What is Sinusitis?

There are times when we feel as though our head is like a huge heavy block of lead and our nose some large and useless fleshy appendage stuck in front of it! Understandably one might become quite desperate when the most basic function in life – the ability to breathe comfortably – is compromised. It is the lightness of the air element that we crave when we feel depressed and bogged down. Imagine how dense we would be with no air circulating through our head and chest cavity. No wonder we feel so miserable when our noses are blocked and our sinuses clogged!

Why do we have sinus cavities?

• Sinuses lighten the weight of the skull and this is the reason why the head feels so heavy and dull during a sinus attack.
• Sinuses give resonance to your voice.
• Sinuses filter and moisten the air that we breathe and remove unwanted air particles. We are able to breathe deeper when we utilize the turbine effect of the sinus cavities through the nose instead of the mouth. In yogic practises correct breathing through the nose (a slow deep audible breath with most part of the tongue against the palate) regulates the endocrine system by stimulating the pituitary gland, situated deep behind the nose. The way we breathe thus has a profound effect on our emotions.

What are sinuses?

What is Sinusitis?

1. Acute Sinusitis. Acute Sinusitis usually lasts for no more than 3 weeks. It is often triggered by a preceding flu or head cold and presents with typical "cold" symptoms but lasts longer than a week.
2. Chronic Sinusitis. To most people under the age of 45, chronic sinusitis is one of the most common chronic illnesses. Chronic sinusitis usually lasts for more than 3 weeks and can continue for months or even years. It is commonly caused by allergies or bacterial infections.The overuse of antibiotics and cortisone sprays have lead to more virulent forms of bacterial infections as well as new fungal infections of the sinus cavities. Asthma and allergic disorders often cause chronic inflammation of the nasal mucosa resulting in chronic sinusitis. About 20% of patients with chronic sinusitis may develop nasal polyps. Nasal polyps are cyst-like growths that develop from sinus tissue and may further obstruct the sinuses.
3. Recurrent Sinusitis. Also called allergic rhinitis or rhino-sinusitis, this type is characterised by several separate attacks during the year. The attacks are usually caused by an allergic reaction to varying weather conditions and environmental factors.

1. Ethmoid sinuses (behind the bridge, at the "root" of the nose between the eyes) Present at birth the ethmoid sinuses enlarge as we grow.
2. Frontal sinuses (above the eyes in the forehead). These develop around seven years of age.
3. Maxillary sinuses (on either side of the nostrils in the cheek bones). They are also present at birth and enlarge as we grow.
4. Sphenoid sinuses (deep in the skull behind the ethmoid sinuses and the eyes) We only develop sphenoid sinus cavities during adolescence.

What causes Sinusitis?

What are the bugs behind the scenes?

• Viral infection - This type of sinus infection is the most common as it may be caused by millions of different strains and viruses. It is also known as an upper respiratory infection (cold or flu) and tends to last for a fort night with symptoms similar to a common cold, i.e. a runny nose, congestion or even a sore throat with accompanying post nasal drip and coughing. If left untreated a viral infection may develop into a bacterial infection such as chronic sinusitis.
• Bacterial infection - This type of infection is most often caused by the bacterium Streptococcus pneumoniae and Haemophilus influenzae. These types of bacteria are commonly found in the respiratory tract of healthy people and will only result in a bacterial sinus infection when the immune system is compromised. Other, less common sinusitis causing bacteria include Staphylococcus aureus and Branhamella catarhallis. Swimming in contaminated water may also result in a bacterial infection of the sinuses.
• Fungal Infection - Fungi are plant like organisms which are unable to produce their own food. They are usually found living harmlessly in our sinuses. However when the body's resistance is low, they may become harmful and feed on the delicate mucus membranes that line our sinus and nasal passages resulting in inflammation and a possible fungal infection. Aspergillus fumigatus is one such fungus. Our moist, dark and warm nasal passages and sinus cavities provide fungi with the ideal environment in which to thrive and propagate. Fungus includes- moulds, yeasts, mushrooms and puffballs.

