DESCRIPTION

What are sinuses? Sinuses are literally holes in our head. There are pairs in our cheeks, nasal bridge, middle half of our eyebrows, and behind our eyes. The sinuses have small openings into nasal passages called ostia. Bacteria reside in all sinuses and viruses will enter them when we catch a cold. If the cilia that line the sinus cavity effectively clear these organisms, we will never experience symptoms. What is sinusitis? When viruses and bacteria are trapped in the sinuses, they continue to grow leading to a sinusitis. Symptoms include nasal congestion, facial pressure, and thick nasal discharge. What are the causes of sinusitis? Mechanical obstruction from a deviated septum or nasal polyp. Swelling- Swollen mucous membranes in your nose will block the ostia. This occurs with Seasonal allergies Head colds Vasomotor rhinitis; a condition when swelling is caused by dilated blood vessels in the nose. Triggers for vasomotor rhinitis include cold weather, barometric pressure changes with the approach of cold fronts, stress, and irritants such as perfumes and air pollution. Drying- Thin watery mucus clears from our sinuses easily. Thick pasty mucus does not. Dehydration, certain medications, and low humidity (low dew point) will dry and inhibit the flow of mucus. Cilia that line our sinuses sweep organisms and debris from sinus cavities. Dry, matted mucus will prevent the cilia from working properly and tobacco products will disable them completely. Even occasional smoking will do this. Treatment of sinusitis Most sinus infections are viral and don't respond to antibiotics. Only 2% of cases are bacterial. Even bacterial infections will resolve without using antibiotics 75% of the time. Do the following when you feel a sinus infection developing. If you are prone to sinus infections, start techniques you have found effective when a cold, allergies, or certain weather conditions place you at high risk for developing one. Hydrate- Staying well hydrated keeps your nasal mucus thin and free-flowing. Salt water spray- This also helps keep nasal mucus thin and may help cilia function more effectively. Nasal lavage- Nasal lavage is even more effective at clearing debris and activating cilia. Examples include a bulb syringe, Netty Pott, and a nasal lavage system. Many find these to be the single most effective way to prevent or treat early sinusitis. Humidity keeps mucus moist. A bedroom humidifier is most effective. It is especially important to humidify air in dry climates and during cold winter months. Cold air doesn’t hold as much water as warm air does. During the winter, as outdoor air is warmed when entering a home, indoor relative humidity can drop to extremely low levels. Guaifenesin (Mucinex and Entex) are medications that work by pulling fluids into mucus secretions. Drinking plenty of fluids is important to allow mucus thinners to work properly. Systemic decongestants like pseudoephedrine (Sudafed) help by opening the ostia through reducing swelling of nasal membranes. Though a prescription is not needed, they must be dispensed by a pharmacist. Often, decongestants are combined with a mucus thinner (Mucinex D). If you have high blood pressure, check with your doctor before using them. Finally, be aware that decongestants cause heart palpitations and insomnia in some people Nasal decongestants such as Afrin and Dristan are very effective, but may only be used for 2-3 days because dependency can occur. Optimal treatment of allergies by medication is essential for many people to avoid sinus infections, especially when they contract a cold or in certain weather conditions. There are two categories: Nasal steroids- These can be very effective in reducing swelling around the sinus openings. Antihistamines should be used with caution because they have the potential to dry and thicken mucus secretions. Drying is less of a problem with the new generation of antihistamines such as Claritin and Zyrtec. Older ones like Benadryl are more drying. When should I see my physician? You should see your physician for high fevers, rapid worsening of symptoms, or prominent swelling around your eyes. Also be seen if symptoms that suggest bacterial sinusitis are not responding to the above treatments. Bacterial infection is suspected when symptoms linger for more than 7 days, include localized tenderness over one or two sinuses, you have pain in your upper teeth, there is thick dark nasal drainage, and especially if you experience “double worsening”. Double worsening occurs when there is worsening of symptoms after an initial period of improvement. When placed on antibiotics, anticipate having to use them longer than with other infections. Antibiotics don't penetrate the sinus cavities easily taking longer to completely clear the infection. It is essential to complete a course of antibiotics .Stopping antibiotics prematurely allows more resistant organisms to survive and cause another infection later.

	RESPIRATORY DISEASES ALLERGIES SINUS INFECTIONS ACHES AND PAINS HEART DISEASE SKIN CONDITIONS HEAT ILLNESS OTHER PHYSIOLOGICAL AND PSYCHOLOGICAL CHANGES LABOR AND BIRTH