Crisp air and falling temperatures are back bringing with them sinusitis season. Sinusitis develops in approximately 31 million Americans each year, according to the American Academy of Allergy, Asthma and Immunology (AAAAI).

Each year, more than 18 million physician office visits result in a diagnosis of sinusitis, and sufferers miss an average of four work days each year because of sinusitis. Annual health care expenditures attributable to sinusitis total more than $5.8 billion dollars.

What is sinusitis?

Sinusitis is an inflammation of the nasal sinuses, hollow cavities within the cheek bones around the eyes and behind the nose. Their primary function is to warm, moisten and filter air in the nasal cavity. Sinusitis usually is caused by inadequate draining of the sinus cavities due to allergies, infection or obstruction. There are two types of sinusitis, acute sinusitis and chronic sinusitis. In both forms, nasal congestion produces swelling in the sinus cavity, obstructing drainage and causing mucus to stagnate, providing a breeding ground for infection. Acute sinusitis, in most cases, is caused by a bacterial infection and usually develops as a complication five to ten days after the first symptoms of a viral respiratory infection, such as the common cold. Those with allergies are predisposed to develop acute sinusitis. Chronic sinusitis is a recurring condition which also may be caused by bacterial infection, but more often is a chronic inflammatory disorder similar to bronchial asthma.

Symptoms of sinusitis may include:

• profuse, thick colored nasal drainage,
• bad tasting post-nasal drip,
• cough,
• head congestion/headache,
• a plugged up nose,
• a feeling of facial swelling,
• toothache,
• constant tiredness, and
• occasionally a fever.

Sinusitis also can affect the nose, eyes, or middle ear and may last for months or even years if left untreated.

Patients often mistake sinusitis for the common cold because the two share similar symptoms however, according to Frank Virant, M.D., Fellow of the AAAAI, Chair of the AAAAI Sinusitis Committee, the common cold resolves in five to seven days. Symptoms lasting more than seven days could be an indication of sinusitis.

Mistaking sinusitis for the common cold is why patients often don't seek treatment. "In the first two to three weeks, most patients assume it's just a lingering cold that will 'eventually go away.' Other patients might think their symptoms are due to increased allergies," Virant said. "It's important to seek treatment for sinusitis because, depending on the type of bacteria, delayed treatment may result in infections of the blood, or adjacent bones, and with all infections, sinusitis may induce asthma."

Treatment

A sinus infection commonly is treated with a combination of medications, such as an antibiotic to control bacterial infection, and a nasal steroid to reduce swelling. For people with chronic sinusitis due to allergies, immunotherapy, or "allergy shots," may be prescribed to reduce susceptibility. Preventive measures, such as the use of nasal steroids or nasal saline irrigation during times of increased susceptibility may help those with chronic sinusitis.

To help alleviate sinusitis symptoms, allergists recommend:

• Taking your medications as prescribed. Do not take more medicine to alleviate severe symptoms. If you are prescribed antibiotics, finish all of the antibiotic.
• Breathing in steam
• Using hot packs to alleviate facial pain
• Increasing fluid intake
• Using an over-the-counter sterile salt water nasal spray

If you have sinusitis symptoms, consult an allergist/immunologist. An allergist/immunologist is a physician trained in the diagnosis and treatment of allergic diseases including sinusitis. The allergist will take a thorough history and conduct tests to make a correct diagnosis.

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