Patients often present with sinus symptoms, or a sinus infection, both in the winter flu season as well as in the summer allergy season. 

Often there is pain, discharge from the nose or down the back of the throat, and sometimes fever.  Many patients will  not be able to inhale through one or both nostrils, and wake up with dry, sore throats as a side effect.

As these symptoms can be caused by either an infection or an allergy it’s good to be able to tell which you may have.

What is a sinus infection?

A sinus infection is an invasion of your body’s tissues by disease-carrying microorganisms. Your body initially reacts to these microorganisms with an innate (or automatic) response followed usually by some type of adaptive (or specific) response depending on the microorganism.

What are allergies?

An allergy is hypersensitivity disorder within your immune system. Your immune system reacts to a normally harmless substance in your environment with sinus infection-like symptoms except that an allergy is generally acquired, predictable, and rapid. 

To put sinuses in perspective, we should review the whole story.

1.    Anatomy: The word sinus actually means any “bay” or “pocket” in the body.  While there are sinuses in the GI tract, or under the skin, for purposes of this discussion we are referring to the NASAL sinuses.  These are basically 4 “caves”, each with a bottle-necked opening into the nasal passage.  Normally air-filled, they are lined with the same mucosa that covers the whole nasal passage.

2.   Function: These provide reservoirs of moist mucosal secretions for helping to humidify and filter dry air as it is breathed through the nostrils.  In addition, sinuses are “reverberating chambers” that allow the human voice to resonate.  To demonstrate how this affects voice, just ask a singer to demonstrate a few notes when they plugged with bad sinus infection. 

3.   Pathology: When the nasal lining gets puffy, the “bottle neck” openings quickly close up.  Then the sinus fills up, as more secretions are produced , either from allergens (such as pollen and dust), or from infections (such as the common cold), either viral or bacterial

4.   Complications: With the opening of the sinus sealed off, changes in pressure inside the cavity can become very painful.  That pressure could be from excessive fluid production inside the sinus, which can even be filmed on X-rays or scans.  External gradients of pressure can come from either extreme: from too much pressure (eg Scuba divers under several atmospheres of water pressure), or too little pressure (eg driving to high altitudes in the mountains).  In airline travel, clogged sinuses can produce pains of both kinds, on the way up to altitude, or, if the sinuses open and then re-close, on the way back down.  In such cases the pain can be intense.

5.   Treatment: For simple sinus cases, a non-prescription antihistamine works well.  Some will also have a form of ephedrine added, for extra sinus relief. Nasal sprays, from simple saline to medicated ones can also help to open up the passages.  Finally, in cases of bacterial infection (green or yellow colored discharge is often a feature) an antibiotic may be needed.  In all cases, a measure of pain relief may be needed with anti-inflammatories or even prescription strength pills from your doctor. 

6.   Prevention: As with any mucous membrane issues, avoid anything that inflames them.  If your doctor’s tests prove allergies, take measures to avoid them.  This might mean air filters, replacing old carpets with wood floors, or simply having the dog and cat sleep further away from your bed.  If you are sensitive to foods, avoid all dairy products when you have sinus problems, as the milk-based proteins will cause the mucous to become thickened, and further clog the sinuses.  Once the sinuses clear, use your own judgement and return to dairy if you insist.  In the meantime, use chicken or vegetable soups as a good basis for thinning your mucous, and always seek to drink plenty of water (hot or cold) to fully  hydrate your body.

7.   Finally: If the sinuses are simply not responding to the above, please consult your doctor for more advice.  If you do need to take antibiotics, don’t forget to read our article on probiotics.