Spring has sprung and with it comes warmer weather, blooming flowers and, unfortunately for those who suffer from allergies, increased risk of sinus infections. An expert at Baylor College of Medicine explains how management of allergies is important in preventing sinus infections.
“Increased sinus infections commonly occur during a patient’s worst allergy months,” said Dr. Mas Takashima, director of the Sinus Center and associate professor of otolaryngology – head and neck surgery at Baylor. “This is due to increased swelling and mucus production of the nasal and sinus passages, which may block the opening of the sinus drainage pathways.”
Sinus infections occur when mucus in the sinuses is not able to drain appropriately, causing the secretions to accumulate, which makes the mucus more likely to become infected. If an individual suffers from a cold or allergies, sinuses can become inflamed and are unable to drain. This can lead to congestion and infection.
“I like to use the analogy of water from a stagnant pond or a running stream. Typically there is much more bacteria in a non-moving body of water,” Takashima said.
Understanding the difference between sinusitis and severe allergies can be difficult, and Takashima said it’s important to know the difference to help receive the best treatment.
Signs and symptoms of a sinus infection are:
- Facial pressure and pain
- Pain along the teeth
- Pain along the cheeks when bending over
- Greenish/yellowish continuous drainage from the nose
- Symptoms lasting greater than 10 days
Signs and symptoms more consistent with allergies are:
- Sneezing/stuffy nose
- Clear or whitish nasal drainage
- Itchy, watery eyes
- Itching of the nose
- Dark circles around the eyes
- Burning sensation in the eyes or nose
There are other sinus problems that occur due to weather change, Takashima said, however it doesn’t necessarily mean it’s a sinus infection. “We see patients that complain of facial pressure and pain associated with weather changes. This may occur along the forehead, around the eyes or behind the cheeks. This is typically not associated with a sinus infection. Instead, it is associated with patients who have a very narrow opening into the sinuses,” he said.
To prevent sinus infections, Takashima said strict allergy management is necessary. “You can manage allergies by pre-medicating with allergy medicine prior to the start of known allergy months, and with allergy medicines such as antihistamines and nasal steroids.”
He said it’s important to use nasal saline rinses to flush away the irritants, keep the sinus openings free of mucus or crusting and to decrease the bacteria in the nose.
When sinus infections do occur, patients often are treated with antibiotics. However, use of multiple antibiotics may completely change the regular microbiome of the sinuses by killing all of the “good” bacteria, which typically reside in the sinuses. These good bacteria tend to prevent pathological bacteria and fungi from settling in and causing chronic sinus infections.
“We have learned that without good bacteria, the bad bacteria can cause a multitude of diseases, such as yeast infections, gastrointestinal problems like diarrhea and lung infections, and we are finally realizing the same thing is occurring in the sinuses,” he said.
For those who suffer from frequent sinusitis and do not find medication that works, surgery may not be the only option. Advances in in-office procedures have significantly improved over the last several years making these less invasive procedures, such as balloon sinus dilation, a viable option. Takashima said research is being done to develop further less invasive techniques to help better treat patients with chronic sinusitis.
“Here in the south where it is warm and humid, mold and fungal infections of the sinuses are common and are very difficult to grow in a routine culture. We have now moved to identifying infectious organisms more precisely with DNA analysis of patient’s sinonasal secretions. In addition, we are currently researching the importance of probiotics in the sinuses and will be looking at the safety of instilling probiotics into the nose to help treat patients with recurrent chronic sinusitis,” he said.