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Allergies and Sinusitis - The Connection

Allergies and Sinusitis Hay fever and other allergic reactions can be contributing factors to sinusitis. Allergies can trigger swelling in the sinus and nasal mucous linings. The swelling can cause sinus passages to close up, trapping bacteria in the upper respiratory tract. Bacteria in the sinuses can develop into a sinus infection.

Sinusitis is an inflammation of the hollow cavities around the eyes and nose known as the nasal sinuses. While allergic rhinitis (hay fever) is an inflammation of the mucous membranes of the nose, sinusitis is an inflammation of the sinuses. Symptoms of sinusitis can vary depending on the level of inflammation and the area inflamed.

Allergy and Sinusitis Symptoms
Frequent allergic reactions, resulting in sinusitis, can cause sinusitis to become a chronic condition. Chronic sinusitis sufferers have frequent and ongoing inflammation of the sinus membranes. The National Institute of Allergy and Infectious Diseases lists several symptoms that are associated with sinusitis. Some symptoms include:

» Headache in the morning

» Pain when pressure is applied to the forehead over the frontal sinuses

» Aching in the upper jaw and teeth along with tender cheeks

» Swelling of the eyelids and tissues around the eye

» Pain between the eyes

» Tenderness when pressure is put on the sides of the nose

» Loss of smell and nasal congestion or runny nose

» Earaches, neck pain, and deep aching at the top of the head

» Fever

» Weakness and tiredness

» Coughing that can increase in severity at night

» Postnasal drip causing a sore throat

Because symptoms of sinusitis are similar to that of allergies or a common cold, it is important to recognize the differences and undergo the appropriate treatment.

According to the American Academy of Allergy Asthma & Immunology (AAAAI): “Nasal allergies (allergic rhinitis or ‘hay fever’) cause nasal itching and sneezing, runny nose, nasal stuffiness and postnasal drainage. These symptoms are similar to those of sinusitis. Most experts believe nasal and sinus swelling from allergies can contribute to the development of sinusitis. However, other factors, such as chronic infection, also contribute significantly to the development of chronic sinusitis.

Because of the importance of allergies to nasal and sinus symptoms, patients with chronic sinusitis should be evaluated for nasal allergies.”

Treatment Options
The AAAAI lists several types of physicians who are involved in the treatment of sinusitis. The physicians include allergists and immunologists, general practitioners, family physicians, internists, pediatricians, and ear, nose, and throat specialists. An AAAAI survey reported that allergists devote 20-30% of their time to treating sinusitis.

In addition to allergens and viral or bacterial infection, sinusitis can be triggered by exposure to noxious chemicals, smoke, and air pollution. Due to the variety of sinusitis triggers, various forms of treatment are available as preventative measures and symptom management. Allergy medicines such as decongestants and antihistamines can be taken at the start of an allergy attack to prevent the development of sinusitis, but once sinusitis develops further treatment is necessary.

Along with taking allergy medication to prevent sinusitis, other treatment options include:

» Pain relievers

» Oral steroids to reduce nasal swelling

» Oral and IV antibiotics to fight bacterial infection

» Expectorants and mucolytic agents to thin mucus to help sinus drainage

» Nasal washes to rinse mucus from the nasal cavity and sinuses

» Sinus surgery to open the sinus drainage pathways

One of the more recent treatment options for chronic sinusitis is the use of intranasal nebulized antibiotics. A recent study by Stanford University has analyzed this new effective treatment for sinusitis, indicating that the use of aerosolized or nebulized antibiotics in the treatment of sinusitis can bring successful outcomes.

Allergic Fungal Sinusitis
Allergic fungal sinusitis is caused by extreme allergic and inflammatory response to a fungal species. It is a rare complication of chronic sinusitis in which the thick mucus secretions containing fungus become impacted. Rather than allergies contributing to sinusitis, the fugal species developed during chronic sinusitis is the cause of an allergic reaction. Oral steroids are useful in the management of allergic fungal sinusitis, but surgical removal of the fungus-loaded secretions is the proven effective treatment.

Related Symptoms and Treatment
There is an obvious connection between allergies and sinusitis. Allergists, ENTs, and patients need to work together to differentiate between similar symptoms and choose the most affective and appropriate treatment.

Sinusitis Facts

» Every year, more than 35 million Americans suffer from sinusitis (approximately 1 out of every 7 Americans).

» Sinusitis is reported by the American Academy of Allergy, Asthma, & Immunology to be "one of the most expensive disorders in the U.S. and its prevalence is on the rise."

» Sinusitis is one of the leading chronic diseases in the United States and the National Academy on an Aging Society named sinusitis the most common chronic condition among Americans.

» 14% of the American population is effected by sinusitis according to a June 1997 report in The Journal of Allergy and Clinical Immunology.

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