Medications
Other medications can be taken alone or with antibiotics to treat specific symptoms and speed recovery. For example, analgesics such as paracetamol or aspirin plus or minus codeine soothe sinus pain and headache, and nasal or oral decongestants reduce swelling of the sinus linings and help you breathe easier fast. Popular decongestants include Sudafed, which contains pseudoephedrine, and Drixine, Logicin and Dimetaapp 12-hour nasal spray, which include oxymetazoline. Be sure to consult your doctor before trying a decongestant spray; in some cases, it can make congestion worse. And always limit use to three to four days to prevent a rebound effect: as the decongestant wears off, it may actually cause swelling in your nasal passages.
>I've never had sinusitis before. Am I going to get a lot of these infections in the future?Probably not. Most attacks of acute sinusitis are really just complications of an especially bad cold, in which thickened mucus in the sinuses becomes infected by bacteria. Once antibiotics have cleared up your infection, there shouldn't be a problem with recurrence.>My doctor prescribed antibiotics for three weeks. Why do I have to take them for so long?
Your sinuses are like caves within your skull. As such, they receive a relatively small supply of blood (as compared with your lungs or kidneys.) Since the antibiotics are carried to the infected sinuses through your blood stream, you need to be on these drugs for at least 10 to 14 days in order for the medication to have its full effect.>If the infection is in my sinuses, why am I coughing so much, especially during the night?
When you lie fat, your sinuses start to drain down the back of your throat. Even though it's only a very small amount of mucus, it can cause a truly agonising tickle that makes you cough. Before going to bed, take some enough syrup containing dextromethorphan (DM) or codeine and you may sleep better. Or elevate the head of your bed by 45 degrees (use bricks or fat books under the legs) to promote sinus drainage. If only one side of your head is involved, sleep on your side, with the congested side up.
In addition, certain other drugs can be effective:
If your sinusitis doesn't clear up after a couple of months of taking antibiotics along with some good home care, your doctor may recommend that you see an ear, nose and throat specialist for nasal
SINUS IRRIGATION: HOW TO USE A NETI POT
Made of ceramic or plastic, a neti pot looks like a small watering can with a narrow spout. It has been used for centuries in India to cleanse nasal passages and enhance breathing during yoga sessions. Today neti posts are recommended by natural therapists for irrigating the sinuses.
Making the saline solution To use a neti pot, first make a saline solution. To do this, mix 1/2 teaspoon of noniodised table salt and a good pinch of bicarbonate of soda into 1 cup of lukewarm water. Pour only half the liquid into the neti pot at a time as half the solution will be used in each nostril.
Doing the irrigation
In some cases of chronic sinusitis, your doctor may order a computed tomography (CT) scan, a sophisticated X-ray that can help find infection hidden in the deeper air chambers. Depending on the results, sinus surgery may be recommended. The surgery uses a tiny fibre-optic scalpel that leaves no scarring and can drain your sinuses, remove any polyps or cysts or widen the openings into your nasal passages (a surgical procedure known as functional endoscopic sinus surgery, or FESS). Today most sinus surgery is done under general or local anaesthesia and you'll go home the same day. Although surgery is never a guaranteed cure for sinusitis, studies show that the majority of people who have it report fewer symptoms.
PROMISING DEVELOPMENTS
For people with allergy-related sinusitis, some doctors are trying leukotriene receptor antagonists, drugs commonly used for asthma. These nonsteroidal drugs, which include montelukast (Singulair) and zafirlukast (Accolate), work by blocking leukotrienes, substances that worsen asthma symptoms. Researchers believe relieving the underlying allergy will also help to treat the sinusitis.
Natural methods
For temporary relief from congestion, try spicy foods. Two good ones are chillies and cayenne pepper: both contain capsaicin, a powerful compound that breaks up mucus and promotes mucus flow. Mustard and horseradish, which contain the natural chemical allyl isothiocyanate, can act in a similar way. And fresh ginger is also a natural antihistamine. Experiment to see which foods are able to best un-stuff you.
Other medications can be taken alone or with antibiotics to treat specific symptoms and speed recovery. For example, analgesics such as paracetamol or aspirin plus or minus codeine soothe sinus pain and headache, and nasal or oral decongestants reduce swelling of the sinus linings and help you breathe easier fast. Popular decongestants include Sudafed, which contains pseudoephedrine, and Drixine, Logicin and Dimetaapp 12-hour nasal spray, which include oxymetazoline. Be sure to consult your doctor before trying a decongestant spray; in some cases, it can make congestion worse. And always limit use to three to four days to prevent a rebound effect: as the decongestant wears off, it may actually cause swelling in your nasal passages.
>I've never had sinusitis before. Am I going to get a lot of these infections in the future?Probably not. Most attacks of acute sinusitis are really just complications of an especially bad cold, in which thickened mucus in the sinuses becomes infected by bacteria. Once antibiotics have cleared up your infection, there shouldn't be a problem with recurrence.>My doctor prescribed antibiotics for three weeks. Why do I have to take them for so long?
