Sinus & Bad Breath

[Picea]

Hi,

I am in my mid 30's and I have been dealing with bad breath and sinus problems pretty well all my life.  My symptoms are:

Thick mucus feeling in the back of my throat causing a constant need for swallowing.  This is probably post nasal drip.

In worst cases, headaches with pressure in the face and sometime in the jaw (but will not hurt if Dr. tap on it like they normally do for a test).  In the very worst episodes, this will even make me feel dizzy.

Most of the time, I can bread normally but I will still feel the pressure in my head and notice my bad breath.

Other days, I will not have apparent pressure but my breath problem will still be there (people will also tell me…  and offer gum….).  Trust me, it’s pretty embarrassing and hard to strive professionally with a problem like that…

My symptoms will be worst in the morning (mid-morning around 10h00) or just before I eat.  After I eat, it is better for a while and then it comes back.

Air conditioning is just terrible and will plug me up good.  Same with wine.

Cold weather will make my nose to run like crazy.

I often have a runny nose after eating.  Could almost be anything and this is almost instantaneous, could start a couple of minutes after I eat.  I did test for diabetes in the past and results have always been good.


What did I try so far?

Decongestant will work and fix my breath problem right away.  Within 30 minutes to 1 hour after I take 2 pills, my breath will be much better.  However, I have to take 2 pills in the morning, 2 for lunch, 2 for dinner, etc..  I have done that for about 5 years.  However, continuing like this scares me, especially after reading on the bottle that I shouldn’t use that product for more than a week…  I also find that after a while, the effect of the pill is not the same and my problem is coming back.  Also, it is not all decongestant that will work the same.  I have one brand that will work good while others will not.  I also don’t want to get addicted to drugs like this.  I used to call those pills my social pills, if you know what I mean.  Without them, it is almost not possible to have a descent social life…

Antihistamine will not help.

Drinking water, lots of water, does not help.

I have changed my diet significantly and exercise 2-3 times a week for about 1 hour.  I did cut milk products completely and I am on rice milk now.  I will not eat yogurt, etc..  I have also significantly cut bread and would only have it once in a while.  My breakfast will basically be a plate of fruit with oatmeal, lunch would be a salad and dinner would be various (chicken, etc..).

I am also now doing sinus irrigation with the sinupulse machine.  I think that it helps but it is still not clearing 100%.  However, it is the most effective after the pills.


Medical attention:

So far, most doctors told me that I will have to live like that.  They couldn’t find any problem (polyps, etc…).  Most prescribe nasonex with saline, etc… However, I find that nasonex will dry nose so bad that it gives me even more headhace.  I have had antibiotic to clear some infections, which did in most cases but did not really clear my breath problem.  However, I don’t think that I ever got 100% clear (probably don't know what it feels like...).

Some naturopath told me I was allergic to tomatoes, others told me milk, nuts, etc.. I did try to cut them out the best I could but still , not very successful.

What can I do?

So, after all that, I have no more option and I am pretty desperate.  Can you suggest anything else?

Regards,






  

[jmora]

Hi Picea,

Any updates?  Your symptoms are exactly like mine.  My sinuses are blocked and I have post nasal drip causing a severe breath problem.  I have been seeing an ENT for about 5 years with no results.  Surgery is my last option.  I was just curious if this is something that helped you.  Thanks.  

[Bhupinder Kaur, MD]

Hello,

Nasal polyps are soft, non-cancerous growths that develop in the lining of the nose or sinuses.They are not a disease but the end product of the ongoing inflammation that may result from viral or bacterial infections or from allergies.So in a way they are just a chronic inflammation of the nasal lining.Why nasal polyps form is still not known.But they are most commonly thought to be caused by allergy.

Rather than antibiotics,steroids(nasal and oral) are the main treatment of nasal polyps.Antibiotics are only for acute sinusitis.Surgery is done for polyps of large size.But it is true that they can recur.Newer treatment options include endoscopic surgery and Mometasone furoate nasal sprays.You can discuss them with your doctor and find out which one works the best for you.

Hope it helps.Take care and pls do keep me posted on how you are doing.

[Picea]

Hello Kindd,

I would like to update you on my situation.

In December, I had a scan of my sinuses done.  Here is what came out of it on the report:

"There is a polypoid filling defect demonstrated at the base of the left maxillary sinus.  Mucoperiosteal thickening is noted within the reight maxillary sinus.  No evidence of osseous expansion or destruction is seen.  The frontal sinuses are hypoplastic.  The ethmoid and sphenoid sinues are well aerated."

