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How do I know if I have acute sinusitis?

Sinusitis is a condition where the sinuses become inflamed or infected.
Sinusitis is a condition where the sinuses become inflamed or infected.
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You may not ever think about them -- those little pockets of air that are part of our skull and in the bones of our head. They're your sinuses, and when they're working normally, they silently help keep the inside of your nose moist and help block foreign substances from being inhaled into your lungs. We have eight sinuses, in four pairs, called the paranasal sinuses, and they include:

  • The frontal sinuses, which are found just above our eyebrows
  • The maxillary sinuses, which are located inside our cheekbones
  • The ethmoid sinuses, which are between our eyes, behind the bridge of the nose
  • And the sphenoid sinuses, which are behind our eyes and upper part of the nose

Our sinuses are lined with the same mucus membranes that line the inside of our noses. These membranes produce mucus to keep the sinuses and respiratory tracts moist, and there are also microscopic hairs called cilia that move mucus around in our nasal passages. On average, when we're healthy we produce about 2 quarts (1.8 liters) of mucus every day, most of which we eventually swallow. When our sinuses become filled with mucus, such as from a cold, the cilia are unable to move properly. This can result in a build-up of mucus that blocks the sinus openings, and that blockage increases our risk for developing sinusitis.

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Sinusitis is a condition where the sinuses become inflamed. It's a common infection, and there are two main types: acute and chronic. Acute sinusitis usually lasts less than a month and occurs no more than three times a year, while chronic sinusitis is a condition that can last upwards of three months or longer per episode and occurs at least four times a year, despite efforts to treat it.

It's estimated that roughly 31 million American adults were diagnosed with sinusitis in 2009, and about 12 percent of Americans age 45 or younger suffer from the chronic condition [sources: National Institute of Allergy and Infectious Diseases; American Academy of Allergy, Asthma & Immunology].

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Often, sinusitis starts out as your average, common cold or a viral upper respiratory infection. Your sinuses become inflamed, your nasal passages are blocked with mucus (let's not forget about the postnasal drip), and the headache and facial pain may seem insufferable. You may have a sore throat and a cough. When you have a cold, you usually begin to feel better in about a week, give or take a few days, but when sinusitis begins to take hold, symptoms begin to get worse, not better. You may begin to run a fever, the facial pressure and tenderness begin to worsen, and you may even find that your ears or teeth ache. What's happening is, instead of your sinuses draining, they've become blocked with thick mucus, allowing bacteria such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis to flourish and inflame the lining of the sinuses. This may be the onset of sinusitis.

It's not only bacteria that can trigger sinus inflammation and sinusitis. Conditions including a deviated nasal septum, nasal polyps, cystic fibrosis or a weakened immune system can increase the odds of developing acute sinusitis, as well. And individuals who suffer from allergies have a greater susceptibility, too, especially those who endure hay fever or an allergy to molds or fungus. Smoking and altitude changes may also increase a person's risk.

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Because a cold is caused by a virus, there is no better treatment than to get plenty of rest, wait it out and maybe try over-the-counter decongestants or other cold symptom relief. But when it comes to acute sinusitis, treatment can be a little different. Next we'll look at a prescription for sinus health, from over-the-counter medicines to alternative remedies. But first let's discuss how your doctor may diagnose your sinusitis.

There are a few ways health-care professionals will diagnose sinusitis. If you've been suffering with symptoms for less than four weeks but aren't getting better, your doctor may evaluate you for thick nasal discharge that is either yellow or green, and for facial swelling, redness or tender areas and/or tooth and jaw aches that may indicate inflamed sinuses. You may also undergo X-rays or a computerized tomography scan (CT scan), a mucus culture to determine if there is bacteria causing your sinus inflammation and which bacteria is the culprit, as well as a nasal endoscopy to determine if there are nasal polyps, all to help with the diagnosis.

