You Need Help for Sinus Infections

Sinus infection, or sinusitis, is a relatively common condition marked by headache, throbbing in the eyes, face and teeth, and congestion. Additional symptoms may include a low-grade fever, a hacking cough, nasal discharge, bad breath and malaise. Any combination of these symptoms may indicate sinusitis.

Millions of Americans are affected by sinusitis each year, according to the National Institute of Allergy and Infectious Diseases (NIAID). When a secondary bacterial infection develops during or following a minor cold or allergy attack, it can progress to sinusitis. Sinus infections can be acute (three weeks or less), chronic (three to eight weeks, or longer) or recurrent (several acute attacks in a year).

What are the sinuses?

A sinus is any hollow air space in the body, but when people talk about their sinuses, they are usually referring to one or more of the four pairs of cavities in the skull surrounding the nose, according to the NIAID. The frontal sinuses are in the brow area above the eyes. The maxillary sinuses are inside each cheekbone below the eyes. The ethmoid sinuses are just behind the bridge of the nose and between the eyes. The sphenoid sinuses lie behind the ethmoid sinuses, behind the eyes and in the upper area of the nose.

All the sinuses in the head are connected to the nose and share a mucous membrane. A sinus infection can occur because an infection or allergy that affects the nose can also affect the sinuses. Air can become trapped in a sinus when the mucous membrane swells. This can cause intense pain. Pain also is caused when air cannot enter a blocked sinus, creating a vacuum.

The telltale signs

Although sinusitis is easily treated with antibiotics, "the difficulty is recognizing that you have sinusitis," says Philip C. Bartlett, M.D., associate clinical professor of otolaryngology at the University of California-San Francisco.

"About five or six days into a cold or an allergy attack, you should evaluate your symptoms," says Dr. Bartlett. "If you're suddenly feeling much worse, you may have sinusitis."

Sometimes the pain can help pinpoint which sinuses are affected, according to the NIAID. Pain when you touch your forehead may mean your frontal sinuses are inflamed. An ache in your upper jaw and teeth may indicate your maxillary sinuses are affected. Swollen eyelids and pain between your eyes can mean your ethmoid sinuses are inflamed; other symptoms include a stuffy nose, loss of smell and tenderness on the sides of your nose. If the sphenoid sinuses are affected, you may have an earache, neck pain and an ache on the top of your head.

Most people with sinusitis, however, have pain and tenderness in several locations on their face and head. The symptoms don’t clearly point to which sinuses are affected.

Other symptoms of sinusitis include:

• Headache, typically on waking in the morning

• Fever

• Weakness

• Tiredness

• A cough that may be worse at night

• Runny nose or nasal congestion

• Sore throat

Causes

What causes acute sinusitis? When you have a cold or an allergy attack, your sinus lining swells, producing extra mucus. The swelling narrows the opening that allows sinuses to drain into your nose. Once the opening is obstructed, mucus is trapped inside. The trapped mucus sets up prime conditions for bacteria to multiply.

The bacteria that cause sinusitis are those normally found in the upper respiratory tract: Streptococcus pneumoniae and Haemophilus influenzae. Under most conditions, these bacteria cause little harm.  However, in the presence of stagnant mucus they can multiply quickly and cause an acute sinus infection.

Fungi also can cause acute sinusitis, but usually only in people whose immune system is weakened. People who are allergic to fungi may develop allergic fungal sinusitis.

Chronic sinusitis may be an infectious process; other experts think it is an inflammatory disease. People with asthma, nasal polyps, or allergies to dust, mold, and pollen may develop chronic sinusitis.  

Treatment

If you have acute sinusitis, your doctor may recommend a pain reliever and a decongestant to reduce congestion and a pain reliever. If your sinusitis is caused by bacteria, your doctor may also prescribe an antibiotic, although many cases of acute sinusitis will resolve themselves without antibiotics.

Keep in mind that decongestant nose drops and sprays, whether over-the-counter (OTC) or prescription, should only be used for a few days. If these drugs are used for longer than a few days, they can cause more congestion.

Chronic sinusitis also is treated with antibiotics and decongestants, although symptoms may persist even after taking antibiotics. A steroid nasal spray can reduce inflammation in chronic sinusitis. Oral steroids are occasionally prescribed for severe chronic sinusitis, but only after other medications have been tried.

These are home care ideas that can provide some comfort from symptoms:

• Soothe inflamed sinuses by inhaling mist from a nebulizer. You can also inhale steam from a vaporizer or a pan of hot water but care must be taken to avoid burns.

• Try an OTC saline nasal spray.

• Place a warm cloth over the sinus area that hurts.

Prevention

Here are several tips to help reduce the number and severity of episodes of sinusitis:

• Use a humidifier during the cold months, especially if your home has a forced-air furnace.

• Use an air conditioner in hot weather to provide an even temperature in the home.

• Add an electrostatic filter to your furnace and air conditioner, if possible, to remove allergens from the air.

• Avoid cigarette smoke.

• Limit your intake of alcohol, because alcohol causes nasal and sinus membranes to swell.

• Avoid or limit your time in chlorinated swimming pools. The chlorine irritates the lining of the nose and sinuses.

• Ask your doctor about using decongestant nose drops or inhalers before you fly. If your sinuses are blocked, you will feel discomfort when the plane ascends or descends.