A few years ago, Harvard researchers reported that chronic sinusitis can cause more discomfort and loss of everyday functioning than both back pain and heart failure.

And now there’s more: A new study from researchers at the University of Washington School of Medicine has found that, in addition to nasal congestion and headache, chronic sinusitis can cause depression and difficulty thinking and concentrating, too. MRI scans show brain changes that suggest that inflammation from chronic sinusitis interferes with the activity of brain cells responsible for mood and thinking.

As if these complications aren’t enough, sinus infections are the most common cause of orbital abscess, a severe infection around the eye that can cause loss of vision and a life-threatening brain infection called cavernous sinus thrombosis. A chronic sinus infection can also spread to the bone in your forehead and cause meningitis or a brain abscess.

Fortunately, there’s a lot you can do to prevent this miserable condition.

Sinusitis basics

Your sinuses are air-filled cavities that are located behind your nose, near your eyes, in your forehead, and on both sides of your face, connecting through openings into your nose. They provide a thin mucus coating for your nose and throat that traps bacteria and other germs.

This mucous membrane relies on millions of finger-like projections called cilia to move the fresh mucus out of your sinuses and nose. When you swallow the mucus, which you do all day and night, your stomach acid kills anything dangerous.

Sinusitis starts when inflammation, most commonly due to a cold virus, disables that cilia. Mucus builds up and thickens, creating a perfect breeding ground for bacteria to gather, reproduce, and cause an infection.

The beginning sinus infection is called acute sinusitis. It may go away or may need to be treated with antibiotics. But up to 25 percent of acute sinusitis infections do not respond to treatment or come back after treatment. An infection that lasts for three months or longer is called chronic sinusitis.

Sinusitis symptoms

How do you know when a simple cold has turned into acute sinusitis? If you have a cold that doesn’t go away after 10 days or keeps coming back, it could be sinusitis. Also watch for headache or facial pain, especially around your eye or over your teeth or forehead, thick and discolored (yellow or green) nasal mucus, loss of smell or taste, bad breath, thick postnasal discharge, and fever.

Symptoms of chronic sinusitis are similar to acute sinusitis, but you’re less likely to have a fever, and more likely to have fatigue and brain fog.

Preventing sinusitis

Preventing acute sinusitis is the key to preventing chronic sinusitis:

  • Start by avoiding colds and the flu. During cold and flu season, wash your hands frequently, and practice social distancing when in crowded places. Get your flu shot.
  • If you have frequent nasal congestion, get a good nasal exam to make sure you don’t have a condition that blocks sinus drainage, like a deviated nasal septum or a nasal polyp. In these cases, an ear, nose, and throat surgeon may be able to do a simple surgical procedure to open your nasal airway and allow better sinus drainage.
  • If you have allergies, work with your doctor to get them under control. Allergies are a big risk factor for sinusitis.
  • Keep the air in your house moist. Dry air dries up the mucus you need to clear nasal bacteria. You can use a vaporizer or humidifier.
  • Avoid taking over-the-counter antihistamines. These medications dry up mucus and decrease sinus drainage.
  • Avoid over-the-counter nasal decongestant sprays. These sprays open your nasal passages but cause rebound swelling once they wear off. The rebound can be worse than the original congestion and block sinus drainage. Long-lasting sprays like oxymetazoline (Afrin) are the worst offenders.
  • Drink plenty of fluids and take an over-the-counter mucus thinner called guaifenesin (Mucinex). Fluids and guaifenesin keep your sinus mucus moist and thin.
  • Sleep with your upper body elevated on a few pillows or a pillow wedge. Keeping your head elevated helps mucus drain during the night.

Nasal irrigation

Doing nasal irrigation with a bulb syringe or a neti pot is an excellent way to keep your nasal passages moist and clean and prevent sinusitis, but, according to a warning from the U.S. Food and Drug Administration, using tap water for irrigation might actually cause a sinus infection.

Tap water may have small amounts of bacteria and other germs. Drinking tap water is safe because stomach acid kills the germs. Forcing it into your sinuses is not safe.

When you use a nasal rinse device as directed, it may come with a sterile irrigation solution or recommend one. If you make your own, use distilled and sterile water from the pharmacy. If you have to use tap water, boil it for three to five minutes and let it cool before irrigation.

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