• Nasal Polyps - Nasal polyps occur when the connective tissue matrix that keeps the mucus membrane linings of the nose intact becomes damaged. The damaged lining gradually becomes detached from the underlying tissue and starts filling with mucus, causing it to sag and develop into a "nasal polyp". Polyps appear jelly-like and opaque to white in colour. Any inflammation or allergy affecting the mucus membranes of the nasal passages and sinus cavities will aggravate the nasal polyps causing them to swell more and block the opening to the sinuses, thereby promoting the growth of bacteria, viruses or fungi. Nasal polyps are more prevalent in people suffering from chronic sinusitis, hay fever and asthma. Symptoms include recurrent or chronic sinusitis, nasal obstruction, mouth breathing, snoring and reduced senses of smell and taste. After surgical removal of polyps (FESS – functional endoscopic sinus surgery) approximately 50% of sufferers experience a regrowth of polyps.
• Deviated Septum - The septum is a large cartilaginous bone dividing the right and left nostrils. Certain injuries to this part, e.g. a broken nose, can obstruct mucus drainage and breathing and therefore lead to sinusitis. Surgery may help to rectify a deviated septum.
• Turbinates - The nasal passages contain bony projections called turbinates which filter and warm the air that passes through these passages. When an irritation of the nasal passages occurs, these processes become inflamed and may swell causing an obstruction of mucus flow and if left untreated lead to a sinus infection.
• Concha Bullosa - This bubble or balloon shaped structure tends to develop on the middle turbinate and can exert pressure on the adjacent tissue thereby causing irritation, sinus pain and nasal blockage. This condition may be treated by endoscopic sinus surgery in severe cases.

What predisposes us to Sinusitis?

• The changing altitudes brought about by frequent flying or scuba diving may not only cause but also make current sinus infections worse. Different altitudes and air pressures irritate and inflame the paranasal and frontal sinus cavities. In severe cases bleeding of the nasal mucus linings may also occur due to the inflammation.
• Frequent dental work may cause damage to the delicate sinus cavities which lie directly above the upper teeth. On the other hand mouth infections may easily spread to the sinuses.
• Over usage of nasal decongestants and cortisone nasal sprays may have an initial drying effect, However the body's normal reaction there upon is to produce more mucus thereby promoting the development of sinusitis. Furthermore the drying effect on infected mucus membranes increases the viscosity of the mucus  resulting in stagnation and an aggravation of the infection. Cortisone also compromises the body's defence system in dealing with the infection.
• Swimming in chlorinated water may cause an irritation and inflammation of the mucus membrane linings increasing susceptibility to a bacterial invasion. The water also results in the cilia performing poorly thereby reducing mucus drainage.
• Pregnancy and Oral contraceptives cause hormonal changes which may lead to an increase in mucus production and post nasal drip. Furthermore the increased blood supply accompanying pregnancy causes intra-nasal venous congestion which gives the sensation of a blocked nose. Frequent blowing in order to clear the nose only irritates the already swollen mucus membranes.
• Any head or face injury may damage the various delicate intra-cranial bones housing the sinus cavities, predisposing them to infection. Nasogastric intubation during surgery may cause damage and inflammation to the delicate mucus membranes making these linings highly susceptible to sinusitis causing bacteria and viruses.
• A diet consisting of refined carbohydrates and sugar, gluten and dairy products may cause an allergic reaction and swelling of the mucus membranes. This promotes the production of excess mucus in both persistent and chronic sinusitis. Sulphur containing foods and drinks also aggravate sinusitis.
• Certain medications may predispose to sinusitis in which case it is best to consult your doctor to find out whether your current prescription may indeed predispose to sinusitis.
• Smoking damages the cilia resulting in post nasal drip and the mucus becoming thick and tenacious allowing bacteria to accumulate. Non-smokers who are exposed to second hand smoke may also experience compromised cilia functioning. 
Smokers are less likely than non-smokers to have a full recovery after sinus surgery due to progressive damage of the cilia and nasal linings of the nose and sinus cavities. 
Asthma and respiratory infections are more common in people who inhale second-hand smoke regularly.
• Dehydration and dehydrating agents such as alcohol, tea and caffeine as well as a dry climate and wind lead to more tenacious mucus and a tendency to sinusitis.
• Environmental factors include dust, house dust mites, mould and damp environments, air pollution, petrol, perfume, paint, glue and other industrial chemicals, mold, furry or feathery pets, plant and grass pollens.
• Compromised immune system In a University of Miami study, 50% of chronic sinusitis patients were found to be suffering from immunological disorders.

