SINUSITIS
Q I would like to learn more about sinus infection. Can you help ?
A Sinusitis is a fairly common problem that can cause a great deal of misery and
discomfort. It is defined as inflammation of the mucus lining of the air cavities located
adjacent to the nose, behind the forehead and the eyes. Most cases of sinusitis are caused
by infections which may be bacterial, viral or fungal. Patients may also have symptoms like
that of infection but it could be due to smoke and environmental allergens.
A person may have infection induced sinusitis if some of the following are present: Cold
symptoms for more than seven days, fatigue, cough, low grade fever, sinus headache,
toothache, facial pain, discolored nasal discharge ( especially green ) or foul breath. Some
patients may have loss of sense of smell and taste and chronic nasal congestion.
Sinusitis often occurs when mucus can not drain normally from the sinuses into the back of
the nose and throat. Usually this happens when there is an obstruction of some kind such as
polyps, enlarged air cells within the inner folds of the nose or more often the thickening of
the lining around these pores may lead to obstruction. Allergies are a common cause of
thickening of the sinus linings.
The management of the infection that has been present for a short time is antibiotics and
observation. However, treatment of Chronic infection is somewhat complicated. It may
include antibiotics, decongestants, expectorants, and anti inflammatory nose sprays. Some
patient require CT scan of sinuses. Allergy testing would help identify what you are allergic
to. Allergy is the cause in at least 50% of the cases of chronic sinusitis. If allergies are
present than environmental control measures, allergy medications and allergy shots may be
beneficial. many patients suffer from sinusitis and choose to live through it. Sometimes they
get better although more often the symptoms such as facial pain, post nasal drip and
chronic nasal congestion may persist without fever or discolored mucus. An allergist may
help in evaluating and treating the problem so that sinusitis sufferer may live comfortably.
for further question do not hesitate to call our office.
ASTHMA TRIGGERS
Q. I have been diagnosed with asthma. What are the things I need to avoid to keep my
asthma from getting worse ?
A. In addition to your medications, you need to avoid what are called ASTHMA
TRIGGERS. These include allergens, irritants, exercise. GERD, medications, foods and
possibly emotional factors.
Allergens include airborne pollens, molds, house dust, dust mites, cockroach droppings and
pet dander. Take steps to minimize your exposure to these in your environment. To
determine if you are allergic to these or not, you may need allergy testing.
Irritants include air pollutants such as tobacco smoke, wood smoke and chemicals in the air.
Occupational exposure to allergens, vapor, dust, gases or fumes, strong odors or spray
household cleansers are others to name a few.
Infections such as common colds and sinus infections may trigger asthma. Obvious or
hidden sinusitis is being recognized more and more as a trigger for ongoing asthma
symptoms. Often patient may not have typical sinusitis symptoms therefore this important
trigger may be overlooked. Plain X-ray and a CT scan is the best way to check if an
individual has a sinus infection.
Strenuous physic an exercise can be another trigger. Mouth breathing, exercise in cold air
or prolonged, strenuous distance running can increase likelihood of exercise induced
asthma.
GERD or gastroesophageal reflux disease is a condition where acidic contents from the
stomach regurgitate up in the food pipe. symptoms include heart burn, belching,hoarseness
of voice and feeling of postnasal drip. This condition can make asthma worse at night.
Medications which can make asthma worse include beta blockers for hypertension and heart
disease. Beta blockers are also used for migraine. Allergy to Aspirin and other non steroidal
pain medications can aggravate asthma symptoms in some patients. Emotional factors do
not cause asthma but will aggravate asthma already present. Certain foods in children can
aggravate asthma these include milk, peanuts, fish, soy, wheat and eggs.
Avoiding what triggers your asthma is not any less important than taking your medications.
If you avoid your triggers you may be able to control your asthma with lot less medicine.
do not hesitate to contact our office if you have any further questions.
NASAL CONGESTION
Q: I feel stuffy in the nose almost all the time. what can I do ?
A: Nasal congestion is due to the blockage of the nasal passages. This can be most
often caused by a cold and it resolves by itself when cold is gone. If someone is having
nasal congestion off and on all the time than one needs to look for the causes of chronic
nasal congestion. Most common causes of chronic nasal congestion are Allergic Rhinitis or
Hay fever and Chronic Sinusitis. Other causes include certain medications and during
pregnancy. Some patients may have structural blockage due to deviated nasas septum,
where the cartilage that divides the nose is bent to one side. If chronic congestion is not
treated it can cause sleep apnea, which in turn will cause several other medical problems.
Congestion can also have an effect on hearing and speech development. Severe congestion
can result in facial pressure and pain as well as dark circles under the eyes. In most
patients congestion switches back and forth from one nostril to the other.
The nose normally produces mucus which traps substances like dust, pollen, pollution and
germs like viruses and bacteria. Mucus would normally flow from the front to the back and
is swallowed. When excessive,it may flow to the front. Normally the musus is clear and
watery. But it may become discolored due to pollution or infection.
Proper evaluation would include history and physical examination. If allergies are a
possibility, one would need allergy testing. Common allergens would include pollens, mold,
dust, dust mite and pets. Infection in the sinuses or structural blockage can be ruled out
by taking a sinus X-ray or a CT scan. Treatment would depend on the cause of nasal
congestion. For allergies, a combination of antihistamines, decondestants and intranasal
steroids would help. If there is an infection some patients may need prolonged course of
antibiotics. Some patients may need surgery.
