Why do people have sinuses in the first place?
If you think about it, your brain is a heavy organ sitting in a heavy skull which then sits on your spinal column. The sinus cavities actually help to make the skull lighter so that your spinal column is able to withstand all of this weight and not collapse. Of course, the sinuses are constructed in such a way that they should remain clear and aerated in order prevent infections. They do this by secreting fluids that continuously bathe the sinuses, keeping them clean and preventing bacteria from growing. In fact, you can think of the sinuses as “gutters” that drain bacteria and debris into the nose for elimination.
My sinus problems always seem to be worse in the morning—why is that?
People can have trouble any time of the day, depending upon the type of sinusitis that they have and what triggers it. But in the morning when you are lying down, stuff is draining in to the back of your throat and not getting cleared out, so it may feel worse. Also, if you are on medication it likely would have worn off overnight. Once you get up and start moving it should start to subside.
Is it safe to fly with sinusitis?
If your sinusitis is being treated and is under control, you should be fine. You may want to consider using a decongestant before takeoff and landing, as that will help prevent problems. But if you have a sinus condition that is untreated, the altitude changes could cause problems such as sinus squeeze, pressure, and pain.
Is there a connection between allergies and sinusitis?
Allergy plays a role in approximately 70% of all sinusitis cases. However, for most people, allergies are not the only contributing factor to their symptoms. Because sinusitis is most often caused by a combination of factors, of which allergy is just one, it makes proper diagnosis and treatment very important to ensure you get optimal symptomatic relief. A recent study shows that most sinusitis sufferers have tried up to eight different products without achieving satisfactory improvement in their symptoms.
OTC medications seem to receive bad press. Is there anything that I should be aware of in using these products?
Decongestant nasal sprays are effective and safe if used according to directions, for no more than 3–5 days. However, if you use these sprays repeatedly, you may experience what is referred to as a “rebound effect.” This means that you have to use more and more of the spray just to get simple relief. Oral decongestants are also effective but can cause insomnia and heart racing in some people. Also, it is counter-indicated in people with certain conditions such as high blood pressure and prostate disease. Many antihistamines such as diphenhydramine work well but may cause sedation and dry mouth. The newer, non-sedating products, such as loratadine, work well for allergic rhinitis but are not very effective in non-allergic rhinitis. So to summarize, there are many products out on the market that are effective and worth trying—but make sure that you use them according to directions.
Have you had any experience with Sinus Buster® in your clinic?
We are using Sinus Buster in our clinic, which sees a broad range of sinusitis and rhinitis patients who have different triggers and symptoms. We have experienced good results with this product, as all of our patients who used it experienced relief, including several who have seen their symptoms significantly resolve. The degree of relief that you will experience is typically a function of your specific condition, its etiology, and symptoms. What I especially appreciate about Sinus Buster is that it is very safe and patients can use it on a regular basis without side effects.
Saline rinses like neti pots and irrigators seem to be getting popular. How effective are they?
I think that these rinses are a very effective treatment and when used in conjunction with capsaicin are a good regimen. We use them widely in our clinic as it cleans out mucus, keeps the osteum open, and helps resolve congestion.
Is there something that I can do to improve the overall health of my sinuses or to prevent problems?
Yes, but first I think it is important to explain how problems like sinusitis can arise. Your nose is the gateway to the sinuses. The nose contains turbinates which act as filters to prevent pollutants and allergens from accumulating and going into the lungs. The sinuses are lined with fine, hair-like projections called cilia, which also prevent the accumulation of microorganisms and irritants that enter the nose and sinuses from the air that you inhale by moving it via mucus (which is normally produced by the sinus) toward a tiny opening called the ostium. The ostium provides a drainage outlet for your sinuses. The ostium can become blocked due to recurrent inflammation caused by infection, allergens, and other irritants resulting in decreased drainage and oxygenation in the sinuses causing pressure/pain and eventual bacterial overgrowth and infection. It is important for optimal health that the ostium or sinus openings are kept clean and open. Regular, gentle rinsing with a saline solution can help accomplish this.
When is it time to stop self treatment and seek a doctor’s help?
When your medications don’t work and you are plagued with infections, headaches and ear plugging (especially if your symptoms mean missing work or school or impact your ability to concentrate or sleep). This would certainly be a good time to seek out a specialist who can help identify the cause of your illness and the best course of therapy.
Biography: Jonathan A. Bernstein, MD
Dr. Jonathan A. Bernstein is a Professor of Clinical Medicine in the Department of Internal Medicine, Division of Immunology/Allergy Section at the University of Cincinnati Medical Center, Director of the Veterans’ Administration Hospital Allergy Clinic and Allergy Laboratory and Director of Clinical Research for the Division of Immunology.
Dr. Bernstein is actively involved in clinical and translational research, in addition to pharmaceutical research, patient care, and teaching. His current research involves the investigation of indoor environmental determinants in the workplace and home that cause or aggravate asthma and rhinitis and investigation of genetic markers that could identify susceptible populations to these exposures. His publications reflect his interest in this area.
Dr. Bernstein has extensive experience conducting clinical therapeutic trials and is a DIA certified investigator. He has considerable experience conducting cross-sectional and longitudinal occupational and non-occupational investigations related to asthma and rhinitis. Dr. Bernstein is an authority on seminal plasma hypersensitivity reactions, an under-recognized problem in women.
Other research topics of interest include non-allergic vasomotor rhinitis, olfactory receptor polymorphisms, environmental control of indoor allergens, mold assessment and remediation, genetically modified foods, and novel therapies for allergies, asthma, and other allergic diseases.
Dr. Bernstein is actively involved in the University of Cincinnati Allergy Fellowship Training Program and in the education of residents and medical students.
He serves as the Vice-Chairman of the Environmental and Occupational Respiratory Disease Interest section for the American Academy of Asthma, Allergy, and Immunology. He is an Associate editor of the Journal of Asthma and on the reviewer board of the JACI. He reviews manuscripts on a regular basis for the Journal of Allergy and Clinical Immunology, Annals of Allergy, Asthma and Immunology, Journal of Asthma and Chest.
Dr. Bernstein has published more than 90 peer reviewed articles, clinical reviews, and chapters on a variety of allergic disease topics.
