Should I take steroids for my chronic sinus infections?

Posted June 12, 2013, 2:00 am

I have chronic sinusitis and nasal polyps. My specialist suggested trying oral corticosteroids. What do you think?

“Steroids” is short for anti-inflammatory hormones called corticosteroids, and “oral” means steroids taken in pill form. I think a short course of five to seven days of oral steroids is worth a try. That’s particularly true if your sinusitis isn’t getting any better. My colleague, Neil Bhattacharyya, an ear, nose and throat doctor and professor at Harvard Medical School, agrees. Much of what I say below is based on his advice.

As you know, sinusitis is an inflammation of the mucous membranes that line the sinuses. It often causes headaches and an uncomfortable feeling of pressure in the face. (I’ve put an illustration of how sinusitis works below.)

Sinusitis is inflammation of the mucous membranes that line the sinuses.

Chronic inflammation in the membranes of your nose and sinuses can cause fleshy growths called polyps. Not all cases of chronic sinusitis result in polyps, but when they form, polyps can block your nasal passages and sinuses. This makes breathing more difficult and can diminish your sense of smell. Polyps also make it easier for infections to start in your sinuses.

I assume you’ve tried the usual techniques for dealing with sinusitis: inhaling steam, taking extra-long showers, drinking lots of water and sleeping with your head elevated. A course of antibiotics is also often appropriate if there are clear signs of bacterial infection in your sinuses (such as green or brown discharge when you blow your nose, a fever and a rotten feeling).

Once sinusitis becomes chronic, the inflammation can take on a life of its own. Corticosteroids become an important treatment option, as they have anti-inflammatory effects.

The first type of steroid to try is one that can be inhaled into the nose. Inhaled steroids deliver the medicine directly to the inflamed tissues that need to be quieted. However, polyps can block the passage of the inhaled steroids to some of the inflamed areas.

If inhaled steroids don’t do the job, it’s worth considering a brief course of steroids in pill form. Taking an oral steroid such as prednisone for a week or so reduces the size of the polyps a little and decreases overall inflammation in the nose. Shrinking polyps and reducing inflammation allow the topical steroid to reach its target and be more effective.

The reason I and many doctors hold off on using steroids in pill form is that the medicine travels in the blood, exposing the whole body to the medication. (In contrast, topical steroids expose only the nose and sinuses.) Side effects are more likely from oral steroids than from inhaled steroids; they may include elevated pressure in the eyes (glaucoma), increased blood pressure and mood swings. But in my experience, a short course of oral steroids, such as what I’m recommending here, rarely produces serious side effects.

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What Causes Sinus Problems?

If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?

Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.

Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.

If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can’t drain, and you may feel pain.

There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.

Two sinus cavities are located in the forehead.Two are behind each cheekbone.Two sinus cavities are within the bones between your eyes.Two are behind each eye.

Sinus Blockages

Each sinus has a narrow spot, called the transition space (ostium), which is an opening that’s responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, mucus backs up.

An Extra Sinus

About 10% of people have an extra sinus. The extra sinus “effectively narrows that transition space,” says Ford Albritton, MD, chairman of otolaryngology at Presbyterian Hospital of Dallas.

Deviated Nasal Septum

Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or injury, in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have sinus issues. A deviated septum can also lead to obstructed breathing and snoring.

Narrow Sinuses

More often, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. “It’s pure genetics, since it’s the way we’ve inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked,” Albritton says.

Sinus Sensitivity and Allergies

Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.

Your doctor can prescribe medications to control your symptoms. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.

