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Respiratory Disorders (Expert Forum)
Chronic-recurrent sinusitis, CT negative, always triggers asthma
Answered by
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Chronic-recurrent sinusitis, CT negative, always triggers asthma
by ARM123, Nov 16, 2003 12:00AM
I have allergic asthma, and have had it for 33 years. Chronic infection, especially sinusitis, seems to play a big role. I've had two ENTs check me out - no fungus or polyps or anything like that. I've been on immunotherapy most of my life. I take all the current meds and just started Xolair. I get several infections a year. I've tried Levaquin for as much as a month at a time. Any suggestions as to where to go next? Other tests to run or things to check out? Thank you.
Doctor's Answer
by National Jewish, Nov 19, 2003 12:00AM
, Nov 19, 2003 12:00AM
Sinusitis is an inflammation, or swelling, of the mucous membranes that line the sinus cavities. Inflammation of the sinuses could be due to an allergy, an infection, or ongoing exposure to an irritant, such as pollution or smoke. Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, postnasal drip, cough, sore throat, laryngitis, constant low fever, and thick, yellow to green nasal drainage. A CT scan of the sinuses is the best way to identify this problem.
The most common cause of sinusitis is an infection, especially when the mucus is green. Sinus infections can be difficult to treat since they respond slowly. When a bacterial infection is the cause you may need to take an antibiotic for at least 3 weeks. Bacteria can become resistant to a particular antibiotic, especially when that antibiotic is used repeatedly. When this happens you will need to be treated with a different antibiotic to clear the bacteria. Even after the antibiotic clears the infection, it is possible for the inflammation to linger.
This inflammation can block sinus drainage and cause increased mucus production. The mucus can drain from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip and sore throat. This can fester sinusitis.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult for you to blow out of your nose. A decongestant like Sudafed® (pseudoephedrine) can relieve your blocked sinuses so the postnasal drip drains better.
A nasal wash helps remove mucus and bacteria from the nose and sinuses. This can temporarily decrease the postnasal drip and help your sinuses to drain better. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
If your symptoms continue, your doctor may recommend a prescription nasal steroid spray. This can decrease inflammation in the nose and sinuses and the mucus production. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. To get the most help from a nasal steroid spray use it after doing a nasal wash. A nasal steroid spray does not provide immediate relief of symptoms. It may take several weeks of routine use to become effective.
The most common cause of sinusitis is an infection, especially when the mucus is green. Sinus infections can be difficult to treat since they respond slowly. When a bacterial infection is the cause you may need to take an antibiotic for at least 3 weeks. Bacteria can become resistant to a particular antibiotic, especially when that antibiotic is used repeatedly. When this happens you will need to be treated with a different antibiotic to clear the bacteria. Even after the antibiotic clears the infection, it is possible for the inflammation to linger.
This inflammation can block sinus drainage and cause increased mucus production. The mucus can drain from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip and sore throat. This can fester sinusitis.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult for you to blow out of your nose. A decongestant like Sudafed® (pseudoephedrine) can relieve your blocked sinuses so the postnasal drip drains better.
A nasal wash helps remove mucus and bacteria from the nose and sinuses. This can temporarily decrease the postnasal drip and help your sinuses to drain better. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
If your symptoms continue, your doctor may recommend a prescription nasal steroid spray. This can decrease inflammation in the nose and sinuses and the mucus production. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. To get the most help from a nasal steroid spray use it after doing a nasal wash. A nasal steroid spray does not provide immediate relief of symptoms. It may take several weeks of routine use to become effective.
