Ask The Expert Question: What can I do about chronic sinusitis?
I've been diagnosed with simultaneous sinusitis and bronchitis so many times that I've lost count. During pollen season my sinuses are so clogged that I only have a week or two of being well before I get hit with another bout of sinusitis and bronchitis. The pattern is always the same: a sore throat, sinus problems with an aching face, possible earache, and then wheezing and a racking, incessant cough. A couple of times the bronchitis has even turned into pneumonia. My doctor finds secondary bacterial infections each time and prescribes antibiotics. He thinks that my immune system has been compromised by too much stress and also by all the sinus infections. Do you know any way I can avoid these twin illnesses again? I feel so worn out! Thank you. Dr. Martha Vetter White responds:
Your problem is incredibly common. I suspect that you have allergies which cause the lining of your nose and sinuses to become swollen and to produce extra mucus. The sinus drainage holes (called sinus ostia) swell closed, the extra mucus can't get out, and the mucus sits around waiting for the first friendly virus or bacteria to settle in. Some infectious agents have a propensity to attack both the upper and lower airways, causing both sinusitis and bronchitis. Sinus drainage, however, goes down the back of the throat, often making it below the vocal cords, and is subsequently coughed up, just as in bronchitis. Thus, you can look like you have simultaneous sinusitis and bronchitis, when in fact the problem is sinusitis. The description of your symptoms suggests that you may have some mild asthma, which is seen in about 25 percent of people who have nasal allergies. Sinus infections and allergies can both trigger asthma flares. I'd suggest that you ask for a referral to an allergist so that you can get your entire airway treated (sinuses, nose and lungs). Even if your allergy season is winding down, it's good to have an evaluation now so that you'll be prepared for the next season. Good luck, Dr. White -- Dr. Martha Vetter White, MD, is cofounder and director of research at the Institute for Asthma &Allergy in the Washington, DC metropolitan area, one of the nation's most active clinical research centers devoted to allergy, asthma, and sinusitis.
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Last updated July 30, 2009
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