Sinus Infection

Sinusitis is a swelling and infection of the sinuses near the nose. About 31 million adults and children in the United States have sinusitis each year. Sinusitis usually begins with an acute sinus infection that lasts for two to four weeks. A chronic sinus infection is one that continues for four weeks or longer.

Signs and Symptoms

• Nasal discharge (yellow or green) postnasal drip
• Headache pain sinus tenderness or toothache
• Cough or sore throat
• Fever in half of patients
• Loss of smell
• General tiredness

What Causes It?

The sinuses cannot drain properly and become infected. Some common causes for this include the following.

• Common cold (upper respiratory tract infection)
• Allergies (hay fever tobacco smoke dry air pollutants)
• Infected tooth
• Swimming
• Disease or an abnormal structure in the sinus area
• Physical injury to the sinuses

What to Expect at Your Provider's Office

Your health care provider will give you a physical examination and will prescribe an antibiotic. You may need to have special tests to determine the cause of your sinusitis if it does not go away.

Treatment Options

Treatment Plan

Treatment for sinusitis includes antibiotics decongestants and avoiding the things to which you are allergic. Sinus infections often come back. Stronger types of antibiotics (broad-spectrum antibiotics) are used for chronic sinus infections. Inhaling steam or mist helps mucus to drain and relieves symptoms. It is important to drink plenty of water because it thins mucus secretions. Surgery may be needed when all other treatment fails.

Drug Therapies

Prescription

• Antibiotics—amoxicillin is usually prescribed first; broad-spectrum antibiotics (for example cefuroxime cefaclor clarithromycin or azithromycin) are prescribed for chronic sinusitis; take for 10 to 14 days or for up to six weeks in chronic cases; various side effects
• Decongestants—oral or by nasal spray; relieve symptoms; do not take decongestants if you have problems urinating or have a heart condition; use nasal sprays only for the prescribed amount of time (usually three to five days) since they can be addictive and make your sinuses worse if used for too long; various side effects
• Nasal steroid spray—for allergic and chronic sinusitis

Over the Counter

• Various over-the-counter sinus remedies are available.

Complementary and Alternative Therapies

A combination of physical medicine and herbal or homeopathic treatment is often effective for treating both acute and chronic sinusitis.

Nutrition

• Vitamin C (1 000 mg three times a day) zinc (30 to 60 mg per day) beta-carotene (15 000 IU per day) to support immunity.
• Bromelain (500 mg three times a day between meals) and quercetin (500 mg three times a day between meals) are anti-inflammatory
• Avoid mucus-producing foods such as dairy products bananas and any known food allergens.
• Drink plenty of fluids. Decrease sugar intake.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

• Wild indigo (Baptesia tinctoria)—specific for sinus infections
• Eyebright (Euphrasia officinalis)—reduces inflammation specifically for sinus problems
• Licorice (Glycyrrhiza glabra)—antiviral soothing especially with exhaustion or heartburn. Do not use if you have high blood pressure.
• Coneflower (Echinacea purpurea)—stimulates the immune system
• Goldenseal (Hydrastis canadensis)—antiviral antibacterial

A combination of all of the above herbs equal parts may be very effective. 1 cup tea or 30 to 60 drops tincture every two to four hours. May add:

• Jamaican dogwood (Piscidia piscipula) or St. John's wort (Hypericum perforatum) in equal parts may be added for pain relief.
• Garlic/ginger tea—two to three cloves of garlic and two to three slices of fresh ginger. Steep 5 to 15 minutes and drink breathing in the steam. Stimulates immune system and drainage.
• Essential oils may be used for bath or steam. For a steam place two to five drops in a pot bring to a simmer and hold your head over the pot. For a bath add 5 to 10 drops of oil to the bath. Eucalyptus lavender and thyme are specific for upper respiratory infections. Lavender and rosemary are also very calming.

Homeopathy

Some of the most common remedies used for sinusitis are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Arsenicum album for sinusitis with watery discharge
• Kali bichromicum for sinusitis with thick "gluey" discharge
• Pulsatilla for thick bland greenish discharge
• Nux vomica for sinusitis with a "stopped up" feeling

Physical Medicine

• Contrast hydrotherapy. Alternate hot and cold applications. Apply wet washcloths over the sinus area. Alternate three minutes hot with one minute cold. Repeat three times. This is one set. Do two to three sets per day.
• Nasal wash. Mix salt and water to taste like tears. Rinse each nostril by holding your head sideways over the sink and letting water run from the upper nostril to the lower nostril. Keep nostrils lower than throat to prevent salt water from draining into the back of the throat.

Acupuncture

May be helpful for both acute and chronic sinusitis.

Following Up

If you are not better in a few weeks you may be sent to an ear nose and throat specialist for tests to find the cause of your sinus infection.

Special Considerations

Some serious diseases are caused by sinusitis or can have similar symptoms. Be sure to see your health care provider if you are not feeling better or have new symptoms. Tell your provider if you may be pregnant.

Supporting Research

Barkin R Rosen P eds. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis Mo: Mosby-Year Book; 1996.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:122–123.

Gruenwald J Brendler T et. al eds. PDR for Herbal Medicines. Montvale NJ: Medical Economics Company; 1998:684–685.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:286–290.

Middleton E ed. Allergy: Principles and Practice. 5th ed. St. Louis Mo: Mosby-Year Book; 1998.

Rakel RE. Conn's Current Therapy. 50th ed. Philadelphia Pa: WB Saunders; 1998.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.