Sinusitis

Sinusitis is inflammation of the sinuses, meaning they become red and swollen. The sinuses are small, air-filled spaces in your cheekbones and forehead. When they're inflamed they get blocked, so the mucus can't drain into your nose the way it normally does.

Most of the time, sinusitis is caused by a viral infection. It's common, and it usually gets better within 2 to 3 weeks.

Sinusitis usually starts after an infection such as a cold. The signs to look for are:

• a green or yellow discharge from your nose
• a blocked nose
• pain and tenderness around your cheeks, eyes or forehead
• a high temperature (fever) of 38°C (100.4°F) or more
• toothache
• a reduced sense of smell
• bad breath (halitosis)

Children with sinusitis may:

• be irritable
• breathe through their mouth
• have difficulty feeding
• sound nasal when they speak, as though they have a stuffy cold

The symptoms of sinusitis often clear up within a few weeks (acute sinusitis). Occasionally they can last 3 months or more (chronic sinusitis).

If your symptoms are mild and getting better, you can often treat sinusitis without seeing a doctor.

• your symptoms are severe or getting worse
• your symptoms haven't started to improve after around 7 to 10 days
• you keep getting sinusitis

Your doctor can usually diagnose sinusitis from your symptoms and by looking inside your nose. If you keep getting sinusitis, or if it's severe, the doctor may refer you to an ear, nose and throat (ENT) specialist.

Sinusitis usually gets better on its own within 2 or 3 weeks.

• get plenty of rest
• drink plenty of fluids
• take over-the-counter painkillers such as paracetamol or ibuprofen (do not give aspirin to children under 16)
• use nasal decongestants, but not for more than a week, because this might make things worse
• hold warm packs to your face
• clean your nose with a salt water solution (you can make it yourself or buy sachets from a pharmacy)

Always read the leaflet that comes with your medicine before you take it, and follow the recommended dosage instructions. If you're not sure which treatments suit you or your child with sinusitis, speak to a pharmacist for advice.

• Boil a pint of water, then leave it to cool.
• Mix 1 teaspoon of salt and 1 teaspoon of bicarbonate of soda into the water.
• Wash your hands.
• Stand over a sink, cup the palm of 1 hand and pour a small amount of the solution into it.
• Sniff the water into 1 nostril at a time. Breathe through your mouth and let the water pour back into the sink. Try not to let the water go down the back of your throat.
• Repeat the first 5 steps up to 3 times a day until your nose feels more comfortable.

You don't need to use all of the solution, but make a fresh solution each time you clean your nose.

If your sinusitis symptoms aren't getting better, or they're getting worse, your doctor may prescribe antibiotic tablets, or a corticosteroid spray or drops.

If your symptoms still don't improve after that, you may be referred to an ENT specialist. They can do surgery to help your sinuses drain better.

Most cases of sinusitis start with a cold or flu virus. The virus spreads to the sinuses from the upper airways. Only a few cases are caused by bacteria infecting the sinuses.

Now and then, an infected tooth or a fungal infection can also leave the sinuses inflamed.

It isn't clear exactly what makes sinusitis become chronic (long-lasting), but it may be linked to:

• allergies and related conditions, including allergic rhinitis, asthma and hay fever
• nasal polyps (benign growths inside the nose)
• smoking
• a weakened immune system

If you can keep an underlying condition such as allergies under control, the symptoms of chronic sinusitis may get better.