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Sinusitis Causes, Signs and Symptoms

sinusitis

Do You Have Sinusitis?

This article will focus on sinusitis causes, signs and symptoms. In part 2, you wil be able to read all about sinusitis treatment. How many people do you know that sniff, clear their nose or throat, or have a handkerchief up to their nose? Some sinus sufferers have an almost continual facial pain or low grade headache, some rely on drugs like pseudoephedrine, paracetamol or even steroidal nasal sprays to get relief from this awful affliction. Sinusitis may be the cause of an annoying condition known as post-nasal drip, where catarrh (mucus) drains almost continually from the sinus cavities down the back of the throat. Some of these people can literally smell and taste mucus or catarrh almost continually. Imagine that for one moment, post-nasal drip can even lead to nausea, a sore throat and a terrible breath. What kind of quality of life is that? It has been estimated that up to 12% of the NZ population are afflicted with sinusitis.I thought it prudent to write this two-part article, because I have had three sinusitis patients so far this week!
Sinus can originate as a residual infection left behind from a cold or ear, nose or throat infection, or an undiscovered food allergy or intolerance or perhaps even a dental problem such as a low grade oral infection from a root canal. I would like to show how you can get relief from this most annoying condition, affecting almost one in ten in this country, without resorting to drugs or surgery. In this issue we will look at what sinusitis is, the signs and symptoms, the likely causes as well as the conventional treatment. In the next issue we will discover some of the most effective treatments I have found to work.

What Are The Sinuses?

The sinuses are hollow spaces in your head, they are lined with mucus membranes and mainly full of air. We don’t really know their real function, some people say they stop our heads being too heavy and may even play a role in helping us hear more clearly. There are 4 sinus spaces, they are above the eyes in the forehead – (the frontal sinuses), either side of the nose behind your cheekbones – (the maxillary sinuses), behind the bridge of your nose and behind the eyes, deeper into the head – (sphenoid sinuses) and the bridge of the nose, between the eyes – (the ethmoid sinuses). Each sinus has a narrow opening or tube connecting it to the back of the nose. I have found that most sinusitis cases generally involve the maxillary and frontal sinuses, particularly the acute cases. When a case has been ongoing and is chronic (longer than three weeks), it can eventually involve all the sinus cavities. Pressure increases in these small spaces, because drainage holes becomes clogged and the small spaces simply can’t handle the sheer amount of mucus produced. This is where the pain and pressure in your face comes from. Anybody who has had recurrent sinusitis will tell you the pain can be down right debilitating.

Sinusitis Signs And Symptoms

Here are some of the typical signs and symptoms, they can vary widely from case to case, depending on which sinus cavities are affected:

Catarrh

Catarrh is the excessive secretion of mucus from the membranes of the nose, the throat, sinuses and the upper respiratory tract. Repeated episodes of catarrh can often lead to that annoying post-nasal drip, which itself can lead to a chronic and annoying cough.

Cough

Post nasal drip can occur, particularly at night or early in the morning the person may cough.

Fever

Generally low grade, but with a severe case of acute bacterial sinusitis the fever can be very high.

Headache

A common sinusitis symptom – typically, facial pressure leads to a headache. A nice hot pack, acupressure or acupuncture can help tremendously here.

Impaired Hearing

Because the drainage holes from the sinuses are narrow they block up easily. A sensation of partial deafness or blockage in the ear may also occur, particularly with little kids, who may start to talk rather loud after a cold! This is because the Eustachian tube, which connects the middle ear to the back of the nose, blocks up in just the same way as the nearby sinus openings.

Nasal Congestion

The person may have a blocked nostril, particularly worse when they lie down at night. The sense of smell is often affected.

Facial Pain

Facial pain is a more common symptom, sometimes a nerve in the face can be affected, and swelling may cause compression of the facial nerve leading to pain like a toothache. Many people think they actually have a toothache or a tension headache, when in fact it is the sinuses which are inflamed causing the headache. I’m sure many a dentist can relate to this! If you put mild pressure just over the eyes (sphenoid sinus) or around the cheekbones (maxillary sinus), or around the bridge of your nose (ethemoid sinus) and it causes pain – your sinuses are generally affected.

Pressure

A sensation of pressure in the head or around the face can occur. This will be particularly present with the congestion and infection of the deeper sinus cavity of the sphenoid sinus, especially if the eyes hurt or feel they are under pressure. The person may also have photophobia (sensitivity to sunlight). Please don’t make the mistake of going on a plane flight (or diving under water) when you have sinusitis. It could really ruin your holiday or trip, I know from past experience myself. Pressurised cabins on board can give you the “headache from hell”.

