Sinusitis: What is That Gunk?

Let’s face it. When your nose is blocked up, the world is terrible.

Your sinuses and head hurt under the pressure. You can barely think about anything other than finding relief.  But, is it a bacterial infection, a virus, allergies or the common cold?  What if you have to fly on an airplane feeling like this? Do you need to see a doctor?

When the sinus passages around your nose, and in your cheeks and forehead, become inflamed, the swelling prevents mucus from draining out of the nose. This is sinusitis, and it’s a common problem. Every year, more than 30 million people are diagnosed with sinusitis in the U.S. As much as 15 percent of the U.S. population suffers with this condition long term, making sinusitis one of the most common chronic illnesses in America.

What type of sinusitis do you have?

“The several common categories of sinusitis that exist are based on the duration of symptoms, and this distinction is important,” said Dr. Corinna G. Levine, a rhinologist with the University of Miami Health System, who specializes in treating diseases and illnesses of the nose, sinuses and skull base. “The symptoms and presentation can vary, and the treatment can also be different.”

Common types of sinusitis:

Acute sinusitis – Symptoms are present for up to four weeks and often develop after a cold or upper respiratory infection. Symptoms tend to be more severe with an acute infection.

Subacute sinusitis – Symptoms last up to 12 weeks.

Chronic sinusitis – Symptoms are present for at least 12 weeks and can vary in intensity from mild to severe, but are often present every day.

Recurrent acute sinusitis – At least four episodes of acute sinusitis occur in a single year with complete resolution of symptoms between episodes.

Symptoms of sinusitis

“It is difficult to diagnose sinusitis by symptoms alone because the symptoms overlap with other nasal pathologies,” said Dr. Levine. “Allergies, rhinitis and headaches can have symptoms that mimic the congestion and facial pressure associated with sinusitis.”

Most common symptoms of sinusitis:

  • Nasal blockage or nasal congestion
  • Thick, discolored nasal drainage or post-nasal drip
  • Decreased sense of smell or taste
  • Facial pressure or fullness

Less common symptoms of sinusitis:

  • Headache
  • Fever
  • Weakness or fatigue
  • Cough
  • Ear pressure or fullness
  • Upper tooth pain
  • Bad breath

Sinus inflammation can be caused or worsened by:

  • Upper respiratory viral infections
  • A common head cold that turned into a bacterial infection
  • Allergy triggers, including molds or fungus
  • Asthma
  • Congenital diseases, such as cystic fibrosis
  • Inflammatory autoimmune diseases, such as sarcoidosis and granulomatosis with polyangiitis
  • Immune system compromises
  • Scar tissue left behind by previous nasal surgery
  • Facial fractures caused by an accident

Treating sinusitis

Over-the-counter (OTC) medications and home remedies may ease symptoms, and oftentimes, acute sinusitis clears up with these treatments alone. If your sinusitis is caused by a bacterial infection, prescription antibiotics may be needed to clear it up. But, if the culprit is a virus, fungus allergy, or another condition that’s affecting your sinuses, antibiotics won’t help.

“It’s helpful to try OTC products first,” says Dr. Levine. “Only if your symptoms persist should you seek medical attention.” When sinusitis symptoms last for more than 10 days without improving, it requires professional medical attention. An evaluation by your primary care physician can help determine the cause and an appropriate course of action. “Most primary care physicians will start you on a short course of treatment targeted at improving the reason(s) why your sinuses are inflamed. However, if simple treatments are unsuccessful, and your symptoms continue, then they may refer you to an ear, nose and throat specialist, which is called an otolaryngologist,” says Dr. Levine.

In addition to asking about your specific symptoms and how long you’ve had them, an otolaryngologist may examine your head and neck, recommend a nasal endoscopy that uses a small telescope, or order imaging tests like a CT scan to see what’s happening in your nasal passages. If a bacterial infection is suspected, your doctor may take a culture of the mucus to determine if bacteria are present.

How to reduce sinus inflammation

If you’re seeking some relief from the pain and discomfort of sinusitis, try these home remedies and tips.

  • Flush out mucus and moisturize the sinuses with gentle sinus irrigation. Dr. Levine recommends using a nasal rinse bottle that you can easily keep clean, such as the Neilmed rinse kit or neti pot.
  • Breathe in steam and use a humidifier to keep the sinuses hydrated between rinses.
  • Try the following OTC medications:
    • Pain relievers and fever reducers (like acetaminophen)
    • Anti-inflammatory medications (like ibuprofen)
    • Nasal decongestant pills
    • Mucolytics (which thin the mucus)
    • Nasal decongestant sprays (which should be used for only up to three days because they are addictive and can make congestion worse)

How to ease the discomfort of sinusitis

  • Place a warm, moist compress over the sinuses.
  • Drink water.
  • Avoid alcohol.
  • Don’t smoke and avoid secondhand smoke.
  • Avoid swimming in chlorinated pools.
  • Avoid allergy triggers (such as pet dander, dust mites, fungus and pollen).
  • Exercise with caution, as you may feel dizzy.
  • If you must fly on an airplane while experiencing sinus inflammation, take a decongestant an hour before the flight and use a saline spray during the flight.

These OTC treatments and home remedies can often help to reduce some of the symptoms of sinusitis while the inflammation runs its course. If the symptoms persist, see a doctor.



Dana Kantrowitz is a contributing writer for UMiami Health News.