Suffering from sinus issues?

Helpful tips on reducing sinus congestion and sinus infection

 I wrote this blog because at my office we see patients all the time that believe they have pain resulting from an upper tooth when in reality it is their sinus.  Often it is a minor sinus infection that with a little at home treatment can be alleviated quickly.
Where are the sinuses at?maxillary sinus infection

1.  Take Mucinex-D twice a day

2.  Take Loratadine once a day.

3. Use a saline rinse 2-3 times a day for 5-10 days.

If problems do not clear by day 10 stop the medications.

mucinex - sinus congestion

loratadine sinus infection

sinus rinse

Treatment of Acute Sinusitis = Short lasting Sinus infection
  • Saline nasal irrigation, decongestants, antihistamines, and expectorants for at least 5 days and a maximum of 10 days for mild-to-moderate symptoms.
  • Sinus infections are usually initially caused by a virus, which do not respond to antibiotics. Antibiotics do have side effects (such as diarrhea or upset stomach) and can contribute to you becoming resistant or allergic to antibiotics in the future.
  • Antibiotics are not helpful for patients with mild-to-moderate symptoms, so they should not be prescribed for at least the first 14 days.
Treatment of Chronic Sinusitis = Long lasting Sinus infection (If this is the case need to see ENT M.D.)
  • Broad-spectrum antibiotic (one that can eliminate a wide range of bacteria).  May need to use for a long time.
  • A corticosteroid nasal spray. Some doctors also recommend oral corticosteroids (such as prednisone), especially if you do not respond to nasal corticosteroids or have nasal polyps. Prednisone is used for those with fungal sinusitis.
  • Saline nasal irrigation is needed on an ongoing basis.
  • If the condition dramatically improves after 1 – 2 months, antibiotics are stopped. The patient should continue with both the steroid and saline nasal solutions. If there is no improvement
    after this time, surgery may be considered. For many people with chronic sinusitis, however, the condition is not curable, only mangabale.  The goal of treatment is to improve the quality of life.
  • Diagnostic work-up should be performed to rule out any underlying conditions; including allergies, asthma, any immune problems, gastroesophageal reflux disorder, and structural problems in the nasal passages.
Hydration
Home remedies may be all that is needed for mild sinusitis.
  • Drink plenty of fluids and getting rest
  • Warm chicken soup does, indeed, help congestion and aches.  Any hot beverage may have similar soothing effects from steam.
  • Spicy foods that contain hot peppers or horseradish may help clear sinuses.
  • Inhaling steam 2 – 4 times a day is extremely helpful.
Nasal Wash
NeilMed Sinus Rinse is a wash that is easy to use and recommended for all ages.  Neti pots are also popular
  • Perform the nasal wash several times a day.
Antibiotic Use in the Treatment of Sinusitis
Overview on Antibiotics and Their Overuse.
Sinusitis is the fifth most common diagnosis for antibiotic prescriptions. But there is much evidence that antibiotics are inappropriately prescribed for many patients:
  • Most acute sinusitis cases clear up on their own.
  • Antibiotics generally help only a very small number of children with persistent nasal discharge for at least 20 days.
  • The overuse has lead to serious problems with digestive systems, development of allergies to antibiotics, and resistance to antibiotics.  All three are serious and regularly cause death around the world.
When to Use Antibiotics.
Wait 0ne to two weeks. Can use earlier if:
  • Fever greater than 39° C (102.2° F)
  • Facial pain or headache
  • Severe swelling around the eyes
Antibiotic Regimens.
  • 10 – 14 day course of amoxicillin.  Trimethoprim-sulfamethoxazole is an alternative choice.
  • More complicated illnesses amoxicillin-clavulanate, cephalosporin, or a macrolide.
Side Effects of Antibiotics.
  • Gastrointestinal issues including C. diff
  • Vaginal infections in women
  • Allergic reactions
  • Oral fungal infections

Severe Fungal Sinusitis.
Sinusitis caused by fungal infections is a medical emergency.  Treatment is aggressive surgery and high-dose antifungal chemotherapywith a drug such as amphotericin B.

 Bryan Bauer, DDS, FAGD
630-665-5550

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