Sleeping Problems

I find that some patients with chronic sinusitis have problems when they lie down, difficulty in breathing can cause snoring and loss of sleep. Pressure in the head can occur with a positional change in the head, and this relates to a problem again with the drainage of the sinuses. A hot pack at night to the face can offer speedy relief in many cases here.

Two Main Types of Sinusitis: Acute and Chronic

Acute Sinusitis

Usually refers to a sudden, severe inflammation of one or more of the para-nasal sinuses with symptom duration of less than three weeks. The sinuses share a common passageway for drainage and ventilation, so any blockage in this area can result in significant and persistent infection of the larger sinuses. In most cases, the maxillary sinuses (the cheek region) are the site of infection of an acute sinus attack. Acute sinusitis can make you feel quite ill indeed; you may have a high temperature, headache, and facial pain, loss of sense of smell and/or taste. There may be a discharge of yellow or green mucus coming from your nose or throat. These and more are all symptoms of this distressing complaint. Acute bacterial sinusitis is a form of acute sinusitis caused generally by detrimental bacteria, and secondary infections may occur of the chest and middle ear, particularly more so in little children.

Chronic Sinusitis

Is sinusitis where the duration of symptoms is longer than three to four weeks; this condition can significantly interfere with the quality of your daily life. Studies have confirmed that chronic sinus people suffer from facial pain, a decline in general health, poor vitality, and decreased social functioning when compared with healthy persons. Allergic Fungal Sinusitis (also known as AFS) is a form of chronic sinusitis caused by allergic reactions to detrimental fungi that have invaded the sinuses. It is amazing, but an amazing 93% to 97% of chronic sinusitis patients are found to have AFR! There are literally tens of dozens of types of fungi, bacteria and other nasty micro-organisms which can invade the dark, warm and moist regions of you sinus cavities. Think of how tough it can be to weed your garden. You spend considerable time pulling out a few weeds here and there, only to come back to find they have all grown back. Most people resort to Roundup on the weeds (antibiotics) sooner or later, just to get a quick fix. But what if you are unfortunate to have the dreaded oxalis? (AFS) Well, this is a bit like what chronic sinusitis is – an overgrowth of bugs; they are micro-beasties that won’t give up without a fight. You need to be strong and fight back – you can win the war against these bugs but you need to be unrelenting. Forget the surgeon with the knife, you can win the war and claim back your sinuses, to finally be able to stop the drip, the awful catarrh smells, the ongoing sniff, and all the other annoying symptoms like headaches, sore eyes, sore ears, the cough, that terrible ‘trickle down the back of the throat’. Anybody with chronic ongoing sinusitis will understand exactly what I am talking about. Because this is how they feel.    I know exactly how they feel; I used to be one of those people myself. Next month I will show you can win this war.

The Main Causes of Sinusitis

There are two main causes of excess mucus production leading to sinusitis: infection and allergy.  An ENT (ear, nose and throat) surgeon may be quick to tell you however, that your sinusitis is the result of a “narrowing of the sinus passages” or a “deviated septum”, and will offer speedy relief with the knife. What a load of rubbish, I have treated too many sinus patients over the years that have had facial surgery, only to find that it made absolutely no difference a year later. Whilst anatomical defects of the face causing sinus are real, they are quite rare indeed and much more likely to result from an accident or injury affecting the facial region, such as car crash or a fall. These may result in an increased incidence of sinusitis, and each case needs very careful assessment before surgery. Never be in a hurry for any surgery unless it is absolutely critical, for if you act in haste, you may very well repent at leisure.

Food allergies or intolerances

You can read a lot more about Food Allergies and Food Intolerances on our comprehensive page. Naturopaths find themselves treating many cases of sinusitis and hayfever in November, because allergic reactions are at their most common in springtime when allergy-producing pollens are at their most abundant. A food allergy or intolerance or sensitivity to a chemical in the person’s environment all of which may cause swelling of the mucous membranes lining the sinus cavities around the face. Allergies can happen at any time in response to a wide variety of things, including dietary allergies, house dust, moulds and fungus and even animals like cats, dogs or horses. What are the most common dietary allergies as far as sinus is concerned? In my experience, they include the mucus producing dairy products – especially cow’s milk and ice cream, but also the more commonly overlooked foods like bananas, breads, biscuits, pasta, noodles, processed breakfast cereals and refined sugars such as sweets. Protein rich foods should be ok though.