I also saw the scan myself and the polyp is pretty evident, very round and defined shape in my sinus.  On the other side, the mucus around my sinus is very thick and almost filling my sinus, I would say over 50% full.  It's like if it's all inflamated.

At the moment, I feel pressure in my sinuses and have a constant bad breath.  The doctor told me that I probably have a chronic infection and he gave me antibiotic.  However, I must say that it did absolutely nothing.  I think that it's even worst...  nothing changed.  

What can I do that get the right antibiotic to cure my infection?

What should I do with the polyps and the tichness of my sinus?  Is surgery the only solution?  If so, will the polyp come back?

What can I do to identify the source of my problem?  Some say that polyps are created by allergies and they come back if the allergy is not treated.  

I am out of resources...

In the mean time, I will see a sinus specialist in May but I have seen him in the and he sent me home saying that I suffered from allergies....  Not too optimistic...  Now that I managed to have  a scan, at least, I can say that it's more than that...

Any help would be appreciated.

Thanks!

[Bhupinder Kaur, MD]

Hello,

To confirm specific bacteria which are causing sinusitis,culture sensitivity of the nasal discharge or mucus is done.Then according to the reports of the test,the specific antibiotics which are sensitive to that bacteria are prescribed.

You can discuss this option with your ENT surgeon.Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional queries.Kind regards.

[Picea]

Hello Kindd,

Thank you very much for your input.  I really appreciate it.

How would you treat a chronic sinusitis?  I did receive antibiotic in the past but I guess that it didn't clear the problem.  I was reading somewhere that doctors can do a test to find out exactly the bacteria causing the problem.  From that, an antibiotic designed to fight that bacteria can be prescribed.  Are you aware if that can be done?  Would that clear the problem?  Perhaps most general antibiotics are not attacking the right thing.  

I have to say that I am pretty sensitive to antibiotics as well, which makes it difficult.  I did receive a lot when I was a kid and now, it is giving me a hard time.  I ended up in the E.R. a few time with pretty bad stomach ache.  But..... I am readdy to try ANYTHING to fix this problem!!!

Thanks again!

[Picea]

Hello Lynn117,

To answer your question, I don't think that I cough more before bed.  However, when I wake up, I surely have a build up from the night and it takes a little while to get over that.

Regarding the acid reflux, I had some test done in the past and they all returned negative.  My dentist also confirmed that it is not a dental problem.

Thanks for your help!
  

[Bhupinder Kaur, MD]

Hello,

Without examination,confirmation of a diagnosis is tough but it sounds like chronic sinusitis.All the symptoms that you are having(headache,dizziness,post nasal drip,bad breath) are symptoms of chronic sinusitis. Chronic sinusitis begins with an inflammation of the mucous membranes in your sinuses — the air-filled passages around your nose and throat. The inflammation causes fluid buildup eventually plugging the sinus cavity and preventing normal mucus drainage. Worse symptoms in the morning because mucus has been collecting and draining all night.

Chronic sinusitis can be caused by infections of the upper respiratory tract,allergies and deviated nasal septum .Other suspected causes include mold or fungi in the sinuses.Although you have tried nasal decongestants and steroid nasal drops,yet there is no relief.So I feel that you need to get an evaluation from an ENT surgeon and get a course of antibiotics and sinus drainage.You may also require sinus surgery.

The golden rule for chronic stuffy nose is steam inhalation. Inhaling steam from a bowl of hot (but not boiling water) may help to soften, and loosen, the build up of mucus in your nose. You may also find that adding some menthol crystals, or eucalyptus oil, to the water, helps to ease your symptoms of catarrh.

Hope it helps.Take care and pls do keep me posted in case you have any additional queries.Kind regards.

[lynn117]

do you cough like crazy before bed and when you wake up? add that to your symptoms and it sounds like me except i use too much nasal spray instead of pills. i have found that zyrtec helps a little but now i have taken it for a while when i try to stop i itch horribly all over (i have lasted a week without but couldnt stand it any longer). my doctor read a study that acid reflux can sometimes be caused by or cause an allergic reaction so she said it cant hurt to take a pepcid when allegeries are really bad. i dont have the bad breath issues but i have craters in the back of my throat that collect debris that forms a stinky white ball of gunk. its fairly normal especially among allergy sufferers. i am able to squish the balls out with my finger so they dont stink up my mouth throughout the day. stay far away from alcohol based mouthwashes which can dry your mouth and make it worse. gum and mints just cover up the smell. my grandma used to use the home remedy  of chewing on a piece of parsley (my dentist agrees) to help eliminate the problem. many cases of bad breath are not from your mouth but from your throat and upper gi tract so if you have regular dental care your mouth may not be the culprit. good luck.