Sinusitis occurs when your sinuses, air filled cavities around your nose, eyes, and cheeks, get inflamed. The inflammation is often due to an infection, caused by a virus (such as a cold), bacteria, or fungus. When your sinuses are inflamed, mucus cannot drain. Eventually, the sinus cavities become blocked, making it difficult for your body to heal the infection.
Sinusitis can be acute (with symptoms lasting fewer than 8 weeks), chronic (with symptoms recurring or lasting longer than 8 weeks), or recurrent (with 3 or more acute episodes a year). Sinusitis is very common.
The symptoms of acute and chronic sinusitis are similar. Chronic sinusitis usually does not cause fever and its symptoms last longer. Chronic sinusitis is most common in people who have allergies.
Sinusitis usually follows an upper respiratory infection (such as a cold) or an allergic reaction (such as hay fever or allergic rhinitis). These can cause inflammation and swelling that prevent the sinuses from draining properly. When sinuses become blocked, they provide a place for bacteria, viruses, and fungus to live and grow rapidly. Although a cold is most often the culprit, anything that prevents the sinuses from draining can cause sinusitis.
Other common causes of sinusitis include:
Risk factors for sinusitis include:
Although chronic sinusitis can be hard to diagnose because symptoms are similar to cold symptoms, your health care provider can generally diagnose sinusitis from your medical history and by examining you. If your provider suspects chronic sinusitis, they may order imaging tests, including an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI).
If your provider suspects allergies may be causing your sinusitis, they may suggest an allergy test. Sometimes, a referral to a specialist, known as an ear, nose, and throat (ENT) doctor or an otolaryngologist, is necessary. This specialist may perform a nasal endoscopy using a fiber optic scope to look at your sinuses.
The best way to prevent sinusitis is by:
Treatment of sinusitis aims to reduce inflammation and clear your sinuses. Your doctor may prescribe antibiotics or corticosteroids. Lifestyle changes, such as using a humidifier or irrigating your nasal passages with salt water, may also help. Several dietary supplements and herbs may help prevent colds and flu, shorten their duration, or work together with antibiotics to treat your infection and support your immune system.
These measures can help reduce congestion in your sinuses:
Antibiotics. Your health care provider may prescribe antibiotics if your symptoms suggest you have a bacterial infection. However, antibiotics should not be prescribed for mild-to-moderate sinusitis within the first week of the illness. To treat acute sinusitis, you may take from 10 to 14 days of antibiotics. Treating chronic sinusitis may take longer, usually 3 to 4 weeks.
Nasal corticosteroids. These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although it can take from a few days to a week after you start using them to see improvement.
Antihistamines. Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter (OTC) remedies. OTC antihistamines are short acting and can relieve mild-to-moderate symptoms. All work by blocking the release of histamine in your body.
Decongestants. Many OTC and prescription decongestants are available in tablet or nasal spray form. They are often used with antihistamines. Oral and nasal decongestants include Sudafed, Actifed, Afrin, Neo-Synephrine. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or an enlarged prostate should not take drugs containing pseudoephedrine. Nasal decongestants can cause "rebound congestion," where the nasal passages swell. Avoid using nasal decongestants for more than 3 days in a row, unless instructed by your health care provider, and do not use them if you have emphysema or chronic bronchitis.
For chronic sinusitis that does not respond to medication, your doctor may recommend endoscopic sinus surgery, which may be done to remove polyps or bone spurs. Enlarging the sinus opening is also sometimes recommended. A newer procedure called balloon rhinoplasty involves inserting a balloon inside the sinus cavity and then inflating it. Your health care provider may suggest other alternatives.
Because supplements may have side effects, or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care provider.
Although studies are few and have found conflicting results, some people may find that acupuncture helps relieve symptoms of sinusitis. Acupuncturists usually describe sinusitis as "dampness," which creates inflammation and congestion in the mucus membranes. This dampness is cleared by strengthening the spleen meridian, and by working with the stomach meridian. Practitioners often perform needling therapy or moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) for this condition.
A 2009 double-blind, randomized, controlled study found that acupuncture significantly improved nasal air flow and decreased congestion in participants with chronic sinusisits. These benefits also increased 30 minutes after treatment.
Some practitioners suggest chiropractic care may decrease pain and improve sinus drainage for some people.
Few studies have examined the effectiveness of specific homeopathic remedies. In one study of homeopathy for sinusitis, more than 80% of the 119 participants had significant improvement in their symptoms after taking the homeopathic remedy for 2 weeks without antibiotics or other medications. Professional homeopaths may recommend one or more of the following treatments for sinus congestion based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is their physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
If you are not better in a few weeks, your doctor may refer you to an ENT specialist for tests to find the cause of your sinus infection.
Sinusitis often acts up during pregnancy. There are many herbs and medications that pregnant and breastfeeding women should not use. Always ask your doctor before taking any medication, whether prescription, over the counter, or alternative.
Some serious diseases have similar symptoms to sinusitis. Be sure to see your health care provider if you are not feeling better or have new symptoms. Tell your health care provider if you may be pregnant.
Acute sinusitis is usually curable. If you have recurrent attacks, you should be evaluated for underlying causes (such as nasal polyps or another structural problem). Although very rare, complications may include:
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M Editorial team.
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