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Sinusitis is inflammation that causes pain, pressure, and swelling in the sinuses. Chronic sinusitis is sinusitis that lasts for a long time, usually longer than 12 weeks.

Unlike acute sinusitis, which is often due to a sinus infection, chronic sinusitis is not usually caused by bacteria and does not always get better with standard treatment, such as antibiotics.

Chronic sinusitis is sometimes called chronic rhinosinusitis.

Fast facts on chronic sinusitis:

  • Treatment for chronic sinusitis depends on the underlying cause.
  • People with allergies and asthma may be more vulnerable to chronic sinusitis.
  • Some home remedies can prevent chronic sinusitis, or prevent it from getting worse.
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Sinusitis may cause a number of symptoms, including a painful or uncomfortable pressure along the sides of the nose, and feeling congested.

The sinuses are moist, hollow spaces behind the bones of the face. They usually drain through the nose.

When the sinuses are unable to drain, due to issues such as an infection that blocks the nose, swelling, irritation, or an allergic reaction, then mucus and other fluid, including pus, stays trapped in the sinuses.

This can cause the sinuses to swell and become irritated or infected. This inflammation is called sinusitis.

Acute sinusitis is usually due to the common cold or a mild infection and usually goes away within 10 days. Some people with acute sinusitis develop an infection that requires antibiotics.

Chronic sinusitis usually persists longer than 10 days, but the symptoms are the same. Those include:

  • pain and pressure above the eyes, along the sides of the nose, and behind the cheeks
  • green or yellow mucous draining from the nose
  • feeling congested
  • pain in the nose or throat
  • fever
  • difficulty sleeping due to congestion
  • frequent sneezing

Doctors now believe that chronic sinusitis may be an inflammatory disorder similar to asthma and allergies. Some treatment options include:

  • Antibiotics: Although doctors still disagree about the role of antibiotics as a treatment for chronic sinusitis, some people may find that amoxicillin with potassium clavulanate can help. Sometimes, doctors may prescribe other antibiotics.
  • Nasal corticosteroids: These steroid drugs can help the body heal, reduce inflammation, and provide some relief from symptoms. Some people experience side effects with steroids, so it is essential to talk to a doctor about the benefits and risks.
  • Surgery: Some people with chronic sinusitis may need surgery to clean their sinuses. This can sometimes be achieved with a balloon dilation, which takes place in the doctor’s office. If this is unsuccessful, then the sinuses may need to be removed.
  • Nasal irrigation: This is a non-prescription treatment to clear out the sinuses. Saline sprays, neti pots, and other devices that flush the sinuses with water can help clear out any infection and reduce irritation.
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Exposure to irritatants, such as second hand smoke, may cause chronic sinusitis.

The most common causes of chronic sinusitis include:

  • A blockage that prevents the sinuses from draining: This can be due to damage to the nose or the face, nasal polyps and tumors, or because of a chronic infection. People with a deviated septum are more likely to develop chronic sinusitis.
  • An unusual infection: Many infections in the sinuses clear up with traditional antibiotics. However, some infections, such as fungal infections and antibiotic-resistant infections, do not go away with conventional antibiotic treatment.
  • Biofilms: A biofilm is a colony of bacteria that creates a thick film similar to the plaque on teeth. Biofilms are hard to get rid of, but strategies that clean the sinuses, including both nasal irrigation and surgery, may help.
  • Exposure to irritants and allergens: People with allergies and asthma are more likely to develop chronic sinusitis because these conditions can increase pressure and irritation in the nasal passages and sinuses. People with allergies and asthma may react to secondhand smoke, nasal allergens, dust particles, air pollution, and other sources of irritation.
  • Immune system problems: Diseases that weaken the immune system make it more difficult for the body to fight infections and inflammation. People with cystic fibrosis may be especially vulnerable to chronic sinusitis. Immune system diseases, such as HIV, may also be a culprit.

Home remedies include:

  • Washing hands frequently to prevent the spread of bacteria and fungi.
  • Using a HEPA air filter on the air conditioner and keeping the windows closed at night. HEPA air filters are available for purchase online.
  • Driving with the windows up and the air conditioning on.
  • Avoiding going outside during times of high air pollution.
  • Avoiding mowing the lawn or using a leaf blower, especially during allergy season.
  • Avoiding allergens whenever possible.
  • Treating seasonal allergies as recommended by a doctor,

The following strategies can help with the pain of sinusitis and may reduce the length of the infection:

  • Rinsing the nose and sinuses with a saline rinse or neti pot several times each day. Neti pots are available for purchase online.
  • Inhaling steam to loosen blockages and mucus in the sinuses.
  • Massaging the sinuses gently to loosen fluid and reduce pressure.
  • Drinking plenty of water. Dehydration can make it harder for the body to fight infection and clear the sinuses.
  • Taking a decongestant to reduce pressure in the sinuses. Pain relievers can help with pain and lower a fever. Acetaminophen and ibuprofen are available for purchase over-the-counter or online.
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If sinusitis symptoms continue for over a week, it is recommended that a doctor is consulted to identify the underlying cause.

Sinusitis, even in its chronic form, is not typically dangerous. In some cases, however, it may indicate a serious underlying condition. A doctor can help identify the cause, so see a doctor if sinus pain or pressure lasts longer than a week or two.

The most common complication of sinusitis is an infection, either in the sinuses or surrounding structures. An infection that is left untreated can spread and cause serious illness.

Rarely, chronic sinusitis can cause other complications. Those include:

  • decreased sense of smell
  • mucocele, a cyst made of mucus that can block the nose or sinuses
  • infections in the eyes, nose, or even the brain

Chronic sinusitis can be difficult to treat. Many doctors now treat it as a chronic condition that comes and goes.

Identifying and treating the underlying cause of sinusitis can reduce the length of the inflammation and prevent it from coming back. People with chronic sinusitis may need treatment from an allergist or an ear, nose, and throat specialist.

Good self-care, including treatment for allergies and asthma and avoiding allergens, may reduce the likelihood of another bout of sinusitis. People who have previously experienced chronic sinusitis should know they are at risk of developing it again, however.

Chronic sinusitis can be intensely painful. People with this condition may feel sick for weeks, and struggle to participate in everyday life.

Prompt medical care from a specialist can help, so see a doctor for signs of sinusitis. Diagnostic tests that help a doctor see the sinuses can determine the underlying cause, and help with prescribing the right treatment.