When you’re all blocked up

Picture: Thinkstock

Picture: Thinkstock

Most cases resolve within a week to 10 days unless bacterial infection develops.

Acute sinusitis (acute rhinosinusitis) is when the cavities around your nasal passages (sinuses) become inflamed and swollen.

This leads to mucus build-up and interferes with drainage. This makes it difficult to breathe through your nose.

The area around your eyes and face might feel swollen and you might have throbbing facial pain or a headache.

Acute sinusitis is mostly caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops.

Most cases resolve spontaneously within a week to 10 days, unless a bacterial infection develops. In most cases, home remedies are all that’s needed to treat acute sinusitis.

However, persistent sinusitis can lead to serious infections and other complications.

Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.

Most people with acute sinusitis don’t need to see a doctor.

Contact your doctor if you have any of the following:

-Symptoms that either don’t improve within a few days or worsen.

A persistent fever.

-A history of recurrent or chronic sinusitis.


Acute sinusitis symptoms often include:

-Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (postnasal drainage).

-Nasal obstruction or congestion, causing difficulty breathing through your nose.

-Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead that worsens when bending over.

Other signs and symptoms can include:

-Ear pressure.


-Aching in your upper jaw and teeth.

-Reduced sense of smell and taste.

-Cough, which might be worse at night.

-Bad breath (halitosis).



The following signs or symptoms may indicate a serious infection:

– Pain, swelling or redness around your eyes.

– Swollen forehead.

– Severe, unrelenting headache.

-High fever.


-Double vision or other vision changes.

-Stiff neck. Risk factors You may be at increased risk of getting sinusitis if you have:

-Hay fever or another allergic condition that affects your sinuses.

-A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumours.

– A medical condition such as cystic fibrosis or an immune system disorder such as HIV/Aids.

Picture iStock

Picture iStock


Acute sinusitis complications are uncommon. If they occur, they might include:

-Chronic sinusitis. Acute sinusitis may be a flare-up of a longterm problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks. v

-Meningitis. This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.

-Partial or complete loss of sense of smell. Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell.

Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent. Diagnosis Consult your doctor who will do a history and physical examination, which includes feeling for tenderness in your nose and face and looking inside your nose.

Other methods that might be used to diagnose acute sinusitis include:

-Nasal endoscopy. A thin, flexible tube (endoscope) with a fiberoptic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.

-Imaging studies. A CT scan or MRI can show details of your sinuses and nasal area. While not recommended for uncomplicated acute sinusitis, imaging studies might help identify abnormalities or suspected complications.

-Nasal and sinus cultures. Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.

-Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that’s responsible for your nasal flare-ups.


Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Self-care techniques are usually all you need to ease symptoms.

Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

– Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.

– Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flixonase), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase).

-Decongestants. These medications are available in over-the counter (OTC) and prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few days, otherwise they may cause the return of more severe congestion (rebound congestion).

-OTC pain relievers, such as paracetamol, acetaminophen or ibuprofen. Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in children.

-Antibiotics usually aren’t needed to treat acute sinusitis.

Even if your acute sinusitis is bacterial, it may clear up without treatment. Your doctor might wait and watch to see if your bacterial acute sinusitis worsens. However, severe, progressive or persistent symptoms might require antibiotics.

If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur.

Possible side effects include stomach upset, diarrhoea and allergic skin reactions.


-If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body’s reaction to specific allergens may help treat your symptoms.

-Alternative medicine. No alternative therapies have been proved to ease the symptoms of acute sinusitis, but products containing certain combinations of herbs may help.

Lifestyle and home remedies

Rest. This will help your body fight infection and speed recovery. v

-Drink water. This will help dilute mucous secretions and promote drainage. Avoid beverages that contain caffeine or alcohol, as they can be dehydrating. Drinking alcohol can also worsen the swelling of the lining of the sinuses and nose.

-Keep your sinus cavities moist. Drape a towel over your head as you breathe in the vapour from a bowl of hot water. Keep the vapour directed toward your face. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucous drain.

-Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain. v Rinse your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others). This home remedy, called nasal lavage, can help clear your sinuses. Use water that is clean-distilled, sterile, previously boiled and cooled to make up the irrigation solution.

-Sleep with your head elevated. This will help your sinuses drain, reducing congestion.


Take these steps to help reduce your risk of getting acute sinusitis:

-Avoid upper respiratory infections. Minimise contact with people who have colds. Wash your hands frequently with soap and water, especially before your meals.

-Manage your allergies. Work with your doctor to keep symptoms under control.

-Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.

-Use a humidifier. If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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