Understanding Sinusitis : Chronic and Acute sinusitis

by National Institute of Health

(Page 2 of 3)

If bacteria cause your sinusitis, antibiotics used along with a nasal or oral decongestant will usually help. Your health care provider can prescribe an antibiotic that fights the type of bacteria most commonly associated with sinusitis.

Many cases of acute sinusitis will end without antibiotics. If you have allergic disease along with sinusitis, however, you may need medicine to relieve your allergy symptoms. If you already have asthma and then get sinusitis, you may experience worsening of your asthma and should be in close touch with your health care provider.

In addition, your health care provider may prescribe a steroid nasal spray, along with other treatments, to reduce your sinus congestion, swelling, and inflammation.

Chronic sinusitis

Health care providers often find it difficult to treat chronic sinusitis successfully, realizing that symptoms persist even after taking antibiotics for a long period. As discussed below, many health care providers treat sinusitis with steroids such as steroid nasal sprays. Many health care providers treat chronic sinusitis as though it is an infection, by using antibiotics and decongestants. Others use both antibiotics along with steroid nasal sprays. Further research is needed to determine what the best treatment is.

Some people with severe asthma are said to have dramatic improvement of their symptoms when their chronic sinusitis is treated with antibiotics.

Health care providers commonly prescribe steroid nasal sprays to reduce inflammation in chronic sinusitis. Although they occasionally prescribe these sprays to treat people with chronic sinusitis over a long period, health experts don't fully understand the long-term safety of these medicines, especially in children. Therefore, health care providers will consider whether the benefits outweigh any risks of using steroid nasal sprays.

If you have severe chronic sinusitis, your health care provider may prescribe oral steroids, such as prednisone. Because oral steroids are powerful medicines and can have significant side effects, you should take them only when other medicines have not worked.

Although home remedies cannot cure sinus infection, they might give you some comfort. Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities. Saline nasal spray, which you can buy in a drug store, can give relief. Gentle heat applied over the inflamed area is comforting.

When medical treatment fails, surgery may be the only alternative for treating chronic sinusitis. Research studies suggest that most people who undergo surgery have fewer symptoms and better quality of life.

In children, problems often are eliminated by removing adenoids obstructing their nasal-sinus passages.

Adults who have had allergies and infections over the years sometimes develop nasal polyps that interfere with proper nasal drainage. Removal of these polyps and/or repair of a deviated septum to ensure an open airway often gives them considerable relief from sinus symptoms.

The most common surgery done today is functional endoscopic sinus surgery, in which the natural openings from the sinuses are enlarged to allow drainage. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare. Surgery should be considered only after failure of medical treatment.

Prevention

Although you cannot prevent all sinus disorders - any more than you can avoid all colds or bacterial infections - you can do certain things to reduce the number and severity of the attacks and possibly prevent acute sinusitis from becoming chronic. You may get some relief from your symptoms with a humidifier, particularly if room air in your home is heated by a dry forced-air system. Air conditioners help to provide an even temperature. Electrostatic filters attached to heating and air conditioning equipment are helpful in removing allergens from the air.

If you are prone to getting sinus disorders, especially if you have allergies, you should avoid cigarette smoke and other air pollutants. If your allergies inflame your nasal passages, you are more likely to have a strong reaction to all irritants.

If you suspect that your sinus inflammation may be related to house dust mites, mold, pollen, or food - or any of the hundreds of allergens that can trigger an upper respiratory reaction - you should consult your health care provider who can use various tests to find out whether you have an allergy and if so, its cause. This will help you and your health care provider take the right steps to reduce or limit your allergy symptoms.

Other activities that can cause sinus problems include drinking alcohol which causes nasal and sinus membranes to swell, swimming in pools treated with chlorine, which irritates the lining of the nose and sinuses, diving, which forces water into the sinuses from the nasal passages.

You may find that air travel poses a problem if you are suffering from acute or chronic sinusitis. As air pressure in a plane is reduced, pressure can build up in your head blocking your sinuses or eustachian tubes in your ears. Therefore, you might feel discomfort in your sinus or middle ear during the plane's ascent or descent. Some health experts recommend using decongestant nose drops or inhalers before a flight to avoid this problem.

Research

At least two-thirds of sinusitis cases caused by bacteria are due to two germs that can also cause otitis media (middle ear infection) in children as well as pneumonia and acute worsening of chronic bronchitis. The National Institute of Allergy and Infectious Diseases (NIAID) is supporting multiple studies to better understand the basis for infectivity of these organisms as well as identifying potential candidates for future vaccine strategies that could eliminate these diseases.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.