Symptoms of Sinusitis:

• Cold symptoms that don't respond to treatment
• Persistent colds with coughs
• Head pain on waking in the morning
• A low grade fever between 99F and 100F
• Weakness or tiredness
• A cough that is more prevalent at night
• A runny nose (rhinitis)
• Nasal congestion
• Halitosis (bad breath)
• Swollen eye lids
• Post nasal drip
• Blocked or stuffy nose
• Congested feeling and pressure
• Facial pain or swelling
• Headaches worse on bending forward
• Voice hoarseness
• A decreased sense of smell
• Fullness of the ears

Sinusitis Remedies:

• Drink at least two litres of purified water a day. This keeps the mucus fluid, relieving congestion and sinus pressure. Hot drinks and adding cayenne pepper or ginger may bring even faster relief.
• Excessive mucus is often a sign that your immune system is overtaxed. Try a fruit and vegetable juice fast for a couple of days. Your mucus discharge may increase initially as the body is eliminating, but if you persist the drainage will be complete.
• Avoid allergens as far as possible. Environmental factors may be difficult but your diet is under your own control. Your diet should consist of 75% raw and lightly steamed vegetables and fruit. Avoid dairy, fries, sugar and refined carbohydrates as well as tea, coffee and alcohol especially during an infection.
• Mix a cup of warm water, half a teaspoon of sea salt and a pinch of bicarbonate of soda and make your own nasal spray (obtain a suitable bottle from your chemist) or nasal wash by drawing the fluid up through your nostrils and spitting it out through your mouth. Though uncomfortable, this is an excellent local antiseptic!
• Steam inhalations with eucalyptus, tea tree and rosemary aromatherapy oils help to clear congestion. Use a towel over the head and lean over a pot of steam water.
• Do not use force when blowing your nose, as this forces the mucus back into the sinuses. Rather keep the mucus fluid and draw it down the back of the throat to expel orally when blowing becomes difficult.
• Boost your immune system by taking 3000mg of a non-acidic form of vitamin C in divided doses each day. Herbs like Echinacea, Golden seal and Cat's claw increase your defences.
• Avoid antibiotics, nasal decongestant, nose drops and sprays as far as possible. These predispose to recurrent infections and undermine the immune system. The drying agents shrink blood vessels in the nose and cause them to weaken as well as thicken the mucus increasing the risk of infection.
• As a rule, stick to therapies that allow drainage of the mucus by keeping it fluid.
• Craniosacral therapy addresses the various cranial bones and has decompression techniques which assists draining of the sinuses. Typically patients report an initial increase in pressure or nasal obstruction, followed by a tremendous relief, ability to breathe and draining of mucus afterwards.
• There are various yoga postures and breathing techniques that assist in draining the sinuses.

Homeopathic remedies for sinusitis

• Kali Bich: Most types of sinusitis especially when the mucus is thick, yellow-green, stringy, tenacious and difficult to expell.
• Hepar Sulph: Thick purulent mucus and post nasal drip in chilly patients worse from draughts. Sinus abscess. Very tender to touch sinuses and bones of the face, typical stitching pains.
• Pulsatilla: Thick yellow green nasal discharge. Congested nose worse in the evenings and warm indoors. Sneezing and runny nose outdoors in fresh air (which generally improves the patient). Sense of taste and smell is lost. The patient has no thirst despite a dry “furry” mouth.
• Generally the patient is moody, tearful and in need of consolation.
• Merc Sol: Nasal mucus is burning and watery alternating with thick green, purulent mucus which may be blood streaked. The nostrils, mouth or throat may become ulcerated. Glands are swollen and painful. The patient is sweaty and all discharges as well as the breath have a foul odour.
• Nat Mur: Discharges are profuse and watery (also from the eyes) or a thick consistancy (like egg white) post nasal drip. Nasal obstruction and headaches worse from exposure to the sun.  The lips are dry and cracked and the patient may be prone to herpes. Excellent remedy for viral colds and sinus infections.
• Silica: Chronic sinusitis and a tendency to catch cold easily from changes of weather, especially cold wet weather. Generally a weak constitution, lacking in stamina due to poor assimilation of minerals. Abscess formation and fistulae are common.