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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

bulletNasal discharge (yellow or green), postnasal drip
bulletHeadache, pain, sinus tenderness, or toothache
bulletCough or sore throat
bulletFever, in half of patients
bulletLoss of smell
bulletGeneral tiredness

 

What Causes It?

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

 

bulletCommon cold (upper respiratory tract infection)
bulletAllergies (hay fever, tobacco smoke, dry air, pollutants)
bulletInfected tooth
bulletSwimming
bulletDisease or an abnormal structure in the sinus area
bulletPhysical 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

 

bulletAntibiotics—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
bulletDecongestants—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
bulletNasal steroid spray—for allergic and chronic sinusitis

 

Over the Counter

 

bulletVarious 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

 

bulletVitamin 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.
bulletBromelain (500 mg three times a day between meals) and quercetin (500 mg three times a day between meals) are anti-inflammatory
bulletAvoid mucus-producing foods, such as dairy products, bananas, and any known food allergens.
bulletDrink 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.

 

bulletWild indigo (Baptesia tinctoria)—specific for sinus infections
bulletEyebright (Euphrasia officinalis)—reduces inflammation, specifically for sinus problems
bulletLicorice (Glycyrrhiza glabra)—antiviral, soothing, especially with exhaustion or heartburn. Do not use if you have high blood pressure.
bulletConeflower (Echinacea purpurea)—stimulates the immune system
bulletGoldenseal (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:

 

bulletJamaican dogwood (Piscidia piscipula) or St. John's wort (Hypericum perforatum), in equal parts, may be added for pain relief.
bulletGarlic/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.
bulletEssential 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.

 

bulletArsenicum album for sinusitis with watery discharge
bulletKali bichromicum for sinusitis with thick "gluey" discharge
bulletPulsatilla for thick, bland, greenish discharge
bulletNux vomica for sinusitis with a "stopped up" feeling

 

Physical Medicine

 

bulletContrast 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.
bulletNasal 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