What is sinusitis?
Sinusitis is an inflammation with swelling of the facial or forehead sinus spaces, which are air spaces behind the cheekbones, between the eyes, and behind the forehead. These sinuses are lined with a mucus layer and tiny hairs called cilia, which trap and expel bacteria and pollutants. Normally, sinuses are filled with air, but when sinuses become blocked and fill with fluid a bacterial infection, or less commonly a fungal infection, can result.
The function of the sinuses is to help control the temperature and water content of inhaled air reaching the lungs. Our noses are designed to serve as high-efficiency air filters. When fully functioning, the human nose is capable of filtering 80% of substances from the air. The cilia are equipped with mucus that’s loaded with substances to counteract toxins and other dangerous elements in the air.
Any condition that inflames the nasal and sinus cavities can cause a blockage of the narrow passageways that drain the sinuses, such as a cold, viral infection, allergic rhinitis, deviated nasal bone, or nasal or sinus polyps (benign lesions of the lining). The paranasal sinuses behind the cheekbones are the most commonly affected.
Infection from a cold or flu virus that spreads from the nasal cavity to the sinuses is the most common cause of sinusitis. A secondary bacterial infection can also develop following a cold or flu virus. An infected tooth adjacent to the sinuses can also cause a sinus infection.
Sinusitis is described as acute when the episode has a sudden onset and lasts no more than a month. In 75% of cases of acute sinusitis, the body’s immune defense and over-the-counter medication will clear inflammation. However, if bacteria have infected the sinuses antibiotics are usually required to treat a bacterial infection.
Chronic sinusitis means a long-term infection of eight weeks or longer. Chronic sinusitis can lead to permanent changes in the mucous membranes that line the sinuses. These changes can make a person more prone to recurrent sinus inflammation or infections, which become increasingly more difficult to treat.
Untreated chronic sinusitis can lead to serious complications, including infections in the adjacent bones (osteomyelitis) and tissue (cellulitis), or the brain (abscess or meningitis). Complications of sinusitis are uncommon, but can be life threatening and require prompt medical or surgical treatment.
Complications tend to affect children more than adults. A child with sinusitis who develops swelling around the eyelid or cheekbone, might have cellulitis, a bacterial infection of the skin. Call a doctor immediately if you suspect this type of advanced infection. Your doctor may refer you to an ear, nose and throat (ENT) specialist.
Conventional medical treatment for sinusitis
The sinuses are hollow cavities within the facial bones, situated in the forehead, cheeks and between and behind the eyes. The facial sinuses connect through narrow passageways no wider that a pinhead.
The inflammation from allergies, viral or bacterial infection, or structural abnormality can block the passageways, causing further inflammation, headache and facial pain. Early treatment of allergic sinusitis could prevent secondary bacterial sinus infections.
Home treatments such as steam inhalation or medication should successfully treat sinusitis. The aim of treatment is to reduce inflammation, unblock nasal and sinus passages to enable drainage and relieve pain, and kill off any bacterial or fungal infection.
Most sinus infections are viral (common cold) but usually a bacterial infection will need antibiotic treatment, which might be three days or several weeks or more.
See a doctor if your symptoms are severe, if they get worse, or if your symptoms don’t improve after one week.
Medicines most often used to treat sinusitis include:
- Cold and flu medicines to treat the underlying viral symptoms
- Nasal decongestant that reduces nasal swelling of the nasal mucous membranes, such as pseudoephedrine
- Saline nasal sprays to keep the nasal cavity clean
- Antibiotics such as amoxicillin, klacid, which kill bacteria
- Paracetamol, aspirin, or ibuprofen for pain and fever
- Do not give aspirin to a child under 16 years of age
Antihistamines, either oral or intranasal, are most effective when taken prior to allergen exposure and will improve allergic rhinitis symptoms. Second–generation antihistamines have fewer unpleasant side effects.
Anaphylaxis is a life-threatening allergic reaction in response to an insect bite or foods such as peanuts of shellfish. The throat swells to block the airways, making breathing difficult. Treat by administering an EpiPen an epinephrine autoinjector if available, or call 000 and ask for an ambulance.
