Sinusitis

Hari (name changed for confidentiality) is a talkative young man who works as a marketing executive in Bombay. His job requires him to meet clients in different areas of the city. He works irregular hours and goes in and out of air-conditioned offices and cars. 

Hari came to my clinic with complaints of always being tired; he had frequent headaches starting above his eyes, which spread to the back of his head. He also had a constant dry cough, which disturbed his sleep. He was constantly clearing his throat, sometimes brought up thick yellow mucous, and frequently had an upset stomach. He had blurred vision on some days, which did not improve by wearing spectacles. He often had pain in his upper teeth, which had not resolved with numerous visits to the dentist, root canal treatments and antibiotic courses. 

Hari had been diagnosed with sinusitis and migraine. He had been through many courses of antibiotic treatment and even had surgery to drain his sinuses. None of these treatments gave him permanent relief from these problems. He was desperate for an answer when he came to consult me. I examined him thoroughly, made a diagnosis and advised him that the only cure for his problem was to take a holistic view of his problems, which involved changes in his lifestyle and diet along with treatment. He was advised to take steam inhalations with holy basil (tulsi) leaves 5 to 6 times a day and to use an ioniser or air purifier in his house, in his office and in his car to reduce the effects of air pollution.

He was treated with acupuncture, which relieved his pain and congestion by helping to drain his sinuses. He was advised to avoid rapid changes in temperature by switching off his car air-conditioning a few minutes before reaching his destination and to set his office air-conditioning at a temperature of 25 degrees C so the temperature change would not be too sudden when he went in and out of his office. I advised Hari to avoid alcohol and foods that increase mucous formation (described later in this article). 

Within a couple of weeks, he was comfortable and pain-free. He was happy when he returned for a review after six months. His sinuses were no longer tender; his cough had reduced. His stomach was comfortable, he was sleeping well, he was not tired, and he felt more vital. I advised him to return to see me again after another year. When he returned to see me, he was feeling good, his cough had resolved, he had no headaches for eight months, and there was no tenderness over any sinuses. His teeth were no longer painful and giving him trouble. 

Many people (30-50%) who live in the urban world have chronic sinusitis and ear infections due to pollution, dust, mould, air-conditioning and rapid temperature changes. Sinus infections are difficult to treat and can take up to 2 years to resolve with the correct treatment. Staying in a polluted environment causes continual irritation of the sinuses and retards healing. Sinusitis is a disease strongly influenced by diet, lifestyle, and environment. Recovery from sinusitis requires modifying these factors so that the body has a chance to heal. Sinusitis is a common problem in polluted urban areas worldwide, where people live in artificially heated or cooled environments.

 Function of the sinuses 

The function of the sinuses is to clean, purify, humidify and adjust the temperature of the air we breathe to the body's temperature. The Sinuses act as filters to remove dirt, air pollution, pollen, smoke, and other suspended particles. Each sinus has several folds of thin mucous membrane, like a car's filter, and many hairlike projections that help clean, purify, and humidify the air. The total surface area available in each sinus to perform this function is more than a hundred square meters. Air pollution is an important cause of sinusitis. 

The World Health Organisation (WHO) recommends that air with particle counts of less than 20 micrograms/cubic meter of air of particles between 2.5-10 microns in size and less than ten micrograms/cubic meter of air for particles less than 2.5 microns in size is safe for human health. http://www.who.int/phe/health_topics/outdoorair_aqg/en/ 

Symptoms of sinusitis 

The characteristic symptom of sinusitis is postnasal drip, which causes a dry cough. A person with sinusitis repeatedly clears the throat to remove the irritation at the back of the throat. Take a torch and look at the back wall of the throat; sinusitis is often inflamed and red, showing a clear, white, or yellow pus-like fluid draining down the back wall of the throat. Headaches are the following common symptom of acute sinusitis. Low-grade headaches occur with chronic sinusitis, which can escalate into severe headaches with the aggravating factors described below. Headaches from the frontal sinus start above the eyebrows and radiate to the top or back of the head. 

Maxillary sinusitis causes pain in the cheeks or teeth. Ethmoid sinusitis causes eye pain. Sphenoidal sinusitis causes pain behind the eyes in the centre of the skull and can be agonising. Sinus headaches are often misdiagnosed as migraines. Other symptoms of sinusitis are bad breath, sore throat, tooth pain, sleep apnea, nasal polyps, nasal discharge that may be white, yellow, green, or brown, and a reduced sense of smell and taste. 

Sinusitis may also affect vision by increasing pressure in the eyes, leading to glaucoma and loss of vision. Chronic sinusitis also causes a feeling of being unwell and can cause tiredness, fatigue or weakness. 

Complications and side effects of sinusitis 

The infected fluid flowing down the throat into the stomach often causes gas, indigestion, abdominal discomfort, dysbiosis (unhealthy bacteria in the intestines) and poorly formed stools. Lung infections. People with chronic sinusitis are more prone to throat and lung infections like bronchitis and pneumonia. 

This is because the sinus, meant to protect the lungs, cannot do its job when infected and instead becomes a source of infection. Any effective treatment of these conditions has to start with treating the sinuses. 

Meningitis. 

Infections from the sinus may also spread into the brain and cause a brain infection called meningitis. 

Nasal Polyps. 

Chronic sinusitis irritates the adjoining nasal lining, which can cause the development of nasal polyps. Nasal polyps obstruct breathing, causing the voice to have a nasal tone. They also lead to a loss of smell and taste. 

Toothache. 

Sinus infections can spread into the roots of the upper teeth, causing infections and pain. 

Tonsillitis and Adenoids

Infection from the sinuses can spread into the adenoids and tonsils. 

Ear Infections. 

Infection from the sinus can quickly spread into the ear and mastoid bones, causing ear and mastoid infections. 

Eye Problems 

1. Sinusitis often causes pain, swelling, puffiness, redness in the eye and dark circles around the eyes. 2. The optic nerve lies under the Sphenoidal sinus, and infection in this sinus can compress the optic nerve, causing reduction or loss of vision. 3. Chronic sinusitis is also associated with glaucoma, choroiditis, iridocyclitis, and other eye problems, as chronic infection on all sides of the eye can lead to infections, inflammation, and eye problems. 

Snoring often accompanies sinusitis and can lead to sleep apnea. This can also disturb your partner’s sleep, causing severe health and marital issues. 

Treatment of these conditions is possible with cranial osteopathy and has to be accompanied by treatment of sinusitis. Alcohol aggravates sinusitis and all infections in the body. If you have sinusitis or any other disease, you should not drink alcohol. If you do drink, you will notice an increase in the problem a few hours after you have taken alcohol. Drinking alcohol with an infection is like pouring the alcohol on a fire! 

Colds cause swelling of the lining of the nose and aggravate sinusitis by blocking their drainage. Hay fever, caused by an allergy to pollen and other air particles, can cause or aggravate sinusitis. Food allergies, especially milk, gluten and nuts, increase mucous secretion and aggravate sinusitis. Bright sunlight aggravates sinusitis, causing headaches and photophobia.