Learn About Sinusitis
What is Sinusitis?
Key Symptoms
What Causes Sinusitis?
Conventional Treatments
Medication
Tests and Procedures
Treatment and Prevention
How Supplements Can Help
Self-Care Remedies
Alternative Therapies
When to Call a Doctor
Evidence Based Rating Scale
References
The sinuses are four pairs of openings in the front of the skull, which are located above, behind, and below the eyes and are connected to the inside of the nose.
Normally these cavities are empty, and their lining produces mucus, which routinely clears away dust, pollen, other inhaled particles, and bacteria. The mucus drains harmlessly into the nose or the back of the throat, and from there it flows into the stomach, where stomach acids destroy any dangerous germs.
However, when the sinus lining becomes inflamed, tissues can swell. The cells produce very thick mucus, which is unable to drain properly through the small sinus channels and openings. The pressure that builds up can result in headache, a sense of congestion, pain around the sinus areas, and other symptoms. If the swelling doesn't subside so that the mucus can drain, bacteria can also breed and thrive.
Sinusitis can be acute or chronic. Acute sinusitis is usually the result of bacterial infection, and it can cause fever and chills as well as severe facial pain and swelling around the eyes. Dental discomfort is also a common complaint. Chronic sinusitis is usually a response to a persistent inflammation of the mucous membranes. Symptoms are usually milder, but can recur frequently.
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- Painful headache in the front of the face, particularly around the eyes
- A sense of pressure and fullness
- Runny nose and congestion
- Frequent coughing and throat clearing
- Swelling of eyelids or pain behind the eyes
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Sinusitis may occur as a complication of an upper respiratory infection, such as a cold or the flu, which spreads to the sinuses. Acute sinusitis is typically caused by a bacterial infection. An infection can also cause chronic sinusitis to develop, though there is now evidence that many chronic cases are caused by an immune system response to naturally occurring fungi carried in the nose.
Chronic sinusitis can also occur when the linings of the sinus cavity are irritated by:
- Prolonged allergy attacks
- Exposure to tobacco smoke, dust, or airborne pollutants
- Swimming in polluted water
- Spread of an infection from an abscess of an upper tooth
- Deviated nasal septum or polyps in the nasal cavities
- Overuse of nonprescription nasal sprays or antihistamines.
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If your symptoms are especially painful or you're not sure whether they're part of a chronic condition, it's always a good idea to consult a physician, who can determine if your sinusitis is caused by a bacterial infection. This may require treatment with prescription antibiotics. But even conventional practitioners are beginning to question the universal application of antibiotics and other drugs, especially for people with chronic sinus conditions that don't stem from bacteria. In addition, antibiotics won't help prevent future sinus infections.
For relief of sinus pain, conventional doctors may also recommend nonprescription pain relievers such as aspirin or ibuprofen--and they may suggest using antihistamines when sinusitis attacks appear to be triggered by allergic reactions.
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If a bacterial infection is causing the sinusitis, you may be prescribed an antibiotic, such as ampicillin or amoxicillin. Patients usually need to take antibiotics for about two weeks.
Decongestants also might be recommended to relieve symptoms. However, nasal sprays can cause dependency if used for a prolonged period. Typically, decongestants should not be used for longer than 3 to 5 days in a row, unless otherwise prescribed by your doctor. You should also avoid decongestants if you have heart disease, high blood pressure, migraines, or Raynaud's disease, if you have difficulty urinating, have emphysema, or take certain medications such as antidepressants.
Steroids (oral or nasal) might also be prescribed to decrease inflammation in patients with acute or chronic sinusitis.
In some cases of chronic sinusitis, surgery might be required. Surgical drainage might be required to combat symptoms not responding to other medicines and treatments; surgery might also be required to repair a deviated septum or nasal polyps if less invasive methods have not been effective.
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Your doctor may take a nasal secretion sample, particularly if a bacterial infection or fungal infection is suspected. (1)
An x-ray, CT scan or ultrasound also might be used to diagnose sinusitis.
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Conventional therapies may only be effective in the short-term, however. Alternative remedies for chronic sinusitis are targeted at relieving pain, draining blocked or swollen sinuses, and strengthening the immune system to ward off infection. A number of vitamin and herbal supplements can help in all these respects, and self-care remedies--such as using hot compresses to relieve sinus pressure--can also be very beneficial.
Acupuncture and craniosacral therapy are alternative modalities that have been quite successful at clearing the sinuses and relieving nasal congestion and pressure.
Rarely, for severe sinus problems, surgery may be recommended to drain or repair sinuses.
To prevent sinusitis, avoiding or quickly treat any flus or colds. Wash your hands frequently, eat foods rich in antioxidants, and avoid foods and airborne allergens to correct the underlying problem that allowed the allergy to develop.
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Dietary supplements that act as immune boosters can be taken on a daily basis. These include echinacea, vitamin C, and flavonoids to which you can add an antioxidant complex that contains vitamin E, beta-carotene, selenium, and more.
In a study of 524 children between the ages of 2 and 11 conducted during the winter months of 2000 – 2002, researchers found that the children who took echinacea after the occurrence of the first upper respiratory tract infection experienced 28% less recurrent (2). For best results, take echinacea at the first sign of illness.
Vitamin C is a natural Antihistamine capable of blocking the effect of inflammatory substances some people produce in response to allergens such as pollen and pet dander. This supplement has value when taken over weeks, at a dose of 500 mg three times daily, rather than just at the time of an attack. Vitamin C works best when combined with bioflavonoids – nutrients found in fruits and vegetables. One especially powerful bioflavonoid is quercetin, which has also been shown to slow the release of histamine (3). It also works as an antioxidant against unstable oxygen molecules that can cause inflammation in respiratory passages. In addition to a first-line treatment for sinusitis, bioflavonoids can be an important supplement at a dose of 1,000 mg daily.
