Sinusitis

What is sinusitis?

Symptoms of sinusitis

Causes of sinusitis

Sinusitis triggers

Remedies / treatment for sinusitis

References

What is sinusitis?

Sinusitis is an inflammation of the mucous membranes lining the sinuses. These membranes are air-filled tubes and pockets behind the nose, cheeks, and forehead. It can be very painful.

The inflammation causes swelling, which obstructs the drainage of the sinuses, which can lead to bacterial infection. Such infections can spread around the head and respiratory passages.

Sinusitis is a common complaint, with 5-10% of the American population suffering from at least one episode each year, and 90% of adults having had an episode at some time in their life. (1)

Symptoms of sinusitis

• Pain around the face, nose and above the eyes.
• A feeling of fullness or tightness around the face, which may worsen when bending over or lying down.
• Congestion with thick green or yellow discharge.
• Headache. Studies suggest that up to 90% of sinus headaches are actually migraines. (4, 5)
• Night time coughing.
• An increase in previously minor or controlled asthma symptoms.
• A feeling of malaise.
• Toothache or jaw pain.
• Halitosis (bad breath) or a foul taste in the mouth.
• A feeling of fever, although fever is not a symptom of sinusitis.

Causes of sinusitis

• Viral infection. Most minor cases of sinusitis are due to a viral infection, and resolve within 7-10 days. (2)
• Bacterial infection. About 30-50% of cases. Bacterial sinusitis is more persistent, with most cases taking weeks or months to resolve. In a few cases, nasal fluid from nose blowing caused secondary bacterial infection. (3) Bacterial biofilms are probably involved in most cases of chronic sinusitis. A biofilm is a complex aggregate of inter-dependent microorganisms from multiple species that cement themselves together for protection. Biofilms are difficult to physically remove, and are antibiotic-resistant. One study found evidence of biofilms in the mucus of 75% of patients undergoing surgery for chronic sinusitis. (6)
• Antibiotics. The more you take antibiotics, the worse it gets in the long term.
• Fungal infection. Although a variety of fungi exist in everyone's nasal passages, fungal sinus infections are typically seen in patients with diabetes or immune deficiencies. Candida is the most common fungal infection.
• Allergies.
• Sjogren's syndrome. Between 2% and 6% of adults suffer from this ailment, with the prevalence being nine times higher in women than men, and in older people rather than younger.
• Chemical irritation. Most often from cigarette smoke or chlorine fumes.
• Abnormally narrow sinus passages can impede drainage from the sinus cavities. This may be caused by a deviated septum (bent nose or nasal passages).
• Poor breathing technique (breathing through mouth rather than nose) and insufficient use of voice.
• Nasal polyps.
• Tooth infection. Only in rare cases.

Sinusitis triggers

• Cold, polluted, or smoky atmosphere.
• Dairy products, especially pasteurised milk, some cheeses, and ice cream.
• Strong nose blowing.

Remedies / treatment for sinusitis

Doctors may prescribe antibiotics, corticosteroids, or surgery. These options have severe consequences and should not be taken without careful consideration of the inevitable harmful side-effects. Before undertaking any of these options cultures should be taken to identify the microorganisms involved in the infection. Anti-fungals have been used with mixed success in the treatment of some infections.

Warning: if you are considering taking an over-the-counter or prescription medication such as pain relievers like Ibuprofen, Acetaminophen and allergy medications for sinus allergy. These medications are hard on the liver, often creating more mucus as it tries to excrete them from your body. Often these medications actually make the sinus condition worse, especially in the long-term. If you are going to take one, note the colour, amount and thickness of your mucus before you start the medication. Within twelve hours after you start, if there is more mucus or it gets thicker or yellow, then you know that it is harmful.

• Nasal saline irrigation. Dissolve a teaspoon of sea salt in half a litre (2 cups) of body temperature water. Use a neti pot (widely available online) to rinse out both nostrils with this solution. (7)
• Nasal baby shampoo wash. Dissolve one teaspoon (10 ml) of baby shampoo in half a litre (2 cups) of body temperature water. Do not use standard shampoo, it is too harsh. Instead use baby shampoo and check that it contains no chemicals or other nasty ingredients. Use a neti pot (widely available online) to rinse out both nostrils with this solution. This treatment, in combination with salt washes, is the best way to remove stubborn biofilm of bacteria and fungi which often occur after taking antibiotics and are a primary cause of sinus and phlegm problems.
• Garlic.
• Iodine. Dip a cotton tip (Qtip) into Lugol's iodine solution, and then circle the cotton tip around the inside of each nostril. You only want a light coat of iodine, not wetting the skin with it. Do this once or twice per day.
• Pressure points. Have someone gently but firmly press with their thumb and first finger on either side of the C2 vertebra at the top of your neck. Within a few seconds you may notice an improvement in your ability to breathe freely through one or both nostrils. Keep pressing for 20 - 30 seconds.
• The Sugar Cure.
• Oil pulling.
• Make a tea by boiling one teaspoon of fenugreek seeds in a cup of water. Let it steep for 20 minutes. Drink 3 - 4 cups daily. This will relieve congestion. Fennel seeds may also be used. Fenugreek is usually the most effective, but try both or a mix of the two.
• Drink plenty of water to keep your mucus thin.
• Get plenty of deep sleep. Sleep with your head raised, and on your back. Sleep on one side if it helps to make breathing easier. How to sleep deeply every night.
• Put a warm, moist washcloth over the face for 5 to 10 minutes several times a day to relieve pain.
• Steam inhalation. Put a cup or two of boiling water in a bowl, and add 3 - 5 drops of eucalyptus oil. Cover your head with a towel, lean over the bowl and inhale the steam. Do this 2-4 times per day.
• Humming and use of voice.
• Inclined Bed Therapy (IBT). IBT costs nothing, has no side effects except good ones, and is sometimes miraculously effective. Why wouldn't you try it?
• Mix 1/2 teaspoon cinnamon powder with enough water to make a paste. Spread the paste on the skin of the head to relieve a sinus headache.
• View remedies & comments contributed by visitors to Grow Youthful's Ailments & Remedies pages.

References

1. Pearlman AN, Conley DB. Review of current guidelines related to the diagnosis and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):226-30.

2. Leung RS, Katial R. The diagnosis and management of acute and chronic sinusitis. Prim Care. 2008 Mar;35(1):11-24, v-vi.

3. Jack M. Gwaltney Jr, J. Owen Hendley, C. Douglas Phillips, Cameron R. Bass, Niels Mygind, Birgit Winther. Nose Blowing Propels Nasal Fluid into the Paranasal Sinuses. Oxford Journals, Volume 30, Issue 2 Pp. 387-391.

4. Schreiber CP, Hutchinson S, Webster CJ, Ames M, Richardson MS, Powers C. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache. Arch Intern Med. 2004 Sep 13;164(16):1769-72.

5. Mehle ME, Schreiber CP. Sinus headache, migraine, and the otolaryngologist. Otolaryngol Head Neck Surg. 2005 Oct;133(4):489-96.

6. Sanclement JA, Webster P, Thomas J, Ramadan HH. Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. Laryngoscope. 2005 Apr;115(4):578-82.

7. Harvey R, Hannan SA, Badia L, Scadding G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD006394.