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Sinus Problems: Home Remedies and Tips

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Allergies Health Center Help for Sinus Pain Email a FriendPrint Article Help for Sinus Pain and Pressure Next Article: Skip to Article Content Help for Sinus Pain and Pressure Is Your Cold Causing Sinus Problems? What happens to your sinuses when you have a cold, and what to do about it. Sinus Problems From Allergies What's the best way to treat a stuffy nose caused by allergies? Dealing With Sinus Pressure Don't let sinus congestion and pressure get you down. Here's how to cope. Sinus Headache Relief How do you know if it's really a sinus headache? What's Causing Your Sinus Problems? What to do when your sinuses misbehave. Home Remedies for Sinus Problems Creating a sinus-friendly environment at home. Your Sinus Action Plan 6 tips for relieving sinus pain and pressure. Sinus Terms to Know Check out this glossary of sinus terms. Using a Neti Pot for Congestion Can flushing out your nasal passages help? Natural Sinus Relief See 6 things you can do at home in this slideshow. False Sinus Problems: Home Remedies and Tips Do you have sinus problems? Here's how to make your home kinder to your sinuses. WebMD Feature

By Kathleen Doheny

Reviewed By Michael W. Smith, MD

Are you among the 37 million Americans who have sinus problems each year? If so, there's a lot you can do around the house to create a "sinus-friendly" environment -- reducing your risk for sinus pressure.

Even better, many of the measures are simple and inexpensive.

Sinus Problems: Getting to the Triggers

First, it's crucial to figure out why you have sinus problems, says Jordan Josephson, MD, a Manhattan ear-nose-throat specialist and author of Sinus Relief Now.  "Allergies are a fairly common reason for sinus problems," he says.

Allergies that affect the nose, such as hay fever and indoor allergies, can cause the nasal membranes to swell, and the passages to the sinuses -- hollow spaces within the bones around the nose -- to become blocked. Mucus, which typically drains from the sinuses to the nose, can't drain.  

Other reasons? "A dry nose leads to more sinus problems," says Richard F. Lavi, MD, an allergist in Beachwood, Ohio.

Whatever the trigger, you can pick and choose from these five tips, or adopt all of them.

Sinus Tip 1: Keep Your Cool

"When the heat is on, the membranes get dry," says Russell B. Leftwich, MD, an allergist in Nashville, Tenn. Mucus isn't cleared as effectively, boosting the risk of sinus problems.

He can't recommend a specific indoor temperature range as ideal, but offers this guide: "You are better off wearing a sweater and keeping it cooler than cranking it up so you are comfortable wearing only a T-shirt."

Let your nose guide your indoor temperature range, suggests Lavi. "If you are not waking up with nosebleeds or congestion, that is probably a good temperature range."

Sinus Tip 2: Humidify Your Air

Strive for an indoor environment that's not too dry and not too humid.  "Dust mites love greater than 50% humidity," Lavi warns. And if you're allergic to dust mites, that's bad news for your sinuses.

A too-humid indoor environment can also encourage the growth of mold, which can also set off sinus problems, says Todd Kingdom, MD, director of rhinology and sinus surgery at National Jewish Health in Denver.

Experts are divided on the value of room humidifiers for creating a sinus-friendly home.

Forget them, Leftwich says. "A room humidifier never makes a difference. There is too much air to humidify."

But Josephson says using humidifiers in the bedroom beginning in October through March or April can make a difference in keeping sinus problems at bay.

Vaporizers can keep you more comfortable if you are in the midst of a sinus problem, Leftwich says. But you need to have it close by. "It doesn't do any good to have a vaporizer on the other side of the room." And, he warns, the devices must be cleaned daily to keep bacteria from growing in them.

Breathe the mist coming from vaporizers, but not the steam, he warns. Steam can easily burn you. Ten minutes at a time is often recommended.

