Nasal Disease Handbook

Sinusitis

Sinusitis is a bacterial infection of the paranasal sinuses. It occurs when there is so much swelling in the nose that the drainage hole from the sinus (called an ostium) is swollen shut. This paralyzes the mucociliary transport system. The sinus then fills with secretions. These secretions become infected and the sinusitis develops. You begin with a feeling of nasal stuffiness. Secretion and postnasal drip may or may not be present. You then develop pressure within the sinuses. This pressure increases until it becomes painful. You will generally feel sick and will often have an elevated temperature. While everyone has some sinus symptoms with most colds, these will be more intense with bacterial sinusitis. More often than not, they will be present on one or the other side and not symmetrically, equally present on both sides.

Sinusitis is best treated with antibiotics. Nasal decongestants such as Sudafed can be taken in the morning. If taken later in the day or the evening they may keep you awake. While many recommend Afrin(R) and Neosynephrine(R), I prefer not to recommend these nasal sprays because of their addictive potential. The best way to keep the nose clean and to wash away the bacteria and thick secretions is to do nasal irrigation.  I should mention at this point that irrigating is relatively easy, but it tends to take a little getting used to. While some people pick it up the first time and become natural irrigators, others find it a little uncomfortable and awkward for the first couple of days. If you are one of these who use it two or three times a year for the common cold and for the occasional sinusitis, it may be difficult or even may be more trouble than it is worth. Nonetheless, if you find the irrigations useful, they do wash out the bacteria and thick secretions. Just as with the common cold, the irrigations can be repeated as often as seems to make you comfortable.

I am opposed to antihistamines for bacterial sinusitis unless there is an underlying allergy.

Steam seems to benefit many people.  Keeping ones room humidified, inhaling steam and remaining well hydrated all contribute to a rapid improvement.

Bacterial infections, like sinusitis, can be potentially dangerous. These benefit from antibiotic treatment. You are strongly encouraged to consult your primary care provider to confirm the diagnosis and obtain the correct prescription.