Patient information from the BMJ Group Sinusitis Sinusitis can be very painful but it usually clears up on its own. If your symptoms don't go away, there are treatments that can help. We've brought together the best and most up-to-date research about sinusitis to see what treatments work. You can use our information to talk to your doctor or pharmacist and decide which treatments are best for you. What is sinusitis?
Sinuses are small spaces filled with air inside your skull. You have them in your cheekbones, behind and between your eyes, and in your forehead. They make mucus, whichnormally drains through small openings into the nose.
If you have sinusitis, it means that your sinuses are inflamed and swollen. This happenswhen the openings to the nose get blocked so the mucus can't drain away. The sinusesin your cheeks are most often affected.
You can have sinusitis that lasts a long time (called chronic sinusitis), or you may getshort attacks. Short attacks that last for four weeks or less are called acute sinusitis. Here, we describe treatments for acute sinusitis, which is the most common type.
People often get sinusitis after they've had a viral infection such as a cold or the flu. Hayfever and other allergies can also cause sinusitis. If your sinusitis lasts longer than aweek, you may have a bacterial infection. What are the symptoms?
Sinusitis can be very painful. The symptoms often start just as you think you're gettingbetter from an infection. If your nose feels blocked, you may think you have a cold butyou may have acute sinusitis.
With sinusitis you may get some of these symptoms as well as a blocked nose:
Pain in your forehead, upper jaw, teeth, or cheeks, or around your eyes
A headache that is worse when you lean forward (it might start when you get up inthe morning)
Large amounts of green or yellow mucus in your nose
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A sore throat caused by the mucus dripping down from your nose into your throat.
Your doctor will probably be able to tell if you have sinusitis by your symptoms. Sometimes, if your sinusitis is very bad or keeps coming back, you may need to see a specialist, or have tests such as an x-ray or a CT scan. What treatments work?
Sinusitis usually gets better on its own. But if your symptoms are very bad, it's best tosee your doctor. Simple painkillers like acetaminophen (Tylenol) or ibuprofen should helpease the pain. Steroid nasal sprays
There are several different steroid sprays. Some commonly used ones (and their brandnames) are beclomethasone (Beconase AQ), budesonide (Rhinocort Aqua), flunisolide(Nasarel, Nasalide), and fluticasone (Flonase).
You breathe these sprays in through your nose once or twice a day. They are designedto reduce inflammation in the nose. Some people who use a steroid nasal spray mightget a headache or nosebleed
One summary of the research (a systematic review) found that, two to three weeks afterstarting treatment, people who used a steroid nasal spray had fewer, or no, symptomscompared with people who used a dummy spray containing no medicine (a placebo). But the difference was small. Medicines you can buy over the counter
There are medicines you can buy over the counter that are sometimes used for sinusitis. But there hasn't been any good research on these treatments, so doctors can't say ifthey work or not. Decongestants come as pills and nasal sprays. They aim to relieve a blocked nose, so you can breathe more easily. Common decongestants (and their brand names) are pseudoephedrine pills (Sudafed) and phenylephrine, which comes as pills or a spray (Sudafed PE pills, Neo-Synephrine Regular Strength Nasal Spray, Vicks Sinex Nasal Spray for Sinus Relief).
These medicines are not suitable for some people. If you have heart disease, diabetes,or a thyroid condition, check with your doctor before using a decongestant.
You should not use decongestant nasal sprays for longer than a week. After that they can cause rebound congestion. This means you get a blocked nose again after you stop taking them. Antihistamines are often used to treat hay fever and other allergies. Some are available over the counter and some require a prescription from your doctor. They come as pills
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or syrups. Some examples are cetirizine (brand name Zyrtec), diphenhydramine (BenadrylAllergy), and loratadine (Alavert, Claritin, Tavist NN).
Some antihistamines can make you sleepy, so you need to be careful how you use them,especially if you operate machinery or drive a car. Other treatments Antibiotics are not often used for sinusitis. They are unlikely to help you feel better or recover faster, and they can cause side effects. Doctors only prescribe antibiotics for severe sinusitis that may be caused by bacteria.
Some people inhale steam to help relieve blocked sinuses, but there is a danger of scalding. Another option is rinsing your nose with salt water spray. This has been a folk remedy for colds for many years, so some people think this should work for blocked sinuses. But there's very little good-quality research to show this works for sinusitis. What will happen to me?
About two-thirds of people with acute sinusitis get better without having any treatmentfrom their doctor. But some people get repeat attacks. There's also a chance that afterone attack you will get chronic sinusitis (sinusitis that lasts more than three months). Ifthis happens to you, see your doctor. You may need to see a specialist doctor for testsand treatment.
Sinusitis can cause serious problems that affect the brain and eyes. But this is very rare. Always see a doctor right away if you have a very bad headache or a stiff neck, if youfind light painful, if you have double vision, or if you feel drowsy or confused.
This information is aimed at a US patient audience. This information however does not replace medical advice. If you have a medical problem please see your doctor. for this content. For more information about this condition and sources of the information contained in this leaflet please visit the BestHealth websiteThese leaflets are reviewed annually.
BMJ Publishing Group Limited 2013. All rights reserved. Last published: Apr 30, 2013
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