Understanding sinusitis

More than half of Canadians with allergies suffer from sinusitis, and the number is growing. The good news is that easy-to-follow treatments done at home can bring welcome relief. And there are plenty of symptom-specific medications that really help.

Understanding sinusitis

1. What is happening

If your cold, flu or allergy simply won't quit, it may have transformed itself into sinusitis, an infection of the sinus cavities. The sinuses are four pairs of air-containing spaces in the front of your skull. They are connected to your nasal passages through narrow passages, which have tiny openings called ostia that normally let mucus drain and air flow in and out.

When you have an allergy or a respiratory infection like a cold, the lining of your sinuses can become swollen, blocking these passages. The blockage then traps mucus in your sinuses, where it builds up and thickens, inviting normally harmless bacteria to multiply.

When this happens you'll know it. Sinusitis' calling card is thick, yellowish-green mucus, a sense of pressure in your face, a headache and difficulty breathing through your nose. You may also have pain in your upper teeth, a persistent cough, a low fever and/or fatigue. If this is your first sinus infection, or you get them only rarely, you probably have acute sinusitis. This is usually caused by the bacteria Streptococcus pneumoniae or Haemophilus influenzae; with treatment, it lasts about three weeks.

If your sinus infection continues for two months or longer, despite treatment, the diagnosis is probably chronic sinusitis. While chronic sinusitis may result from a hard-to-treat bacterial infection, damaged mucous membranes from unsuccessfully treated acute sinusitis may also play a role. Or, it may be the result of polyps or cysts — small benign growths — in your nasal passages.

A blockage could also result from a deviated septum, a common structural abnormality in which the septum (the bone and cartilage in the centre of the nose) is crooked. If you have hay fever and asthma (both associated with allergies), they contribute to chronic sinusitis as well (in fact, about 70 percent of people with chronic sinusitis also have allergies). And for some people, sinusitis is worsened by a sensitivity to certain foods, such as dairy products or wheat. Recently, evidence has also shown that some types of chronic sinusitis are triggered by an immune response to fungi that occur naturally in the nose.

2. First steps

  • Steam inhalation, sinus irrigation and drinking plenty of fluids to thin mucus and reduce nasal swelling.
  • Analgesics, decongestants, cough suppressants or expectorants to relieve specific symptoms.
  • If required, antibiotics to fight an acute bacterial infection.
  • If nothing is effective, or you have a sinus blockage, surgery may be necessary to clear sinus passages.

3. Taking control

  • Reduce your stress level. Studies have shown that stress and anger can weaken the immune system, and a weakened immune system certainly contributes to the frequency and severity of sinus infections.
  • Learn to blow the right way. Even if you're totally congested, never forcefully blow your nose. Instead, inhale through your mouth, then blow gently through one nostril at a time, pressing the other nostril closed as you do so.
  • Sniff some eucalyptus oil. Putting a few drops of eucalyptus oil on a tissue and sniffing it periodically during the day can bring welcome relief to swollen nasal tissues. When inhaled, eucalyptol, the oil’s key medicinal ingredient, tightens and thus soothes inflamed mucous membranes.
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