Chronic Sinusitis

Chronic sinusitis is an on-going condition involving the sinuses. There is a continuous mucous membrane that lines the insides of the four paranasal sinuses and the nose. The cilia move the mucus along this membrane and drains into the nose. From there, it is swallowed and eliminated by the stomach.

This process is what helps keep the sinuses clean and healthy. The mucus carries with it foreign matter that it has trapped. When something causes this membrane to swell or to become inflamed, all sorts of problems results.

Chronic sinusitis is a reoccurring condition characterized by;

• A swollen mucous membrane.
• Sinuses not draining well.
• A fresh oxygen supply not getting into the sinuses.
• Mucus building up inside the sinuses.
• The hair-like cilia not performing their sweeping action and moving the mucus out. The mucus then becomes thicker making it even harder for the cilia to work.
• Congestion.
• A feeling like a cold that never goes away.

The sinus ducts and the ostia (the hole where the sinus drain into the nose) are not very big to begin with. It does not take much to create a blockage. When this happens, the sinuses become a breeding place for bacteria which develops into infections.

It affects everybody differently. There are different degrees to the aches and pains and different degrees to how we all deal with illness. It is hard to be social and productive at work and school when we feel lousy. Chronic sinusitis can get to be depressing when it keeps coming back and you realize that you don't seem to be getting any better.

The persistency eventually wears on the person and even the physicians get frustrated at the lack of progress. Chronic sinusitis has an economic, social, and medical cost impact. The persistent health condition affects other family members as well.

Chronic Defined

Chronic sinusitis is not a disease that you wake up and discover that you have. It is an on-going process that gradually develops. The word chronic itself means 'long lasting.' The condition is well established with reoccurring infections happening 3-4 times a year. It is persistent to a point that it becomes a 'lifestyle.' It certainly keeps returning enough times that it has an impact on the quality of life and overall health.

The length of time of suffering from the symptoms affects many people differently. As mentioned above, some people accept the condition as a lifestyle. If an infection exist, it is usually not serious and doesn't keep them from functioning.

On the other end of the spectrum are those who do suffer from more serious infections. They seem to be always taking antibiotics and not getting much relief. They have tried surgery which did not give them back the quality of life that they hope for.

What they all seem to have in common is the sensitivity to irritants. Fumes, cigarette smoke, pollen, mold spores, temperature changes all seems to make the symptoms more noticeable.

The Risk of Ignoring Sinusitis

I have noticed with those around me who have sinusitis don't really consider their condition to be serious. It seems like they have learned to live with it over time. This is understandable when you consider that the disease develops slowly over time. Slowly, the quality of life slips away and the person doesn't become aware of it. The changes that occur in the nose and sinuses happen gradually and one day the person wakes up and starts to think about and considers surgery.

Chronic sinusitis starts out as acute or as a sub-acute condition. Antibiotics are taken to fight off the bacterial infection. As they recover from these early episodes, they see themselves as being healed. When the condition returns, back for treatment they go. What they fail to realize is that a vicious circle is starting: the bacterial infections leads to inflammation and, the inflammation will promote infections. The inflammation blocks the area where the sinuses drain into the nose. This creates a moist and dark environment for bacteria to multiply.

With repeated episodes, scarring eventually develops on the membrane that lines the nose and sinus cavities. The scarring makes it more difficult for our bodies to heal itself. Imagine scarring taking place on the skin. Do the scars ever heal themselves and go back to normal? No, and neither does the scarring that is occurring on the inside of the nose and sinuses.

The point that many people miss: scarring occurring on top of scar tissue and adding to the existing scar tissue means that all of the sinusitis episodes can have an accumulative effect.

The damage occurs slowly and is hardly noticed. I give the analogy about aging to my friends. When you haven't seen someone for 10 years, you notice how much they change. But to the person who has changed, it is hardly noticeable. They have seen the changes so gradual every day in the mirror for 10 years that they don't think they have changed at all.

Gradual changes and damage is occurring to:

• the sinus ducts
• the ostia
• the delicate tissues inside the nose and sinuses
• the cilia (and their cell tissues)
• the glands that secret mucus
• nerves in the nose needed for smell (and taste)

Before you know it, we wonder what happened and start to think about having surgery. It just can't be over emphasized the importance of treating acute conditions and not letting them turn into a chronic sinusitis disease.

The Cause of Chronic Sinusitis

There are many reasons for this disease to develop. The cause can be anything that will cause the mucus membrane to become inflamed. This inflammation can squeeze shut the channels in which the sinuses drain into the nose. It can affect the sinus ducts themselves or the blockage can be at the ostia, which is the hole here the sinuses drain into the nose by the turbinates.

Factors that contribute to chronic sinusitis can come from within the nose or from outside.

Inside the nose

• nasal polyps
• deviated septum
• malformation inside the nose
• tumors
• damage mucous membrane
• scarred tissue
• enlarged turbinates
• enlarged adenoids
• not taking care of acute sinusitis adequately

Outside factors

• nasal allergies
• potent irritants
• air pollution (both inside and outside air pollution)
• stress
• bacteria, mold and viruses
• the common cold

Allergies (and the common cold) seem to be the most common factor. There is no cure and allergens are all around us. It is very difficult to stop an allergic reaction once it has started. Histamine that is released during an allergic reaction will cause the mucous membrane to swell. It is this swelling inside the nose and sinuses that stop the air exchange and drainage from the sinuses.

What To Do?

If you suffer from chronic sinusitis, don't give up hope! The body has an amazing ability to heal itself and to recover even if a lot of scarring tissue exist. But you must be proactive and take responsibility for your own health. Doctors can help you but it is up to you to be in charge of your own self-care.

I was telling my friend the other day that it is like smoking. Smoking causes great damage over the years. But once the person stops smoking, the body immediately begins to heal itself. Likewise, to avoid the causes of sinusitis gives your body a chance to heal itself.

Work with your physician to consider medical and surgical treatment. There may not be a cure but there are many sinusitis treatments that bring your sinusitis symptoms to a level that is manageable. You can bring back the quality of life to your situation!

The Mayo Clinic has a good article on chronic sinusitis if you would like to learn more.

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