Sinusitis health tip.
Why does Sinusitis frequently reoccur?
Sinusitis is better divided into one off or occasional episodes (acute sinusitis) or a constant grumbling disease (chronic sinusitis).
Chronic sinusitis always involves more than just the sinuses, so we call it chronic rhinosinusitis (it is often associated with asthma too).
There are some people who suffer something in between the two – a propensity to regular attacks called recurrent acute sinusitis.
Acute sinusitis leads to cold-like symptoms associated with more severe aspects including facial pain, fever (high temperature), and copious discoloured nasal discharge.
Treatment is as per a cold (as above) but antibiotics may have an additional role, especially if the patient is more unwell than a typical cold and has a temperature.
Recurrent Acute Sinusitis
If you are prone to recurrent cold-like illnesses and are more affected than most, it may be that you have some form of predisposition.
It may be structural (a deviated nasal septum causing partial nasal or sinus blockage that is easily compromised.
It may also be that you have allergy or chronic sinusitis (often associated with asthma) underlying the problems.
In such cases, medical or surgical treatments may have a role – as in Chronic Rhinosinusitis (next).
Chronic rhinosinusitis is when symptoms become constant.
It is often less severe, with no fever, and much less pain.
A poor sense of smell, nasal blockage, pressure, and a runny nose may be constant features.
In these cases, medical and sometimes surgical treatments can be helpful, but there is no outright ‘cure’.
I usually recommend nasal corticosteroid sprays and daily saline (salt water) nasal washes.
Neilmed sinusrinse (available ‘over the counter’) is the best way I have found to deliver saline washes.
Antibiotics usually only give a transient relief that can lead to a misconception that they are helpful.
In the longer term they only lead to more complicated antibiotic resistant infections.
In severe cases (usually acute sinusitis) with a persistent high fever antibiotics ARE required however.
Decongestants are harmful if used more than occasionally – avoid them except perhaps for a special occasion or flight.
Antihistamines are mainly useful for mild allergy only.
People with facial pain often think, or are told that they have sinusitis.
Acute sinusitis can be painful, but is easily recognised by the fever, nasal symptoms, and resolution within a week or two.
Very few patients with constant facial pain for more than a week or two have sinus troubles.
Common causes in these patients are either dental, related to the jaw, stress or tension headaches, migraines or neuralgia.
Many of these processes can cause some limited nasal symptoms (congestion, clear mucous), but this is NOT sinusitis.
If there is uncertainty, examination in an ENT clinic of the inside of the nose (and sinuses) can be helpful.
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