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Stuffy head? It's not always sinusitis

Published On: Jan 03 2013 04:01:13 PM CST
Updated On: Aug 22 2013 10:49:22 AM CDT

By Sean McKinney, Pure Matters

Say it out loud: Sinusitis. It even sounds painful. This inflammation of the sinuses, usually caused by an infection, is one of the most common problems doctors treat. Yet a lot of us don't know much about it.

"Sinusitis affects about 16 percent of adults and costs close to $5.8 billion a year in health care," says Raymond G. Slavin, M.D. "But often people believe they have sinusitis when they might have a cold or nasal allergy."

In 2005, Dr. Slavin and colleagues wrote guidelines on diagnosing and treating sinusitis in the Journal of Allergy & Clinical Immunology. They found most cases don't need X-rays or CT scans. "The diagnosis can be made by taking a good history and examining the patient," he says.

Sinusitis differs from colds and nasal allergies, but either one can set up sinusitis by swelling the sinuses. "If the sinuses are too swollen to drain through tiny openings, mucus pools and provides a breeding ground for viruses and bacteria," Dr. Slavin says.

Sinusitis symptoms can include a swollen nose and sinuses, fever, fatigue, thick yellow or green nasal discharge, congestion, facial pain, swelling around the eyes, headache and coughing. Colds and nasal allergies can share many of these symptoms. But unlike sinusitis, colds (and sometimes allergies) include sneezing. Colds usually don't last as long, and the nasal discharge is whitish or thin. Allergies may cause an itchy nose and clear nasal discharge.

How to treat sinusitis

Viruses cause about 85 percent of sinus infections, Dr. Slavin says. Antibiotics won't help in those cases. Treatment for sinusitis caused by a virus includes decongestants, mucus-thinning medications, nasal cortisone sprays or drops, and pain relievers. You can use topical decongestant sprays for just two or three days or use saline nasal sprays longer.

"We urge doctors to wait 10 to 14 days with the patient getting no better before antibiotics are prescribed," Dr. Slavin says. "If the patient has a high fever and is getting worse, then antibiotics are indicated."

OTC medications commonly used to treat sinusitis:

Decongestants. Currently, the only OTC decongestant available is pseudoephedrine. This drug decreases the secretion of mucus. Typical OTC medications containing pseudoephedrine include Sudafed, Advil Cold and Sinus, Contac Non-Drowsy Decongestant.

Expectorants/mucus thinners. The only OTC drug of this type is guaifenesin. It should be taken with plenty of water to increase the fluidity of mucus. This medication can help empty the sinuses by thinning the mucus trapped in the inflamed sinus. Typical OTC medications containing guaifenesin include Mucinex, Robitussin (plain), Sudafed Non-Drowsy Non-Drying Sinus.

Nasal sprays. OTC nasal sprays come in three types: moisturizing, decongestant and anti-allergy/anti-inflammatory. Only the moisturizing and decongestant are commonly used. Moisturizing sprays are a mild salt solution called normal saline. They liquefy the mucus, allowing it to drain and keep the lining of the nose moist. These include Ayr, Oceans and a host of private store brands. Decongestant nasal sprays shrink the blood vessels in the nose, cutting production of mucus. OTC medications include Vicks Nasal Spray, Neo-Synephrine brand nasal sprays and private store brands.

Underlying causes of sinusitis

  • upper respiratory infections such as a head cold
  • allergies
  • asthma
  • crooked bone and cartilage between the nostrils (also known as a deviated septum)
  • environmental factors, such as freezing cold air, poorly ventilated indoor air, cigarette smoke and car exhaust
  • abnormal hormone activity
  • nasal polyps
  • foreign bodies inserted in the nose (common in children)
  • overuse of decongestant sprays

    Source: Pure Matters