Sinusitis sufferers make up about 20 percent of the patient visits to allergists and immunologists every year, and no less than 30 million prescriptions for antibiotics are written to help treat the condition [source: American Academy of Allergy, Asthma & Immunology].

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Antibiotics, while they may help, are not always the first course of treatment for acute sinusitis.

Just like treating a cold, the best way to fight acute sinusitis includes rest and sleep, staying hydrated by drinking fluids, and managing symptoms with over-the-counter remedies such as acetaminophen for pain relief and fever reduction. When it comes to over-the-counter medicines you may want to skip any cold medicines that will add to the dryness of the mucus membranes, such as antihistamines or decongestants -- moist sinuses are healthier than dry sinuses. It's best to take the advice of your health-care provider when choosing what medicines are right for you and your symptoms.

Additionally, some patients find relief through alternative remedies. Sipping hot liquids such as teas and clear broths, and applying hot towels to the face -- steamy showers or baths work well, too -- can help to reduce inflammation and loosen up the mucus blocking your nasal passages. Saline irrigation, made with table salt and warm water in a neti pot or store-bought saline nasal spray, may help to clear mucus from the nasal passages, as well. Other alternative remedies such as vitamin C, yogurt (with active probiotics), zinc lozenges and Echinacea may be helpful, but the word is still out on whether or not they will reduce symptoms or the amount of time you're sick. In some cases, sinusitis may go away without any treatment.

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Sources

  • American Academy of Allergy, Asthma & Immunology. "Allergy Statistics." (June 20, 2011) http://www.aaaai.org/media/statistics/allergy-statistics.asp
  • Asthma and Allergy Foundation of America. "Sinus Problems." 2005. (June 20, 2011) http://www.aafa.org/display.cfm?id=9&sub=19&cont=269
  • Brawley, Otis. "Expert Q&A: What can I do for my chronic sinusitis?" CNN. March 2010. (June 20, 2011) http://www.cnn.com/2010/HEALTH/expert.q.a/03/09/chronic.sinusitis.brawley/index.html
  • The George Washington University Hospital. "Acute Sinusitis." (June 20, 2011) http://www.gwhospital.com/Hospital-Services-A-N/Ears--Nose-and-Throat-Otolaryngology/Acute-Sinusitis
  • MayoClinic. "Acute sinusitis." 2010. (June 20, 2011) http://www.mayoclinic.com/health/acute-sinusitis/DS00170
  • Nabili, Siamak. "Chronic Rhinitis and Post-Nasal Drip." MedicineNet. (June 20, 2011) http://www.medicinenet.com/chronic_rhinitis/article.htm
  • National Center for Biotechnology Information. "Sinusitis." 2010. (June 20, 2011) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001670/
  • National Institute of Allergy and Infectious Diseases. "Sinusitis." 2011. (June 20, 2011) http://www.niaid.nih.gov/topics/sinusitis/Pages/Index.aspx
  • Snow, Vincenza; Mottur-Pilson, Christel; Hickner, John M. "Principles of Appropriate Antibiotic Use for Acute Sinusitis in Adults." Annals of Internal Medicine. Vol. 134, no. 6. Pages 495-497. 2001. (June 20, 2011) http://www.annals.org/content/134/6/495.full
  • Torpy, Janet M.; Burke, Alison E.; Glass, Richard M. "Acute Sinusitis." The Journal of the American Medical Association. Vol. 298, no. 21. 2007. (June 20, 2011) http://jama.ama-assn.org/content/298/21/2576.full
  • U.S. Department of Health & Human Services. "Acute rhinosinusitis in adults." 2007. (June 20, 2011) http://www.guideline.gov/content.aspx?id=12682
  • WebMD. "An Overview of Sinusitis." 2009. (June 20, 2011) http://www.webmd.com/allergies/guide/allergies-sinusitis
  • WebMD. "Sinus Infection." 2007. (June 20, 2011) http://www.webmd.com/allergies/sinus-infection

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