Until symptoms disappear, the amino acid NAC (N-acetylcysteine) and an ephedra-free herbal decongestant can be very helpful in easing breathing and clearing nasal passages. (4) Conventional physicians routinely use NAC to dilute thick mucus, making it much easier to cough up or drain from the nasal passages and other congested areas. NAC is often used as a diluted saline, sodium bicarbonate, and sterile water solution, but it also can be used orally for sinusitis. (5) An anti-inflammatory supplement, such as serratia peptidase or bromelain, can be added to help reduce discomfort. (6) When patients with chronic sinusitis were given serratia peptidase at a dose of 30 mg daily for four weeks, it significantly reduced the viscosity of nasal mucus. (7)
Goldenseal's properties as both an anti-infective and mucous membrane anti-inflammatory may be helpful in easing sinusitis symptoms and hastening the healing process. It is particularly effective when used in the form of a warm sinus irrigating solution that loosens and washes away the thickened, infected Mucus that can cling to the walls of the sinus cavities. (8)
Siberian Ginseng, an herb best known for its energy-boosting and stress-reducing properties, also has been shown to ease symptoms of sinusitis. (9)
When inhaled, eucalyptol, the key medicinal ingredient in eucalyptus oil, works as an expectorant, loosening sticky mucus and making it easier to cough up and out of the chest. (10) In addition, astringent substances in the oil called tannins tighten and thus soothe mucous membrane inflammation in the mouth, nose, and throat. Lozenges containing eucalyptol increase saliva production, prompting more frequent swallowing and thus reducing the impulse to cough. The oil's germ-fighting actions may reduce the risk of a secondary respiratory infection.
Get supplement dosages and tips in our WholeHealthMD Supplement Recommendations for Sinusitis.
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It's important to drink plenty of water or other fluids--six to eight glasses daily--to loosen impacted mucus. Soup, tea, or other warm liquids can be especially soothing.
Inhaling steam helps to thin mucus. Heat water in a pan, place a towel over your head, lean over the pan of hot water, and inhale the steam. Adding a few drops of eucalyptus oil to the water will enhance this effect.
Apply a hot compress (a moistened warm hand towel or wash cloth) to your face. The heat "opens up" sinuses to relieve pressure.
Reduce or avoid drinking alcohol; it has a dehydrating effect that can make mucus dry and thick.
A sinus irrigator, which you can purchase in drug stores and health-food stores, can be used to clear out sinuses with saline solution.
Washing the sinuses out with a saline solution that contains goldenseal may help the body combat viruses, bacteria, and fungi.
Avoid air-borne irritants, especially secondhand smoke, that can inflame sinuses. Use an air purifier in your home, if necessary, to control irritants. If indoor air is dry, which can aggravate sinusitis, use a humidifier.
Long-term avoidance might require eliminating any foods that caused the allergy to develop. Common food allergens include citrus, corn, eggs, milk, peanuts, and wheat.
Some particularly sensitive patients may need to have all pets, carpeting and feather bedding removed. (11)
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A gentle form of manipulation, craniosacral therapy is a hands-on healing technique that can help clear blockages and correct the flow of cerebrospinal fluid so it is smooth and even. Several weekly sessions might be required to ease sinusitis symptoms, but patients often feel profoundly relaxed after each treatment.
Breathing in the intense aromas of essential oils through aromatherapy is often
Supplement Recommendations for Sinusitis
From Monica Myklebust, M.D. at WholeHealthMD:
The vitamins and herbs we recommend for sinusitis are especially valuable for anyone who suffers from recurrent sinus problems. None of these supplements has any of the irritating side effects, such as dry mouth or jitteriness, that often accompany antihistamines, decongestants, or other conventional medications commonly prescribed for sinusitis.
How to Take the Supplements
If your sinus congestion begins to flare up, immediately start using the immune boosters echinacea and vitamin C as well as an ephedra-free herbal decongestant.
If the mucus drainage is very thick, consider adding N-acetylcysteine, or NAC, (a mucus thinner) and bromelain (an enzyme) but don't forget regular steam inhalation with a little eucalyptus oil. If you have access to a neti pot or a sinus irrigator, use it as well to help clear away the infected mucus. Morning and evening, add a teaspoon of goldenseal liquid extract to the irrigation solution to make a useful natural antibiotic.
On a preventive basis, use echinacea three weeks of every month during the cold and flu season. If you're really troubled with a lot of sinus infections, regular irrigation of your sinuses is highly recommended.
Of special interest
If flare-ups of your sinus congestion can be associated with stress, considering adding the herb kava (250 mg 3 times a day) for several days.
The FDA has recently issued warnings on kava due to its adverse effects on the liver. Before using this herb, please read the entry on kava in the WholeHealthMD Reference Library.
If you're female and your sinusitis seems to predictably worsen during the week or so before your period, then treating your PMS may also benefit your sinuses. An good solution is a
PMS herbal combination (two capsules twice a day starting 10 days or even longer prior to flow, and stopping during actual menstrual flow itself). It will probably take two cycles for maximum benefit to be apparent.
The Healing Path for Sinusitis provides more extensive therapeutic information about this condition.
Important:
We at
WholeHealthMD strongly recommend that everyone take a high-potency
multivitamin/mineral and well-balanced
antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain
cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you're taking medications. Key cautions are given in the listing below, but you need to see the
WholeHealthMD Reference Library for a comprehensive discussion of each supplement's cautions and drug/nutrient interactions.