By Alfred Mangonese
If you have a stuffy nose for more than a week or two, you may not be suffering from a cold—but from sinusitis. That’s an inflammation or infection of the sinuses, the hollow spaces in the bones near the nose.
Among other functions, the four groups of sinuses warm humidify air on its way from the nostrils to the lings. A lining of mucus keeps the sinuses moist.
When everything’s working right, tiny hairs called cilia sweep mucus from sinuses down into the nose. But when passages connecting the nose and the sinuses are congested such as during a cold or allergy attack—the sinuses may fail to drain. Bacteria and/ or fungi multiply in trapped mucus, causing infection.
Sinusitis can lead to persistent cough or bronchitis and can exacerbate existing cases of asthma. In rare cases it can result in a life threatening infection of the eyes or brain.
Symptoms and Causes
Sinusitis is usually marked by severe congestion headache, mild fever pain in the face or teeth and …and a thick yellowish-green nasal discharge that continues all day and night. Some sinusitis sufferers are sensitive to shifts in barometric pressure—for example, on plane flights or during changes in the weather.
The common cold, in contrast, is the characterized by watery white or yellow mucus that clears up as the day goes on. Allergies are often accompanied by itching and watering eyes.
Most cases of sinusitis occur during or shortly after a cold. Other cases are caused by irritants… mouth infections…or anatomical problems, such as nasal polyps or a deviated septum, which obstruct sinus drainage.
More than forty percent of cold-related sinus attacks get better without treatment as sinuses begin to drain again. But sinusitis often becomes chronic, creating long-term changes in the delicate lining of the sinus (the mucosa).
Chronic sinusitis may damage the cilia or acidify the mucus, leading to further irritation and inflammation. Over time, repeated bouts of sinusitis can permanently narrow the opening of the sinusitis into the nose.
Treating Acute Sinusitis
The standard treatment for acute sinusitis is a course of antibiotics lasting 10 to 14 days…plus oral decongestants and nasal spray. Antihistamines are not recommended because they can be too drying.
Caution: Using over-the counter decongestant nasal sprays for more than five days can produce a “rebound” effect, in which the sprays themselves cause the nose to clog up.
With antibiotics, it’s important to take the full course—even after you start feeling better. Otherwise, you create prime breeding condition for drug-resistant bacteria.
Another good treatment for acute sinusitis is saline irrigation. When done under a doctor’s supervision, it can be highly effective at reducing nasal and sinus congestion.
What to do: Each morning, fill a clean, narrow-tipped plastic squeeze bottle with a mixture of one teaspoon salt to one pint lukewarm water. As you lean over a sink, squirt the solution into your nose until it’s all gone. The solution will drain out. Be sure to clean the container and tip after each use.
Treating Chronic Sinusitis
Chronic sinusitis is harder to treat. In addition to decongestant sprays and pills, a three-week course of antibiotics is often helpful. If there’s still no improvement at that point, see an allergist or otolaryngologist.
To pinpoint the source of your sinus trouble, this doctor may recommend an X-ray or CT scan…or perform endoscopy.
Via this simple procedure—done in the doctor’s office—the doctor can determine whether you have nasal polyps or another anatomical obstruction. If so, surgery to remove polyps or to widen the sinus opening slightly may be helpful.
If your sinusitis is diagnosed as allergy-related, it may be necessary to avoid dust, animal dander and other allergens.
Nasal medications such as steroid inhalers may also provide recurrence; take precautions whenever you have a cold—to keep it from turning into a sinus attack.
Note: Alfred Mangonese is a nurse practitioner. He lives and works in Beaufort, South Carolina.