Your sinuses are like caves within your skull. As such, they receive a relatively small supply of blood (as compared with your lungs or kidneys.) Since the antibiotics are carried to the infected sinuses through your blood stream, you need to be on these drugs for at least 10 to 14 days in order for the medication to have its full effect.>If the infection is in my sinuses, why am I coughing so much, especially during the night?
When you lie fat, your sinuses start to drain down the back of your throat. Even though it's only a very small amount of mucus, it can cause a truly agonising tickle that makes you cough. Before going to bed, take some enough syrup containing dextromethorphan (DM) or codeine and you may sleep better. Or elevate the head of your bed by 45 degrees (use bricks or fat books under the legs) to promote sinus drainage. If only one side of your head is involved, sleep on your side, with the congested side up.
In addition, certain other drugs can be effective:
- If you have a nagging cough and are losing sleep from postnasal drip, try a cough suppressant with dextromethorphan (Robitussin). Or if your cough is severe, ask your doctor to prescribe a cough suppressant with codeine (Rikodeine).
- If you need to loosen mucus, an expectorant that contains the mucolytic (mucus thinner) guaifenesin, the active ingredient in Robitussin and Benadryl, can help.
- If an allergy is triggering your sinusitis, your doctor may also recommend antihistamines such as Polyaramine or Avil or a prescription corticosteroid nasal spray (such as Beconase or Nasonex) to reduce inflammation. There are also nonsedating antihistamines available, such as Telfast, Claratyne or Zyrtec. But don't use these if you have bacterial sinusitis; they can actually thicken mucus, making a bacterial infection even worse.
- If you have chronic bacterial sinusitis, you may require intense treatment with a more potent antibiotic such as clarithromycin (klacid). You'll take the drug anywhere from three to eight weeks. In addition, your doctor may recommend that use a corticosteroid nasal spray as well as the expectorant guaifenesin and an oral decongestant. This powerful combo works for many people.
Procedures
If your sinusitis doesn't clear up after a couple of months of taking antibiotics along with some good home care, your doctor may recommend that you see an ear, nose and throat specialist for nasal
SINUS IRRIGATION: HOW TO USE A NETI POT
Made of ceramic or plastic, a neti pot looks like a small watering can with a narrow spout. It has been used for centuries in India to cleanse nasal passages and enhance breathing during yoga sessions. Today neti posts are recommended by natural therapists for irrigating the sinuses.
Making the saline solution To use a neti pot, first make a saline solution. To do this, mix 1/2 teaspoon of noniodised table salt and a good pinch of bicarbonate of soda into 1 cup of lukewarm water. Pour only half the liquid into the neti pot at a time as half the solution will be used in each nostril.
Doing the irrigation
- Place the spout of the pot into one nostril, making a firm seal so it doesn't drip.
- Stand over a sink, then tilt your head to the side and down, away from the spout.
- Pour the saline solution into the nostril, Very shortly, the liquid will come out the other nostril (see photograph above).
- Once the solution has drained out, blow gently into a tissue to clear out your nasal passage.
- Repeat steps 1-4 with the other nostril, using the other half of the solution.
- keep breathing through your mouth as you pour to prevent the solution from draining from the back of your nose into your mouth and throat. It sounds tricky but this gets easier with practice.
- If the saline solution stings your nostrils, dilute the saline strength by half and then gradually work back up to full strength.
In some cases of chronic sinusitis, your doctor may order a computed tomography (CT) scan, a sophisticated X-ray that can help find infection hidden in the deeper air chambers. Depending on the results, sinus surgery may be recommended. The surgery uses a tiny fibre-optic scalpel that leaves no scarring and can drain your sinuses, remove any polyps or cysts or widen the openings into your nasal passages (a surgical procedure known as functional endoscopic sinus surgery, or FESS). Today most sinus surgery is done under general or local anaesthesia and you'll go home the same day. Although surgery is never a guaranteed cure for sinusitis, studies show that the majority of people who have it report fewer symptoms.
PROMISING DEVELOPMENTS
For people with allergy-related sinusitis, some doctors are trying leukotriene receptor antagonists, drugs commonly used for asthma. These nonsteroidal drugs, which include montelukast (Singulair) and zafirlukast (Accolate), work by blocking leukotrienes, substances that worsen asthma symptoms. Researchers believe relieving the underlying allergy will also help to treat the sinusitis.
Natural methods
For temporary relief from congestion, try spicy foods. Two good ones are chillies and cayenne pepper: both contain capsaicin, a powerful compound that breaks up mucus and promotes mucus flow. Mustard and horseradish, which contain the natural chemical allyl isothiocyanate, can act in a similar way. And fresh ginger is also a natural antihistamine. Experiment to see which foods are able to best un-stuff you.
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