Problems with the Nose and Sinuses

Stuffy, runny noses, headaches, sneezing, pressure... these are some of the symptoms you might have if you suffer from acute or chronic sinusitis or rhinitis.

Rhinitis

Rhinitis is an inflammation of the mucous membranes that line the nose. It produces symptoms like a stuffy, runny nose, and sneezing. It can either be caused by allergies (i.e., allergic rhinitis) or by a cold, injury, or pollutants (i.e., nonallergic rhinitis).

Allergic Rhinitis

If you are allergic to airborne things like pollens, dusts, pet dander, molds, etc., your body is overreacting and treating the substances you're coming in contact with as if they were harmful. A substance in the blood called immunoglobulin (IgE) recognizes allergens and attaches itself to them. In fact, a different type of IgE is produced for each substance your body is allergic to.

The more IgE you have for the allergen, the worse your reaction to it. The IgE attaches itself to a cell called the mast cell and forms an allergy "bomb" that is then triggered whenever you come in contact with its specific allergen. The bomb releases histamine, which is what causes the watery eyes, runny nose, congestion, and all of those other miserable symptoms you have with allergies. This is the body's attempt at flushing the allergen out.

Nonallergic Rhinitis

If your symptoms are not caused by allergy then you may have nonallergic rhinitis. This form of rhinitis is caused by the common cold, an infection, injury to the nose, or sometimes certain pollutants.

One type of nonallergic rhinitis caused by irritants or pollutants in the air is called vasomotor rhinitis. These irritants can be things such as tobacco smoke, aerosol sprays like hair spray, perfumes, powders, paint fumes, insecticides, detergents, birth control pills, or other things.

Treatment

With either type of rhinitis, your nasal passages may swell up causing a stuffy nose, you'll have more and thicker mucus draining in the back of your throat, and may also have a cough and sore throat.

Treatments include:

• Antihistamines: These drugs work by drying up the mucous membranes. They are available both over-the-counter and by prescription. Many will make you sleepy. Some newer prescription antihistamines last longer and do not make you sleepy.
  
  
• Decongestants: These over-the-counter drugs reduce the swelling in your nasal passages and let you breath easier. You may also find combinations of decongestants and antihistamines. They may cause you to be jittery and have a hard time sleeping. They are also not recommended if you have high blood pressure, diabetes, heart disease, or thyroid disease.
  
  
• Nasal sprays: Nasal sprays can be decongestants, cromolyn sodium, corticosteroids, or simply saline. Decongestant nasal sprays should not be used for more than three or four days at a time. They work by reducing swelling in the nasal passages and are available over the counter. Cromolyn sodium sprays work by blocking the release of those chemicals that cause your body to react to the allergen. They are used regularly to help prevent symptoms from occurring, and they require a prescription. Corticosteroid sprays reduce the inflammation that allergic reactions cause. They too can be used regularly to prevent symptoms from occurring and also require a prescription.
  
  
• Allergy shots: Regular allergy shots can help prevent the symptoms of rhinitis from occurring. These shots work by bombarding the immune system with the allergen in order to decrease the body's sensitivity to it.

Sinusitis

You have four sinus cavities in your head that are filled with air. Their job is to aid speech by resonating and vibrating and to help the nose produce mucus to carry away dust particles, bacteria, viruses and other air pollutants that you breathe in. That mucus drains into the back of your throat where you swallow it. The acid in the stomach destroys any dangerous bacteria or viruses.

When you get a cold, have an allergic reaction, or are bothered by some pollutant, your nose and sinuses produce extra mucus to try to wash away the problem. You may notice this extra mucus in the back of your throat (you probably don't notice the normal mucus). It is called post nasal drip. When this mucus is green or yellow and thick and sticky, you may have sinusitis.

Sinusitis is an inflammation and infection of the sinuses. It occurs when the sinus openings are blocked and the mucus can't drain. This creates a perfect environment for bacteria to grow. (Which is why you get that green or yellow mucus!) You may have a sinus headache that is felt in the face, cheeks, upper teeth, forehead, and around the eyes. You may also feel pressure in the sinuses.

Acute Sinusitis

Sinusitis that occurs with a cold or other respiratory infection is considered "acute sinusitis."

Chronic Sinusitis

When the sinuses are blocked for an extended period of time, chronic sinusitis may result. This form of sinusitis may the result of allergies or chronic infection. Other problems like a nasal polyp, or a deviated septum can block the nasal passage and may also contribute to chronic sinusitis. In some cases, nasal polyps can also be caused by chronic sinusitis. These polyps are fleshy growths that extend from the nasal membranes.

With chronic sinusitis, you will often have less severe symptoms than with acute sinusitis, however, the symptoms usually don't go away.

Treatment

Dr. Alexander will ask you questions about your symptoms such as how often your headaches occur, the type of mucus secretions you are experiencing, and whether you have any allergies. He will examine your ears, throat, and nose looking for signs of polyps, deviated septum, or infection. He may also use an endoscope to see into the sinus openings.

Your treatment will depend on the diagnosis. Infections may require antibiotics and/or surgery. If it is acute sinusitis you may be able to simply take medications. Chronic sinusitis more often requires surgery. If your problems stem from allergy, Dr. Alexander will talk with you about ways to manage your them.

Here are some other tips on taking care of your sinuses:

• Minimize your exposure to colds and other infections through consistent hand washing and avoiding sharing items that can spread the virus, such as wash cloths, towels, or utensils.
• If you have allergies, try to keep them under control with allergy shots or by avoiding known allergens.
• Stay healthy by eating right and exercising. Drink plenty of water.
• When you do have a cold, run a humidifier to keep plenty of moisture in your sinuses to help them drain.
• Try to avoid air pollutants such as tobacco smoke.

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