Sinusitis: When you have a headache and a stuffy nose

Dear Doc,

My relative has been having cold-like symptoms, but on visiting a doctor, she was told she had sinusitis. What is sinusitis and does it have any relationship with the common cold?

Terry

Dear Terry,

Sinusitis (infection of the sinuses) is an inflammation of the sinuses characterised by swelling and irritation that is usually the result of an infection. Sinusitis can be either acute or chronic.

The sinuses are air-filled cavities in our heads lined with mucosa. These cavities ensure that the head is not too heavy to carry around, and also allow us to talk without hearing ourselves too loudly.

They produce mucus that moves through their small openings and drains into the nose. When a person has sinusitis, these tiny openings become swollen and congested as as result of an allergy, viruses, bacteria or irritants like chemicals that block the sinuses.

This obstructs drainage, thereby causing mucus build-up. At times bacteria can infect this mucus. In most cases, the common cold is usually the cause of acute sinusitis.

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Dear Doc,

For some time now, I have been having frequent nasal congestion. Could I be suffering from sinusitis and how is it diagnosed?

Awuor

Dear Awuor,

Nasal congestion is one of the symptoms of sinusitis as a result of a blocakge of the sinuses, which interferes with the normal drainage of mucus.

Other symptoms might include persistent symptoms of an upper respiratory tract infection, thick nasal discharge and postnasal mucus drainage, reduced or lack of sense of smell and taste, facial pain, pressure and swelling around the eyes, nose, cheeks or the forehead, headache, fever and a cough, which can worsen at night.

Other symptoms might include aches in the teeth and upper jaw, ear pain, and fatigue.

The diagnosis of sinusitis is based on medical history, physical examination, imaging and/or laboratory tests. Acute sinusitis is primarily diagnosed from a person’s medical history and physical examination; imaging might not be necessary.

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Dear Doc,

What are the causes of sinusitis?

Kimani

Dear Kimani,

Sinusitis can be caused by anything that obstructs airflow to the sinuses and the draining of mucus from the same. A viral upper respiratory tract infection or the common cold are the most common causes of acute bacterial sinusitis.

Allergy, trauma, growths or tumors near the openings of the sinus, as well as other inflammatory diseases, environmental factors, dental infection, and anatomic variations which can impair normal mucus clearance can also predispose a person to bacterial infection.

Over-the-counter nasal sprays, cigarette smoke, and cocaine use can also cause infection of the sinuses. Only rarely is sinusitis caused by fungi. Sinusitis caused by bacteria tends to make a person appear sicker than that caused by a virus. Usually, a person with bacterial sinusitis has more swelling and facial pain than a person with viral sinusitis, and might even develop a fever. Sinusitis caused by bacteria is treated with antibiotics.

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Dear Doc,

What is the difference between acute and chronic sinusitis? Also, advise on some remedies to help manage and relieve the symptoms.

John

Dear John,

The symptoms of acute sinusitis last less than four weeks while those of chronic sinusitis persist for between eight and 12 weeks. In recurrent sinusitis, there are three or more acute bouts annually.

To help relieve the symptoms of sinusitis, allow yourself enough rest to help the body fight the infection and speed up recovery. It is also advisable to sleep with your head elevated to help the sinuses drain and thereby reduce congestion. To help ease the facial pain, place a warm, damp towel on your cheeks, eyes, and nose.

Drink lots of fluids such as fruit juices and water to help dilute mucous secretions and enhance drainage. Avoid beverages that contain alcohol or caffeine since they can cause dehydration. Alcohol can also cause swelling of the nose and lining of the sinuses.

Moisten the sinus cavities by covering your head with a towel as you breathe in steam from a basin or bowl of hot water. You can also have a hot shower, and breathe in the moist, warm air. This helps drain the mucus and ease the pain.

Rinse out the nasal passages using a specially designed squeeze bottle, like sinus rinse. This is a home remedy that helps clear the sinuses. You might need to see your doctor for more specific treatment.

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Dear Doc,

When is surgery an option for a person with sinusitis and what kind of medical professional has the competence to carry out the surgery?

Doreen

Dear Doreen,

Surgery is normally recommended for cases that do not respond to medical treatment.

The main objective of the surgery is to re-establish sinus ventilation and to restore normal clearance of the mucus.

Recent developments in endoscopic technology and a better understanding of sinusitis have resulted in the introduction of functional endoscopic sinus surgery (FESS) as the surgical procedure of choice for the treatment of chronic sinusitis. Because FESS carries certain risks, it should only be carried out by a highly experienced ENT surgeon.

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