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Sinusitis

 


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Condition
Sinusitis
Class
Ear, nose and throat
Description
Sinusitis is an inflammation of the membranes lining the sinuses, which are the air filled spaces in the bones of the face. These spaces can be found in the cheeks, forehead and between the eyes and nose. When the membranes become inflamed they secrete increased amounts of mucus or ‘catarrh’ that blocks the sinuses, causes pain and makes breathing difficult.

There are two forms of sinusitis, acute and chronic. Acute sinusitis tends to develop rapidly and clear after a few days. It is extremely common, affecting people of all ages many times during their life. Chronic sinusitis may last for several weeks or even months and is the less common form of the condition.
Causes
The most common cause of sinusitis is a viral infection such as a cold or influenza. Other causes are a bacterial infection arising for example from a tooth abscess or from swimming in polluted water. Allergies may also cause sinusitis.
Symptoms
Sinusitis causes pain in the cheeks, forehead and nose, which often gets worse when the head is moved or the person bends down. Severe sinusitis can also cause toothache, so eating may be painful. The nose may become blocked or runny, and if there is a viral or bacterial infection, the mucus will thicken and turn yellowy-green.

Young babies, who tend to breathe through their nose rather than their mouth, may have difficulty in breast feeding or bottle feeding, making them irritable.

All people affected will experience a general feeling of being unwell.
Treatment
Sinusitis will normally get better by itself within a few days, but if it is particularly troublesome there are a number of ways to ease symptoms.

Allergic sinusitis may be treated by means of anti-allergic nasal sprays containing sodium cromoglicate, or steroid nasal sprays containing beclometasone. Oral antihistamines such as acrivastine, cetirizine and loratadine may also help relieve symptoms and are less likely to cause drowsiness than some of the older antihistamines.

Sinusitis arising from a cold or influenza may be eased by means of steam inhalation. Simply placing a towel over the head and inhaling the steam from a bowl of hot water, or from a bowl of hot water to which menthol, eucalyptus or other essential oils has been added, can help clear the sinuses as it breaks up the mucus, making it easier for it to drain away.

Decongestants, such as pseudoephedrine, phenylephrine, oxymetazole and xylometazoline, can help clear a blocked nose and sinuses but should not be used long-term as they can make the condition worse.

Decongestants should not be used in children under 6 years of age, but vapour rubs and inhalant decongestants may be applied to the baby's clothing to help clear a blocked nose. If a baby has difficulty in feeding because of a blocked nose, nose drops containing saline may help.
When to see your pharmacist

All of the products for the relief of sinusitis are available from your community pharmacy without a prescription. Describe your symptoms to your pharmacist who will be able to determine whether the sinusitis is caused by an infection or an allergy and so recommend an appropriate product. Tell your pharmacist who the medicine is for and whether the person is a child or elderly, likely to be pregnant, has any other illnesses or is taking any other medicines. Some of the products, but particularly the decongestants, must not be used in children under 6 years and should be avoided by people with high blood pressure or heart problems.

When to see your doctor

If you have very severe pain or your symptoms have not got any better after five days, see your doctor. If you have a bacterial infection, you may need a course of antibiotics. You should also check with your doctor if you develop a high temperature or your face swells.

If you have sinusitis that last for weeks or months, you may have chronic sinusitis and your doctor may decide to refer you to an Ear, Nose and Throat (ENT) specialist.

Living with sinusitis

Some simple measures can reduce the risk of sinusitis. If you smoke, make every effort to stop smoking. Not only will this help reduce sinusitis it will also reduce your chances of getting other serious illness such as heart problems. Even if you do not smoke, you should avoid smoky conditions and very dry environments that can irritate the sinuses.

If you do get sinusitis, try one of the over the counter remedies recommended above before going to see your doctor.

If you think that your sinusitis is caused by an allergy, keep a diary of things that you have done, places you have been and what the weather was like to try to find a link with your symptoms. If you do find what triggers sinusitis or makes symptoms worse, you can try to avoid exposure to these triggers in future.

Useful Tips
  • Give up smoking

  • Do not blow your nose too hard as it damages the delicate internal membranes of your nose

  • Try steam inhalation methods

  • If you have had sinusitis before, use a decongestant when you have a cold

  • Do not use decongestants for long periods


Reviewed on 27 June 2011



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