Dear Readers,

Lawrence F. writes Lifeline from Portmore, St Catherine. He is a 28-year-old accounting clerk who has suffered with nasal stuffiness, sneezing, cold and cough, recurring face pain and headaches "on and off" for the past three years.

Lawrence says that he visits his doctor quite often for this problem, which the doctor says is due to his sinuses having an infection. The problem clears up for a while after the treatment but always recurs. Lawrence says he hasn't gone one full month without feeling sick in recent times, and the head cold and headache makes it hard to concentrate at work and stops him from getting rest at nights.

Sometimes he feels like he has the "flu" and has to stay home a few days from work. He is asking Lifeline what can be done to permanently treat his sinus problem and get rid of his permanent cold and "post-nasal drip".

Lawrence seems to be long suffering with CHRONIC sinusitis. This is initially caused by germs (bacteria, viruses or fungi) infecting the sinuses and growing there. The sinuses are the hollow, membrane lined, air cavities located in the facial bone cavities. The inflammation associated with this process can, at times, block off the ostea which are narrow exits from the sinuses and from which any mucous formed drains to the back of the throat.

When this occurs, a sensation of "pressure" or pain builds in the face due to either a vacuum formed or fluid under pressure which cannot drain. This causes a great deal of discomfort and makes it difficult to concentrate on any other matter until some relief is obtained.

Symptoms include:

Frontal headaches

Facial pain

Stuffiness

Yellow nasal discharge

Post-nasal drip

Nasal stuffiness

Sneezing

Cough

Ear pain

Bad breath

Itchy eyes and other allergic symptoms

Sinusitis can result as a complication of a simple cold, or recurring nasal allergies with congestion. The thick mucus formed in the sinuses can become dehydrated and forms a thick heavy sludge in the sinus cavities.

This can actually be worsened with the use of antihistamines (such as DPH, Tavegyl, Benadryl, Allegra, Claritine, Zyrtec, Aerius, etc) which also dry out the sinus secretions. Cigarette smoke and dry humid air also aggravates the sinuses and make all the symptoms worse.

Other risk factors are:

Air pollution

Smoke

Allergens

Asthma

Deviated nasal septum

Gastro-esophageal

reflux disease (GERD)

Overuse of nasal

decongestants

Foreign body to nose

Nasal polyps

What sufferers with this condition can do is to keep very well hydrated at all times to keep mucus secretions thin so that they can drain easily. Avoid smoke and industrial pollutants and all risk factors.

misleading

X-rays are no longer used in the diagnosis of sinusitis as they have been found to be misleading, instead, CT scan or MRI of the sinuses are now used when confirmation is needed. Because of the expense involved in requesting these tests, most doctors will use clinical findings (history and examination findings) to make a diagnosis of sinusitis, and then begin treatment.

Treatment of bacterial and fungal infections involves the use of antibiotics or/and antifungal medication for an average of two weeks. Nasal decongestants, painkillers and menthol crystal steam inhalations at night, can also help ease the distress suffered. Fluid hydration is also a must. Antihistamines can also be used if allergic symptoms are present but again, fluid intake must be maintained as these medications dry the sinus secretions and can impede sinus drainage.

proper relief

Sometimes the sinusitis treatment regimens are not taken for long enough to give proper relief of the symptoms. Causative factors such as dry humidity and cigarette smoke should be avoided as much as possible. There are no permanent treatments for sinusitis. What is useful is the practice of healthy lifestyles with NO CIGARETTE smoking (no ganja smoke either), the avoidance of foods and all situations which are known to trigger allergies, the use of antioxidants as dietary adjuvants, keeping the body well hydrated at all times, avoiding smoke-filled polluted environments and recognising symptoms early and treating the problem early, before painful, distracting symptoms occur.

If the problem persists, an ear, nose and throat surgeon should be consulted as, occasionally, surgical drainage of the sinuses is useful and nasal polyps, if present, can be removed.

Write to: LIFELINE, PO Box 1731, KGN 8