Sniffing out the best course of treatment for your sinus symptoms

This article was originally written by Brad Briscoe, APRN, at UF Health Family Medicine – New Berlin, and was featured in a recent North Jax Monthly issue.

Your sinuses don’t necessarily want to be troublemakers. These four cavities at the front of the skull — one pair over the eyes and one pair below — are connected by narrow channels and make thin mucus that drains out the nose, helping keep the nose clean and free of bacteria.

What is sinusitis?

When you’re healthy, the four cavities are filled with air. But when the tissue lining the sinuses gets inflamed, that’s called sinusitis. If those spaces get blocked and filled with fluid, it can cause bacteria growth, which leads to infections. Sinus infections cause a wide range of uncomfortable symptoms for more than 30 million people in the U.S. each year.

The good news is that 60 to 70% of patients with sinus infections recover without the use of antibiotics, according to a study by the American Academy of Allergy, Asthma and Immunology. Yet, 90% of adults diagnosed with sinus infections in the U.S. are prescribed antibiotic therapy, studies have shown.

Nearly every day, we see patients in our practice who are suffering with some form of sinusitis. There are two types — acute and chronic.

What is acute sinusitis?

Acute sinusitis is the culprit when breathing through the nose becomes difficult, and the face and eyes get puffy. Other symptoms may include:

• Thick, yellow or greenish discharge from the nose or down the back of the throat
• Ear pressure
• Headache
• Face pain
• Dental pain
• Cough
• Bad breath
• Fatigue

This sinusitis is usually caused by a viral infection, often the common cold, or by allergies. It can also be caused by bacterial and fungal infections.

Most cases resolve in a week or two without prescription medication, unless a bacterial infection takes hold. In the vast majority of cases, acute sinus infections resolve without the use of antibiotics. Conservative home treatment is usually best and may include using nasal decongestants, nasal steroids, saline spray, getting enough rest and drinking enough fluids. Taking unnecessary antibiotics could pose problems, like upset stomach, dizziness, rashes, allergic reactions or destruction of healthy bacteria in the gut.

On the other hand, antibiotics could be the best course of treatment when the illness seems to worsen after starting to get better, symptoms have lasted more than one week and have become severe, or high fevers or extreme pain or tenderness around the eyes and nose occur.

What is chronic sinusitis?

Sinusitis is considered chronic when symptoms last three months or longer despite treatment. Common causes include swelling of the lining of the sinuses, a deviated nasal septum, immune system-related diseases that can lead to nasal blockage, allergies, nasal polyps or viral, bacterial or fungal respiratory infections.

Fever usually is not a symptom of chronic sinusitis. Chronic infections that don’t respond to treatment could require surgery.

How would I know if I have sinusitis?

Your doctor will determine if you have a sinus infection by asking about symptoms and performing a physical examination.

It’s important to contact your primary care provider for treatment if you have any of the following:

• A history of recurring or chronic sinusitis
• Persistent or high fever
• Symptoms lasting more than one week and fail to improve
• Pain or swelling of the face or eyes
• Confusion
• Stiff neck
• Visual changes

UF Health Family Medicine and Pediatrics – New Berlin offers services for patients during every stage of life, from childhood through adulthood. Call 904-633-0340 to schedule an on-site or virtual visit appointment.