The Citizen (Gauteng)

What to do when you are all blocked up

Most cases resolve within a week to 10 days unless bacterial infection develops. SINUSITIS: MOSTLY CAUSED BY THE COMMON COLD, WHICH IS A VIRAL INFECTION

- Dr Dulcy Rakumakoe

Acute sinusitis (acute rhinosinus­itis) is when the cavities around your nasal passages (sinuses) become inflamed and swollen. This leads to mucus build-up and interferes with drainage.

This makes it difficult to breathe through your nose. The area around your eyes and face might feel swollen and you might have throbbing facial pain or a headache. Acute sinusitis is mostly caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops.

Most cases resolve spontaneou­sly within a week to 10 days, unless a bacterial infection develops. In most cases, home remedies are all that’s needed to treat acute sinusitis. However, persistent sinusitis can lead to serious infections and other complicati­ons. Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.

Most people with acute sinusitis don’t need to see a doctor. Contact your doctor if you have any of the following:

Symptoms that either don’t improve within a few days or worsen. A persistent fever. A history of recurrent or chronic sinusitis.

Symptoms

Acute sinusitis symptoms often include:

Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (postnasal drainage).

Nasal obstructio­n or congestion, causing difficulty breathing through your nose.

Pain, tenderness, swelling and pressure around your eyes,

Thami Kwazi

010 492-5227

city@citizen.co.za

cheeks, nose or forehead that worsens when bending over.

Other signs and symptoms can include:

Ear pressure. Headache. Aching in your upper jaw and teeth.

Reduced sense of smell and taste.

Cough, which might be worse at night. Bad breath (halitosis). Fatigue. Fever.

The following signs or symptoms may indicate a serious infection:

Pain, swelling or redness around your eyes. Swollen forehead. Severe, unrelentin­g headache. High fever. Confusion. Double vision or other vision changes.

Stiff neck.

Risk factors

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You may be at increased risk of getting sinusitis if you have: Hay fever or another allergic condition that affects your sinuses. A nasal passage abnormalit­y, such as a deviated nasal septum, nasal polyps or tumours. A medical condition such as

cystic fibrosis or an immune system disorder such as HIV/Aids.

Complicati­ons

Acute sinusitis complicati­ons are uncommon. If they occur, they might include:

Chronic sinusitis. Acute sinusitis may be a flare-up of a longterm problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.

Meningitis. This infection causes inflammati­on of the membranes and fluid surroundin­g your brain and spinal cord. Partial or complete loss of sense of smell. Nasal obstructio­n and inflammati­on of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell. Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.

Diagnosis

Consult your doctor who will do a history and physical examinatio­n, which includes feeling for tenderness in your nose and face and looking inside your nose. Other methods that might be used to diagnose acute sinusitis include:

Nasal endoscopy. A thin, flexible tube (endoscope) with a fiberoptic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.

Imaging studies. A CT scan or MRI can show details of your sinuses and nasal area. While not recommende­d for uncomplica­ted acute sinusitis, imaging studies might help identify abnormalit­ies or suspected complicati­ons.

Nasal and sinus cultures. Laboratory tests are generally unnecessar­y for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.

Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that’s responsibl­e for your nasal flare-ups. Treatment

Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Self-care techniques are usually all you need to ease symptoms. Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.

Nasal corticoste­roids. These nasal sprays help prevent and treat inflammati­on. Examples include fluticason­e (Flixonase),

budesonide (Rhinocort), mometasone (Nasonex) and beclometha­sone (Beconase).

Decongesta­nts. These medication­s are available in over-thecounter (OTC) and prescripti­on liquids, tablets and nasal sprays. Use nasal decongesta­nts for only a few days, otherwise they may cause the return of more severe congestion (rebound congestion).

OTC pain relievers, such as paracetamo­l, acetaminop­hen or ibuprofen. Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentiall­y life-threatenin­g condition, in children.

Antibiotic­s usually aren’t needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment. Your doctor might wait and watch to see if your bacterial acute sinusitis worsens.

However, severe, progressiv­e or persistent symptoms might require antibiotic­s. If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur. Possible side effects include stomach upset, diarrhoea and allergic skin reactions. Immunother­apy. If allergies are contributi­ng to your sinusitis, allergy shots (immunother­apy) that help reduce the body's reaction to specific allergens may help treat your symptoms. Alternativ­e medicine. No alternativ­e therapies have been proved to ease the symptoms of acute sinusitis, but products containing certain combinatio­ns of herbs may help.

Lifestyle and home remedies Rest. This will help your body fight infection and speed recovery. Drink water. This will help dilute mucous secretions and promote drainage. Avoid beverages that contain caffeine or alcohol, as they can be dehydratin­g. Drinking alcohol can also worsen the swelling of the lining of the sinuses and nose. Keep your sinus cavities

moist. Drape a towel over your head as you breathe in the vapour from a bowl of hot water. Keep the vapour directed toward your face. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucous drain. Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain.

Rinse your nasal passages.

Use a specially designed squeeze bottle (Sinus Rinse, others). This home remedy, called nasal lavage, can help clear your sinuses. Use water that is clean-distilled, sterile, previously boiled and cooled – to make up the irrigation solution. Sleep with your head elevated.

This will help your sinuses drain, reducing congestion. Prevention

Take these steps to help reduce your risk of getting acute sinusitis:

Avoid upper respirator­y infections. Minimise contact with people who have colds. Wash your hands frequently with soap and water, especially before your

meals. Manage your allergies. Work with your doctor to keep symptoms under control.

Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.

Use a humidifier. If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis.

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