Giving sinusitis the royal treatment
I am called several times a week by patients who have all of the symptoms of an acute (sudden onset) sinus infection (sinusitis) and they are not alone.
It is estimated that 37 million suffer from acute sinusitis in the U.S. alone every year. You can well imagine then that treatment of acute sinusitis is big business. Indeed, it is reaching billions spent annually.
Some of the primary symptoms of acute sinusitis include:
Loss of smell
Acute sinusitis may be diagnosed when a person has two or more symptoms and/or the presence of thick, green, or yellow nasal discharge.
Teeny holes that connect your nasal passages to your sinuses (basically a collection of hollow, moist cavities that sit beneath your nose, eyes, and cheeks) get blocked. Then gunk builds up in your sinuses, germs may grow, and you feel lousy!
Many sinus infections are caused by a host of things, including viruses (antibiotics will not work!), allergies, pollution, swimming and smoking. Certain medical conditions, like cystic fibrosis, that thicken mucous can all trigger a blockage which then leads to an infection
Nasal decongestant sprays relieve congestion. They constrict the blood vessels in the nose and they can be useful before a plane flight or for a couple of days. But prolonged use of these over-the-counter nasal sprays can make your symptoms worse!
If you use sprays for an extended period of time, you become less sensitive to their effects and your nose becomes swollen again, known as rebound nasal congestion. Bacteria can then infect your blocked sinuses, but typically the infection resolves spontaneously.
Antibiotics most often do not cure the bacteria any faster. This is important because, when you take an antibiotic, you run the risk of side effects like diarrhea, allergic reactions, female yeast infections, even coronary symptoms. If the antibiotics are not going to change anything, why spend the money and take a risk that it could make things worse?
Fungi can infect alone or with bacteria. Antibiotics do not treat fungi and while there are drugs to treat, they are toxic and are rarely needed. Again, most infections get better on their own.
Health care providers seem to feel the need to treat acute sinusitis even when it is unnecessary (which is most of the time). Consumers often expect treatment, regardless of being told the prescription is not needed. They rarely get the idea that the treatment could be worse than the disease. Health care providers often prescribe not just useless antibiotics, but spray or oral steroids, assuming that this will decrease the inflammation in the sinuses. There is no data to prove that assumption at all. In fact, a new study has shown that powerful oral steroids do no better a job than just waiting it out.
If the congestion is really getting to you, I suggest you get X Clear Nasal Spray (a spray solution of salt water and the sugar Xylitol) which is safe and perhaps decreases the ability of microbes to attach to the wall of the sinuses. Products like AYR are pH adjusted so they do not feel weird when you spritz and take a deep inhalation in your nostril. Comparable products are readily available in pharmacies. In a "pinch" a smidgen of salt in a glass of lukewarm water can do just fine. You will have to see if this helps. As for me, I would use even salt water as a last resort. There have been studies suggesting that for some even this simple treatment could make things worse.
For pain? Well, acetaminophen (Tylenol or a generic) or an NSAID (Non-Steroidal Anti-Inflammatory Drugs) like Ibuprofen (Motrin) could help. Personally, I find acupuncture, simple and effective, without concerns of side effects as a treatment for sinus pain.
In the end, a good book on your iPad or Kindle, some nice chamomile tea (restful), maybe enjoying a steam bath at the gym, a massage or some meditation may give your body the rest it needs to do its job. Why settle for second best when you can have your body give you the treatment?
Full disclosure: I have received no royalties or have any financial relationship with the producers of X Clear, AYR, Motrin, Tylenol, the iPAD or Kindle.
Dr. Sam Benjamin, M.D. - Integrative Medicine, weekend show host