Got nasal congestion that just won't go away? It could be sinusitis

By Michelle Villett

3 remedies for acute sinusitis

Runny nose, nasal congestion, and pressure or pain in and around the sinuses and above or around the eyes—these could be cold symptoms, or they might indicate sinusitis, a common chronic illness that affects one in seven adults.

Located behind the nose and around the eyes, “our nasal and sinus lining helps to warm, filter and humidify the air we breathe through the nose,” says Dr. Arif Janjua, clinical instructor in the department of otolaryngology at the University of British Columbia. Sinusitis occurs when the mucus membrane that forms this inner lining becomes inflamed. “This triggers mucus production and results in typical ‘cold’ symptoms. It can also block the small openings through which the sinuses drain into the nose. Then the inflammatory mucus doesn’t have anywhere to drain and so it becomes the perfect breeding ground for bacteria,” explains Janjua. Other symptoms of sinusitis include post-nasal drip (mucus dripping at the back of the throat), obstructed nasal breathing and a reduced sense of smell and, potentially, taste.

Acute sinusitis—usually caused by a viral upper respiratory tract infection—is more common than chronic sinusitis. “The symptoms are similar to a cold, but when they don’t resolve after a week, then there has likely been a secondary bacterial infection of the trapped mucus within the obstructed sinuses,” says Janjua. When symptoms persist for more than eight to 12 weeks, the condition is considered chronic. This may be commonly caused by acute sinusitis that was not adequately treated. “Chronic sinusitis is a serious quality-of-life issue. Patients report worse functioning [more impact on their day-to-day life] than those with heart disease or chronic respiratory disorders.”

For people with sensitive nasal lining, the other common cause of chronic sinusitis is long-standing exposure to irritating airborne materials. “This does not need to be a true allergy, simply a sensitivity of the nasal lining to airborne particles, such as pollen, which are common in the spring and fall,” says Janjua.

The easiest way to prevent a viral infection, and in turn sinusitis? Wash your hands regularly. Minimizing your exposure to irritants is more challenging, but regularly using a nasal irrigation device can help rinse matter from the nasal lining before it can trigger inflammation. See a doctor if you’ve had persistent symptoms for more than a week; left untreated, the inflammation can become chronic and may leave you prone to more frequent acute sinusitis.

If you think you might have chronic sinusitis, see your doctor. But if you’ve just started experiencing symptoms, here are some remedies you could turn to as your first line of defence for acute sinusitis.

To decongest nasal passages

Examples: Otrivin Cold & Allergy, Advil Cold & Sinus, Dristan 12-Hr Nasal Spray, Tylenol Sinus

How they work: “There are two types of decongestants: topical ones that spray right into the nose and oral ones that you swallow,” says 
Patrick Zachar, pharmacist and manager at Rexall pharmacy in Airdrie, Alta. “They help decrease inflammation and fluid in the sinuses so there is less pressure and pain.” Sprays contain the active ingredients xylometazoline (Otrivin Cold & Allergy) or oxymetazoline (Dristan 12-Hr Nasal Spray), which contract the blood vessels beneath the nasal lining so that swelling goes down. Oral decongestants contain either pseudoephedrine (Advil Cold & Sinus) or phenylephrine (Tylenol Sinus), which work the same way but are usually combined with a pain reliever such as ibuprofen (Advil) or acetaminophen (Tylenol).

Need to know: Spray decongestants can cause rebound congestion, so limit your use to three to five days. Oral decongestants with pain relievers can be taken every six hours for up to 10 days, but may cause increased heart rate and blood pressure, so should be avoided by anyone with hypertension or a heart or thyroid condition.

To irrigate mucus

Examples: Pulsating: Waterpik SinuSense Water Pulsator; HydraSense Congestion Relief Nasal & Sinus Decongestant. Squeeze: SinuCleanse Squeeze; Simply Saline Saline Sinus Wash; Sinus Rinse. Gravity: NasaFlo Neti Pot

How they work: Nasal irrigation devices send a warm 
saline solution through one nostril into the sinus cavity and then back out through the other nostril, helping to flush out mucus and particles. The salt in the solution also has a decongesting and drying effect on the sinuses, though it does not kill the bacteria.

The battery-powered Waterpik SinuSense Water Pulsator and the HydraSense Congestion Relief Nasal & Sinus Decongestant feature an automated pulsating water flow that is gentler than the squeeze-bottle devices. Neti pots rely on gravity, while squeeze bottles use positive pressure to move a higher volume of solution through the nasal passages; Janjua says the latter are most effective. All these products come with sterile, premixed packets of saline solution that should be dissolved in the device with warm distilled, or previously boiled, water.

Alternatively, you can make your own nasal irrigation device using any clean plastic bottle with a squirt nozzle—just don’t use plain water, which is unhealthy for the nasal lining. Janjua recommends purchasing pre-measured saline packets. They are inexpensive and ensure the correct concentration of salt (follow package directions for use).

Need to know: These devices are meant to be used at least once or twice a day, preferably in the evenings after exposure to irritants. Nasal irrigation is safe to perform on its own or in combination with other remedies.

Natural treatments and preventive options

Example: Life Brand Organic Oregano Oil, Nature’s Harmony Quercetin capsules, Quest Vitamin C Plus Citrus Bioflavonoids tablets, RX Balance Moducare capsules

How they work: For symptoms, oregano oil is believed to have antibacterial and antifungal properties that can combat infections of the upper respiratory tract. Quercetin, a flavonol, is believed to have an anti-inflammatory and natural antihistamine effect.

“Chronic sinus inflammation can be related to suppressed immunity, the wrong diet, yeast overgrowth or the overuse of antibiotics and corticosteroids,” says Natasha Turner, a naturopathic doctor in Toronto. She recommends following an anti-inflammatory diet for at least 30 days to determine any food allergies that could be triggers, while also boosting the immune system with a plant sterol supplement and vitamin C with bioflavonoids.

Need to know: For symptoms, Turner recommends three drops of oregano oil under the tongue, twice per day, and 500 to 1,000 mg of quercetin, three times per day. For prevention, take two to three capsules of plant sterols along with 2,000 mg of vitamin C daily. As always, check with a health professional if you have any questions.

This article was originally titled "Breathe easy" in the September 2011 issue of Best Health. Subscribe today to get the full Best Health experience–and never miss an issue!

Best Health Magazine, September 2011

Average: 3.6 (10 votes)