Salicylate sensitivity

A commonly overlooked sinus problem. I’ll never forget a patient in her 60’s who suffered from sinus almost all of her life, once we discovered it was salicylates causing her grief, her sense of smell came back and her sinus cleared up completely when we placed her on a salicylate free diet. Salicylates are chemicals that occur naturally in many plants, acting as preservatives to delay rotting and as protectants against harmful bacteria and fungi. They are a type of insecticide which are designed to protect the plant from various bugs and insects, which they readily poison. Salicylates can affect some adults considerably though, and can particularly affect younger children, sometimes causing their behaviour to be really hyper, particularly so when a child already had asthma or eczema as well. Nasal polyps and sinusitis are both problems stemming from salicylates and aspirin intolerances in up to one third of people suffering from these annoying complaints. The highest containing salicylate foods are most berries, citrus, capsicum, champignon mushroom, chicory, endive, gherkin, radish, tomato products (tinned and paste), zucchini, green olive, red chili, almonds, honey, liquorice, peppermints, any confectionery containing mint, normal tea, peppermint tea, liqueurs, port, rum and wines.

Dental trauma

I have found that root canal therapy, particularly in the upper jaw, can lead to sinus infection. Think about it, the maxillary sinus are right on top of the teeth in the upper jaw, and even the tiniest infection can cause a continual “seeding” of the maxillary region. Since many patients with sinus problems of dental origin typically do not have any complaints of tooth or mouth pain, the correct diagnosis is generally overlooked by the unsuspecting clinician, according to the School of Dental and Oral Surgery, Columbia University in New York. I always ask patients with sinusitis these questions: “When did you see a dentist last, have you had any root canal therapy or have any known dental problems, particularly the upper jaw?” It is amazing how many people actually confirm they have one or more root canals, and then some on the same side of the face they actually have the problems!  Do you have recurrent sinus, and have a root canal? See your dentist soon.

Antibiotics are not the answer

Generally, sinusitis is treated with an antibiotic which is deemed to “cure” the patient by” killing” the infection. Because the penetration of antibiotics inside the sinus cavities is poor, an extended period of treatment will often be deemed necessary. Some American studies have shown that antibiotics are only really effective for clearing the very most acute maxillary sinusitis cases, but are pretty useless once they get to the chronic (often fungal) stages. This is because antibiotics rarely penetrate well into bone tissue, and many detrimental bacteria or fungi particularly, in sinusitis patients are located inside the actual bone tissue. According to the New England Journal of Medicine (Vol. 330-1994), there is a great deal of evidence that antibiotics are generally not required to treat cases of sinusitis.
Studies show that the majority of people with colds show evidence of sinusitis on sinus CAT scans, and that their immune systems cure sinusitis all be themselves without any antibiotics within one to two weeks. Millions are being spent on drugs in NZ which are supposed to “cure” and to produce truly “marvellous results” with immune related illnesses from which we were probably going to get better all by themselves anyway. In the year 2006, an incredible $579 million was spent in NZ on pharmaceutical drugs alone. Even when bacteria do invade the sinus cavities, the sensitivity of bacteria to specific antibiotics and the response of the person to those same antibiotics generally don’t always match up. You will sometimes here the doctor say “well, let’s try this one”, you have probably been given a drug which didn’t match the bugs it was designed to kill. But kill it will, if not the bad bugs, usually your good bugs. Repeated antibiotic dosing may lead to a fungal overgrowth (candida) and down your immune health goes – resulting in a merry-go-round of drugs, sinus symptoms and continual health problems. If this is you, then for goodness sakes get out of the of drug “fun park”.
In the Journal of Allergy and Clinical Immunology (Vol. 91 -1993) an interesting article discusses that “children with sinusitis fare no better if they receive antibiotics than if they don’t” Unfortunately, children are not generally recommended lifestyle changes when they present to a medical clinic with sinusitis, their diet is not altered, mucus promoting foods are not reduced, recommendations are not generally made to use essential oils to relieve congestion, no offer of a lower risk treatment than a drug or even a recommendation to drink more water and less milk or soda drinks. In fact the poor little sinus sufferer’s caregiver was probably only told in a rushed 3 minute visit to place the child on a ten day drug course.