Sinusitis:
It's More Than Just a Headache
This
article first appeared in the November 15, 2001 issue of Sinus
News:
You
haven't been feeling good for well over a week. Your whole
face hurts, you have a stuffy nose and a nasty cough. While
it could be a cold you caught a few weeks ago, the persistent
symptoms could be a sign of something more serious, sinusitis.
Sinusitis shouldn't be taken lightly. As many as 31 million people develop
sinusitis every year, according to the American Academy of Allergy, Asthma
and Immunology (AAAAI). Headaches and other sinusitis symptoms not only decrease
the quality of life for sufferers, they impact workplace productivity. People
suffering from sinusitis miss an average of four days of work each year and
there are more than 18 million office visits to primary care physicians resulting
in a diagnosis of sinusitis. Overall health care expenditures attributable
to sinusitis in the United States are more than $5.8 billion.
What is Sinusitis?
Sinusitis, which is common in the winter, is an inflammation of the nasal sinuses
-- hollow cavities within the cheek bones around the eyes and behind the nose. "Sinusitis
can be caused by colds, allergies, problems with the immune system or structural
problems in the nasal cavity. Left undiagnosed or untreated, sinusitis can
cause further complications with the nose, eyes or middle ear and may last
for months or even years," said Allen Adinoff, M.D., FAAAAI, Vice Chair
of the AAAAI's Sinusitis Committee.
The signs and symptoms of sinusitis vary, and many people who suffer from it
may not be aware they have the disease or may be self-medicating improperly.
Symptoms of sinusitis include: thick yellow nasal discharge, headache, a feeling
of facial swelling, congestion, fatigue, and fever.
"There are two types of sinusitis, acute sinusitis and chronic sinusitis," said
Adinoff. "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
Acute sinusitis may be caused by a previous viral infection, which causes swelling
of the sinus membranes. As a result, one or more of the sinuses may become
blocked. A bacterial infection may then occur as a result of the sinus blockage.
-
Acute sinusitis commonly follows a typical "cold." If
cold symptoms last much more than one week, the cold
may have advanced into a sinus infection.
- The most common bacteria that cause acute sinusitis are streptococcus
pneumoniae, Hemophilus influenza, type b and Branhamella catarrhalis.
- If this is your first episode of acute sinusitis and you are not too
sick, you may want to give it a few days to resolve before asking a physician
to prescribe an antibiotic. A decongestant might help relieve symptoms
and promote drainage of the infection.
- If you (or your child) have a fever (greater than 100.5° F), pain
or swelling in the face or eye, redness on the cheek or around the eye,
severe headaches, confusion or a stiff neck, see your physician immediately.
- If you have frequent episodes of acute sinusitis or if your symptoms
never completely go away, you may have chronic sinusitis.
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Chronic Sinusitis
A diagnosis of chronic sinusitis is made when sinusitis symptoms last for more
than 12 weeks despite medical treatment. Chronic sinusitis may be caused by blockage
of the sinus openings, problems with the movement of mucus or a weakness in the
immune system. Symptoms are similar to those of acute sinusitis however, patients
usually do not have a fever.
-
Factors such as allergies or bacterial infection
also play a major role in chronic sinusitis by producing
inflammation in the sinus membranes.
- Chronic sinusitis is one of the most common chronic illnesses in Americans
under 45 years of age.
- Approximately 20% of patients with chronic sinusitis develop nasal polyps.
Nasal polyps are cyst-like growths that develop from sinus tissue. The
resulting growth causes the sinus cavities to become blocked.
- Chronic infection and exposure to allergens can contribute to sinus membrane
inflammation that fails to clear up. People with chronic sinusitis should
undergo an evaluation for allergies, especially to test for allergens that
are difficult to avoid, such as indoor dust mites and molds. |
People with sinusitis should consult with an allergist/immunologist when their
symptoms interfere with their performance, causing them to miss significant amounts
of school or work, or when they do not respond to the usual antibiotic treatment
and the condition becomes chronic, recurring two to three times per year.
An allergist/immunologist is a physician trained in the diagnosis and treatment
of allergic diseases including sinusitis. The allergist/immunologist will take
a thorough history and conduct tests to make a correct diagnosis.
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