Stuffy nose? Headache with pressure? Cold-like symptoms that won’t go away? It could be a sinus infection. According to the Centers for Disease Control and Prevention, more than 28 million Americans suffer from sinusitis, also known as sinus infections. Allergies, a cold, or a physical blockage, such as a deviated septum, can cause a sinus infection.
In this episode of San Diego Health, host Susan Taylor and guest Hessam Tabrizi, MD, a family medicine physician with Scripps Coastal Medical Center Solana Beach, discuss sinusitis in-depth, its symptoms, treatments and when to seek medical attention. Dr. Tabrizi also outlines how you can help prevent sinus infections.
First, we need to know about the sinus anatomy. Sinuses are spaces in our skull. They are lined with very thin lining, with hair cells. They moisturize the air that we breathe. In a normal situation, millions of bacteria are floating there. The problem happens when there’s a blockage that can be caused by allergies, cold, or any type of anatomical problem, such as deviated septum or polyps. That blockage causes this surge of mucus and that is a perfect culture media for bacteria to cause infection.
Sinuses are small spaces and they get filled with fluid and that has a pressure effect. You get headaches in different parts of your head and your cheekbones and your forehead, behind the eyes and you may get bad breath. You also get fever and plugged ears. You get a sore throat occasionally.
It can happen because of allergies. It can happen because of a cold. One of the most common reasons is viral infection. Occasionally you get them because of anatomical blockages, such as deviated septums or nasal polyps. There are other risk factors. You may have people that have trouble with their immune system. Cigarette smoking, first-hand or second-hand smoking, are big risk factors.
In a normal situation, there’s a thin layer, a thin membrane between our nasal passages. It’s called nasal septum. Sometimes it’s deviated to one side and that causes problem with the breathing. You may feel it, or not feel it. Many have it and don’t feel anything. The most common reason for it is trauma. Sometimes, they have deviated septum for genetic reasons.
The most common risk factor is viral infection. In the cold and flu season, you may have more chance of getting sinusitis and also allergies. Some of that happens in only cities. They have more pollens in certain times of the year. In San Diego, it happens sometimes throughout the year.
Another risk factor is smoking because that goes against the natural defense of the body inside our sinuses. Second-hand or first-hand smoking are risk factors.
Nasal polyps are little growths inside our nose. Imagine that being like a small mole growing inside your nose and causing blockage and that blockage causing bacteria overgrowth and sinusitis happening.
The immune system plays a big role. As we talked about, we have millions of bacteria naturally there and our immune system keeps them at bay. But when our immune system is down for any reason, maybe due to taking a medication that brings down the immune system or a disease that brings down the immune system, that causes the bacteria to overgrow and go out of control.
Usually in the first few days we assume that this is a viral sinusitis and viral infections usually last five to seven days maximum. If anything goes beyond seven days, between seven to 10 days, then that’s the time to see your doctor. Some acute sinusitis last a little bit longer, more than four weeks. Chronic sinusitis last more than 12 weeks.
When your doctor prescribes medication, usually it takes care of the problem. But sometimes the bacteria are resistant. Sometimes those blockages, including deviated septum or nasal polyps and other factors, such as medications, low immune system, make sinusitis chronic. At that point you need the help of an ear, nose and throat doctor.
From the beginning, you can do nasal rinses or nasal saline sprays and those are very helpful. They get the flow of the secretions going and you can get some relief from those. You can take lot of hydration, a lot of fluid, and it helps with the flow of the fluid inside your nose. Over-the-counter nasal sprays are available as well. You can use a warm compress, have a warm towel or a steam shower. Taking a regular shower also helps.
A sinus rinse is an introduction of the nasal saline through a pod that you can use to rinse your sinuses with and that helps to remove the secretions and plenty of the bacteria from your sinuses.
Definitely. Kids under the age of three months cannot take Tylenol. They can take ibuprofen. You can use other means, such as by giving them more hydration. Cool mist humidifiers are very helpful. Steam showers are generally helpful. Anyone above the age of six can easily do saltwater gargling.
It’s not recommended for more than three days. The reason is that it has a rebound effect. It can cause a stuffier nose and more swelling. Remember, that was the original reason for the bacterial sinusitis. It’s usually used once or twice a day for three days.
Prevention is much better than treatment. When you have an allergy, you can take allergy medications to open up your nasal passages. You want to prevent a viral infection. If you have somebody with a viral infection at home, you want to make sure that you avoid close contact. You want to make sure that you cover coughs, do all the personal hygiene things that work, such as washing your hands a lot. Using cool mist humidifiers is also helpful. It keeps those floating particles and bacteria from getting into a susceptible patient and getting them sick. In general, hydration and taking plenty of fruits and vegetables to keep your immune system strong are very helpful things to do.
Flu vaccine is definitely recommended. Flu is one of the main reasons for infections during the flu and cold season. We see a lot of cases each year in San Diego. On average, we see about 10,000 cases and I bet the actual number is a lot higher. Flu vaccine is good to prevent sinus infection. We definitely recommend it. The season starts from October and goes all the way to May of each year in San Diego.
Pneumonia vaccine is also recommended. Certain populations are more prone to getting infections like pneumonia. We definitely recommend them for people 65 and older, patients with diabetes, and patients with an immune system that is compromised for any reason.
I have a personal motivation against smoking because all the health issues associated. It makes people prone to respiratory infections, including pneumonia, sinusitis and colds. Second-hand smoke can get you infected. Tobacco smoking gets those hairy cells that are naturally functioning and cleaning your nasal passages to become kind of paralyzed, so they don’t do their job properly and that can cause a surge of bacteria and becoming more prone to infections.
Lightly edited for clarity.