How to stop chronic sinusitis

Cold and Flu


Owen Wiseman
@AVogel_ca


07 December 2020

What is chronic sinusitis?

The nose is an incredible product of evolution that allows the body to filter and humidify air. There are a few different paired sinus cavities including the frontal and maxillary ones. These are prone to inflammation and sinusitis - also known as a sinus infection or rhinosinusitis - is actually far more common than you might expect. It also doesn't discriminate between age groups and is one of the most common reasons for antibiotic prescriptions.

What type of symptoms should I expect to battle?

Sinusitis can bring about purulent discharge that can be green or yellow and reduce one's sense of smell as scents can't get through the mucus to the receptors beneath it. As the bacteria builds up, it begins to exert pressure on the walls of the sinus cavities. This pressure then triggers a signal and can radiate up the head and throughout the jaw.

This pressure can create a sense of debilitating pain that can test even the hardiest of individuals. Not to mention how the build-up of mucus runs the risk of completely obstructing the nasal passages. Obstruction would lead to trouble sleeping and mouth breathing, potentially leading to halitosis (bad breath) and poorer filtration of pathogens. The other aspect to consider for an official diagnosis is that the symptoms must be present for at least 12 weeks.

What are the causes?

Humans have various pathogens to potentially thank for their condition including members from the streptococcal and pneumococcal families. Certain bacterial species love dark, moist places like those found in the nasal passages. This makes it an ideal breeding ground for them to proliferate.

In 1999, research out of the University at Buffalo noted that a fungus was present in the mucus of over 96% of those suffering from chronic sinusitis and following the administration of antifungals, over 70% of patients noticed improvements in their condition. Though a meta-analysis in 2012 noted that the side effects of antifungal therapy outweigh the benefits.

The nasal cavities also respond to irritation or inflammation by producing mucous to coat the tissue in an effort to soothe it. This is also to protect the tissue as the swollen blood vessels are closer to the surface and make infiltration by pathogens easier. Irritants such as cigarette smoke or even excess dust can irritate the nose causing the body to respond with increased mucous production.

It is also worth a visit to your doctor to have them perform tests to rule out other causes. Certain individuals may have structural changes including nasal polyps or a deviated septum which impair proper air flow. Finally, these tests will help rule out more serious conditions including cystic fibrosis or immunodeficiencies that can manifest with sinusitis.

Does chronic sinusitis ever go away, or am I stuck with this?

Day by day, chronic sinusitis definitely feels like something that will be with you for years to come. However, this is actually a condition that can be alleviated with the right approach. This may lead you to consider decongestants, but evidence for their use is chronic sinusitis is seriously lacking.

Interestingly enough, due to the lack of evidence for the benefit of nasal decongestants in treating sinusitis, the FDA ordered manufacturers of over-the-counter (OTC) nasal decongestant products to remove all references to sinusitis from their labeling. These decongestants may also contain oxymetazoline which is incredibly fast acting by inducing vasoconstriction in the nasal passages, reducing mucous production and swelling, but their use is not recommended past 72h due to a host of systemic side effects.

Certain saline sprays contain benzalkonium chloride (BKC) as a preservative, and its presence has been linked to a condition known as rhinitis medicamentosa. BKC has also been shown to significantly impair nasal mucociliary clearance. This is the ability of nasal passages to clear the mucous containing trapped pathogens.

Is chronic sinusitis an autoimmune disease?

As discussed above, the causes of chronic sinusitis are numerous, and it could be a manifestation of other autoimmune conditions like cystic fibrosis.

Are there ways to prevent any of these symptoms?

Individuals should seek means of reducing triggers that might irritate the nasal passages including allergens. A significant portion of Canadians may experience allergic rhinitis that they're completely unaware of and may be putting themselves at risk of symptoms without realizing. If you suspect allergies, it is worth speaking to your healthcare provider about seeking testing.

It's worth considering adding some plants to your house to help increase humidity and contribute to a small reduction in volatile organic compounds and indoor particulate matter.

Through this article, we have come to understand that the condition may have a strong bacterial or viral component to it. Certain herbal products with antibacterial and antiviral properties demonstrated through clinical trials may be worth considering. Echinaforce is an herbal preparation made from fresh, organic Echinacea purpurea. Over more than 20 clinical trials have demonstrated its broad antiviral activity against species including rhinovirus, influenza A & B, respiratory syncytial virus and herpes simplex. It has also been shown to have antibacterial properties against species including Staphylococcus and H. influenzae.

I need some symptomatic relief!

While the goal is to focus on treating the root cause of chronic sinusitis, products like Sinna may be worth turning to for relief. A clinical trial conducted in 2003 demonstrated symptomatic relief in 67% of the 81 participants suffering from chronic rhinosinusitis.

If you're looking for more information, feel free to check out the Cold and Flu Coach Program for days of general information delivered straight to your inbox!

References:
https://www.jacionline.org/article/S0091-6749(05)03754-1/fulltext
https://www.ncbi.nlm.nih.gov/books/NBK441934/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906505/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402865/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423572/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480428/
https://pubmed.ncbi.nlm.nih.gov/10566570
https://www.semanticscholar.org/paper/Acute-and-chronic-sinusitis-%3A-treatment-with-a-of-a-Suter-Bommer/3fcbc479f8e08da2b3800592de8b4b5e40d773a4