Your doctor may prescribe antibiotics if he or she suspects that you have a bacterial infection and three or more of the following symptoms:
- Persistent purulent nasal discharge for more than one week
- Fever (a temperature of 38.5°C or more)
- Tenderness over the sinuses around the nose
- Blocked nose despite using a nasal decongestant
- Tooth pain and tenderness in the jaw around several teeth (not caused by toothache)
Antibiotics are only effective against bacterial sinus infections. Taking a course of antibiotics when you don’t really need them may lead to antibiotics being less effective next time when you really need them to work effectively.
From NPS MedicineWise http://www.nps.org.au/conditions-and-topics/conditions/respiratory-problems/respiratory-tract-infections/for-individuals/conditions/sinusitis/for-individuals/medicines-and-treatments
Telfast tablets contain fexofenadine, a type of antihistamine used to relieve the symptoms of seasonal and perennial allergic rhinitis. Sudafed contains pseudoephedrine, a sympathomimetic decongestant that reduces congestion in the nose nasal passages and sinuses, making it easier to breathe.
Prescription or over-the-counter antihistamines and prescription nasal sprays can reduce chronic inflammation in the sinuses and nasal lining. However, the best treatment is avoidance or a reduced exposure to allergens, and boosting the immune system to prevent catching the common cold virus.
Up to 75% of people with acute sinusitis improve without antibiotic treatment, because sinus infections are commonly caused by viral infections, which don’t respond to antibiotics. See a doctor if your symptoms persist or get worse to find out whether you need treatment with antibiotics.
A person with acute sinusitis caused by a bacterial infection who takes a full course of antibiotics will usually enjoy a complete recovery. Remember to take the full course of antibiotics prescribed by your doctor even if you feel much better in the interim. The number of days you take antibiotics depends on the type of antibiotic and the severity of the infection. Always take an antibiotic exactly as prescribed, or the infection may not resolve completely. Some antibiotics need to be taken with food, so check the instructions supplied.
A person has chronic sinusitis, when the episode endures for eight weeks or longer. Chronic sinusitis is much harder to treat and responds more slowly to antibiotics, compared with acute sinusitis. Your doctor may recommend a corticosteroid nasal spray, which will reduce inflammation and swelling of the lining of the nasal and sinus cavities.
A US survey asked prescribers which antibiotics they usually recommended for the treatment of acute and chronic sinus infections. The penicillin antibiotics were the most commonly prescribed (27.18% for acute, 30.35% for chronic), followed by macrolides (24.32% and 14.03%), and then cephalosporins (17.98% and 13.80%).
Types of antibiotics used to treat bacterial sinus infection:
Penicillin – Amoxicillin, Augmentin, Ampicillin
Macrolides – Azithromycin, Clarithromycin, Erythromycin,
Cephalosporin – Vantin, Ceftin, Cefalexin, Keflex
A person with an impaired immune system is more at risk of sinusitis than the general population, in particular to fungal infections. People who must use an oral or inhaled corticosteroid medication, such as prednisone, are at risk. Fungal infections of the sinuses do not respond to antibiotic treatment and need antifungal medication, corticosteroids, or occasionally surgery.
Nutritional medicine treatment for Sinusitis
Sinus infections, the cause of untold misery, strike hundreds of thousand of Australians each year. The cause of sinus problems is inflammation and blockage of the nasal passageways. Infective material builds up in the sinuses, bacteria colonise and flourish, making the patient feel very unwell.
Nutritional factors, specifically longer duration of breast-feeding and avoidance of early introduction of potentially allergenic foods, appear to reduce the likelihood that an infant will develop allergies. New mothers are advised to breast-feed their infants for at least six months and avoid introducing known allergic foods, such as cow’s milk, eggs, fish, nuts, corn, wheat, soy, and cocoa, during the first year.
Nutritional medicine assessment for sinusitis begins with taking a thorough medical history in order to identify any allergic triggers. If you are prone to allergies or hay fever, avoid allergic triggers, such as suspect foods, pollen, dust mites, pet dander, mould, and cockroaches.
Chronic sinusitis can be a stubborn problem but there are safe, effective natural treatments available. In reality, how often you get sinusitis and how long the problem lasts is in your hands.