasal congestion/nosebleed,
• 3. Headaches,
• 4. Chronic sore throat and cough,
• 5. Poor or decreased sense of smell.

What Causes Acute or Chronic Sinus Problems?

When the openings into the sinuses become plugged up sinus pressure develops and the nose may feel blocked. These blockages may be caused by infections, irritants, anatomic (physical) problems, and allergies. Sinus disease can be common among family members, and even stress may play a role in chronic sinus diseases.

Causes of blockage: 1. Infection: Most adults viral get colds and upper respiratory infections about three times per year. Children get them more frequently. Bacterial infections often follow the common cold. When the mucus changes from clear to yellow or green, it usually means a bacterial infection has developed. Bacterial and bacterial infections cause swelling of the tissues inside the nose and thickening of the normal mucous. This slows down or even stops proper sinus drainage.

2. Irritants: Air pollution, smoke, and chemical irritants (e.g., some sprays containing pesticides, disinfectants, and household detergents) may cause swelling and blockage of the narrow channels from the nose to the sinuses, leading to bacterial growth and sinus infection.

3. Anatomic Problems: In some people, the cartilage and bone in the center of the nose (called the septum) can be shifted to one side through injury while others may be born that way. If this shift is severe, sinus drainage on that side of the nose can he affected. This can lead to complete closure of one or several of the sinus channels. Mucus then builds up behind these obstructions and causes sinus infection. If the swelling becomes severe, the lining of the sinuses can grow excessively. These growths are called nasal polyps, which can cause further blockage of the sinus channels. Trapped or stagnant mucus provides a breeding ground for bacteria.

4. Allergies: Allergies can cause inflammation inside the nose. Common symptoms of an allergic reaction include; nasal stuffiness, runny nose, sneezing, and itchy, watery eyes. Chronic sinusitis is sometimes associated with asthma. Allergies are responsible for asthma in some patients and may also cause nasal stuffiness, resulting in a strain on the lungs that makes the asthma worse

Diagnosis and Treatment

Before starting treatment, your doctor will take a complete medical history and perform a physical examination. Acute sinusitis is usually treated with antibiotics and decongestants. Chronic sinusitis may need long-term treatment (eight weeks or longer), for maximum effectiveness.

Medical treatment options include antibiotics, decongestants, Medicines that thin the mucus, nasal steroid sprays, and oral steroids. Some antihistamines have side effects, and only patients with documented allergies should use them.

Discuss over-the-counter anti-histamines with your physician; the side effects may be greater than the benefits. If treatment does not cure your sinusitis, or it recurs, a CAT scan may be necessary to evaluate the sinuses and the drainage channels in the nose that are not visible on a routine examination. Small telescopes (endoscopes) may also be used to look directly inside the nose.

Sinus Surgery: Surgery should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications. When surgery is needed, the ENT specialist can choose from a number of different options, depending on the severity of sinus disease and the type of sinus surgery best suited to the patient.

Surgery can be performed under the upper lip, behind the eyebrow, next to the nose or scalp, or inside the nose itself. Another type of surgery is called functional endoscopic sinus surgery (FESS). It is used for certain types of sinus disease.

With the endoscope, the surgeon can look directly into the nose, while at the same time, remove diseased tissue and polyps, and clear the narrow channels between the sinuses. The decision whether to use local or general anesthesia will be made between you and your doctor, depending on your individual circumstances.

Getting Ready for Surgery: Before surgery, be sure you understand all the possible risks and benefits of the procedure and you are aware of realistic results, recovery time, and post-operative care. Good results require not only good surgical techniques, but the cooperation of the patient throughout the healing process. It is especially important for patients to follow pre and post-operative directions.

After the Operation: Following surgery, endoscopes may be used to monitor healing, to keep the nose clean, and to prevent recurring obstructions. Sometimes the results are not immediate. It may take 12 weeks or longer before the sinus cavity heals. Patients with chronic sinus problems who are hypersensitive to air pollution or with allergies may require on-going medical care.

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