Dear Readers,
L.V., 33, is a female bank teller who works in Kingston and lives in Portmore, St. Catherine. Where she lives is quite dusty and she suffers recurrently with 'sinus' problems with one affecting her significantly at this time. She is often stuffy and has a post-nasal drip. Sometimes she is hoarse and feels bad (nausea). She experiences headaches especially over her forehead.
L.V. has seen her doctor more than once for her condition and has received several medications which help for a while. But this time, she says, the sinus condition is hardly giving her any ease. She has taken cloritine, DRH, Betredol-N nose drops and cataflam (decongestants and pain killers.)
L.V. presents with a range of symptoms which could be due to hay fever (allergic rhinitis), sinus congestion or sinusitis. Treatment of these conditions overlaps, but differ slightly so when the condition persists it is best to know what is the correct diagnosis. This can usually be determined with an x-ray procedure which looks at the facial sinuses, although CT scans (computerised) are more reliable and give more information, but are significantly more expensive.
A long-standing sinus infection can usually be readily recognised with these tests by the changes which occur with thickening of the mucus membranes lining the affected sinus and fluid within the sinus cavity. Sinusitis is an inflammation or an infection occurring in the sinuses. The sinuses refer to four sets of open spaces which occur in the bones of the face.
1. The Ethmoid sinuses which are located in the back of the nose, high up.
2. The Sphenoid sinuses which are also in the skull, behind the nose bridge.
3. The Frontal sinus which are located behind the forehead and
4. The Maxillary sinuses which are found in the cheek bone.
When the membranes lining the sinuses become inflamed and block the Ostea (entrance/exit) which drain the sinuses, fluid accumulates within the sinus cavities which are quite likely to become infected with bacteria (germs). When the sinuses are blocked or inflamed the following symptoms may be experienced:
Headaches
Earaches
Toothaches
Facial pain
Fever
Loss of sense of smell
Bad breath
If left untreated sinusitis can feel worse than a bad case of flu! Sinusitis can also lead to meningitis (inflammation of the tissues covering the brain) pneumonia or even asthma. Treatment will involve antibiotic therapy as well as decongestants. Hay fever, food allergies, milk sensitivity and exposure to environmental pollutants such as cement dust, cigarette smoke and many chemical agents can also lead to sinuses. Antibiotics are usually taken for at least two weeks to prevent recurrences.
Decongestants help to open the blocked ostea (entrance to the sinus) and allow the congested sinuses to drain. Tropical decongestants such as Afrin or Otrivin Nasal Spray should be used for only a few days.
Antihistamines (Cloritine, DPH, Tavegyl, Allegra etc.) can at times thicken the mucous by drying it out and actually slow down the drainage from the sinus but they do have a place in the treatment of sinusitis where allergies are clearly a strong component. They clear up hay fever and other allergic symptoms.
Nasal steroids also settle inflammation and congestion and several of these are available e.g. Nasonex, and others. Over the counter pain killers such as Panadol, Tylenol and Motrin help to settle the headaches and face pain although prescribed pain killers are sometimes necessary. When sinusitis is severe and not responding to medication, surgical drainage of the sinuses is sometimes necessary. Persons with sinus congestion and sinusitis should drink a lot of fluids to thin the mucous and allow for better sinus drainage.
Milk and dairy products should be eliminated from the diet during an attack of sinusitis and their use should generally be minimised. Many individuals get some relief from congestion with menthol crystal steam inhalation. Minimising exposure to smoke and other pollution will also help. Sinusitis and hay fever tend to be a recurring condition and require dietary restrictions, proper hydration, avoidance of pollutants, prompt treatment of hay fever and positive life style changes to minimise recurrences.
Write LIFELINE
P.O. Box 1731
Kingston 8
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