What’s behind your sinus problems?


Patient: Doc, my nose runs and my feet smell.
Doctor: I see the problem. You’re built upside down.

Sinus problems aren’t funny if you’re the one with the headache. With a cold, runny noses come and go, but if you have sinus problems for more than 12 weeks, you could have chronic sinusitis, an inflammation of the sinuses due to a viral, bacterial, or fungal infection. According to the U.S. Centers for Disease Control and Prevention, over 29 million American adults are suffering along with you.

While sinusitis is not a cold, it’s usually a cold that leads to sinusitis. Congestion in your nose blocks the drainage of your sinuses. Both your nose and your sinuses are lined by moisturizing mucous membranes. When mucus can’t get out of the sinuses, bacteria start to grow, and that causes a sinus infection. If you have allergies, your risk for sinusitis goes up.

The sinuses are holes in the skull between the facial bones. There are four large sinuses: two inside the cheekbones (the maxillary sinuses) and two above the eyes (the frontal sinuses). There are also smaller sinuses (ethmoidal and sphenoidal sinuses) located between the larger ones. The sinuses are lined with membranes that secrete antibody-containing mucus, which protects the respiratory passages from the onslaught of irritants in the air we breathe.

Symptoms of chronic sinusitis are not very different from acute sinusitis symptoms — they just last longer. In fact, they can go on for years. Whether sinusitis symptoms are the result of infection or allergy, the actual cause of the symptoms is the blocked drainage of mucus from the sinuses into the nose.


  • Nasal congestion with thick nasal discharge
  • Pain over the upper teeth
  • Headache
  • Post nasal drip and cough that is worse at night
  • Bad breath
  • Loss of smell
  • Fatigue
  • Fever
  • Snoring

Allergies to dust, pollen, pet dander; indoor air pollutants, such as cigarette smoke, rug shampoo and formaldehyde (used in the manufacture of carpeting, particleboard and plywood); and outdoor air pollutants all can induce inflammation. Excessive dryness in homes and offices from dry-air heating and air-conditioning systems can also inflame the sinuses.

Some people are born prone to sinus problems with narrow drainage passages or a deviated septum. A nasal obstruction could be caused by tumors or polyps. Allergic fungal sinusitis is difficult to treat and often requires surgery, and is more common in people who have diabetes or a weakened immune system from other causes.

Acute bacterial sinusitis that occurs after a head cold usually responds to antibiotics, but chronic sinusitis may require stronger stuff like anti-inflammatory medications, irrigation, and sometimes surgery to open up the sinuses and the nasal passages.

A relatively recent advance in the treatment of sinusitis is a type of surgery called functional endoscopic sinus surgery. This surgery removes anatomical and pathological obstructions associated with sinusitis in order to restore normal clearance of the sinuses. Another recently developed treatment is balloon sinuplasty, which is similar to balloon angioplasty used to “unclog” arteries of the heart. Don’t try this at home, however.

Some things your doctor might prescribe include:

  • Antibiotics for four weeks or more.
  • Antifungal medication.
  • Steroid nasal sprays to fight nasal and sinus inflammation.
  • Antihistamines or allergy shots for allergic sinusitis.
  • Surgery to open and drain sinuses or to remove nasal obstructions that block sinus drainage.

You can do some things on your own to treat sinusitis:

  • Drink plenty of fluids to keep your mucus thin and flowing.
  • Use steam or hot compresses to loosen up thick mucus secretions.
  • Keep your environment moist by using a clean humidifier.
  • Use over-the-counter saline nasal sprays or irrigations to open nasal and sinus passages.
  • Avoid overuse of over-the-counter decongestant sprays (like Afrin or Neo-Synephrine) that can cause rebound congestion.

Sinusitis is one of those sneaky ailments that could be due to a sinus infection, but also might be the result of an allergy or fungus. Look around your home. Your doctor can help you find out the true cause and refer you to a specialist for treatment.


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