1 2 #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em;} Sinus Problems Colds and Sinus Allergies Sinus Pressure Sinus Headaches Sinus Problems: Causes Home Remedies Sinus Action Plan Sinus Glossary Neti Pots Natural Help Slideshow Videos: Sinus Relief Health Solutions From Our Sponsors Vaccine Questions? Low Testosterone? Diabetes Care for Kids Birth Control for Moms Blood Sugar Control Chronic Widespread Pain Diagnosed With Low T? Fibromyalgia Therapy Hearing Aid Alternative Insulin Pump Therapy Vaccines for All Ages Knee Pain Relief Type 2 Diabetes Support Treating Fibromyalgia Relapsing MS Community In-depth coverage: Psoriasis Treatment on Target?|Healthy Mouth Help|RA Assessment|Living Healthy Guide|Family & Pregnancy Toolbox|Check Your Heartburn Symptoms Find us on:URAC: Accredited Health Web SiteHonCode: Health on the Net FoundationAdChoicesAbout WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact UsMedscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD CorporateFirst Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

©2005-2012 WebMD, LLC. All rights reserved.

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

View the original article here

Sinus Problems: Home Remedies and Tips

Do you have sinus problems? Here's how to make your home kinder to your sinuses. WebMD Feature

By Kathleen Doheny

Reviewed By Michael W. Smith, MD

Are you among the 37 million Americans who have sinus problems each year? If so, there's a lot you can do around the house to create a "sinus-friendly" environment -- reducing your risk for sinus pressure.

Even better, many of the measures are simple and inexpensive.

Sinus Problems: Getting to the Triggers

First, it's crucial to figure out why you have sinus problems, says Jordan Josephson, MD, a Manhattan ear-nose-throat specialist and author of Sinus Relief Now.  "Allergies are a fairly common reason for sinus problems," he says.

Allergies that affect the nose, such as hay fever and indoor allergies, can cause the nasal membranes to swell, and the passages to the sinuses -- hollow spaces within the bones around the nose -- to become blocked. Mucus, which typically drains from the sinuses to the nose, can't drain.  

Other reasons? "A dry nose leads to more sinus problems," says Richard F. Lavi, MD, an allergist in Beachwood, Ohio.

Whatever the trigger, you can pick and choose from these five tips, or adopt all of them.

Sinus Tip 1: Keep Your Cool

"When the heat is on, the membranes get dry," says Russell B. Leftwich, MD, an allergist in Nashville, Tenn. Mucus isn't cleared as effectively, boosting the risk of sinus problems, including sinus headache.

He can't recommend a specific indoor temperature range as ideal, but offers this guide: "You are better off wearing a sweater and keeping it cooler than cranking it up so you are comfortable wearing only a T-shirt."

Let your nose guide your indoor temperature range, suggests Lavi. "If you are not waking up with nosebleeds or congestion, that is probably a good temperature range."

Sinus Tip 2: Humidify Your Air

Strive for an indoor environment that's not too dry and not too humid.  "Dust mites love greater than 50% humidity," Lavi warns. And if you're allergic to dust mites, that's bad news for your sinuses.

A too-humid indoor environment can also encourage the growth of mold, which can also set off sinus problems, says Todd Kingdom, MD, director of rhinology and sinus surgery at National Jewish Health in Denver.

Experts are divided on the value of room humidifiers for creating a sinus-friendly home.

Forget them, Leftwich says. "A room humidifier never makes a difference. There is too much air to humidify."

But Josephson says using humidifiers in the bedroom beginning in October through March or April can make a difference in keeping sinus problems at bay.

Vaporizers can keep you more comfortable if you are in the midst of a sinus problem, Leftwich says. But you need to have it close by. "It doesn't do any good to have a vaporizer on the other side of the room." And, he warns, the devices must be cleaned daily to keep bacteria from growing in them.

Breathe the mist coming from vaporizers, but not the steam, he warns. Steam can easily burn you. Ten minutes at a time is often recommended.

1 2 #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em;} Sinus Problems Colds and Sinus Allergies Sinus Pressure Sinus Headaches Sinus Problems: Causes Home Remedies Sinus Action Plan Sinus Glossary Neti Pots Natural Help Slideshow Videos: Sinus Relief Health Solutions From Our Sponsors Vaccine Questions? Low Testosterone? Diabetes Care for Kids Birth Control for Moms Blood Sugar Control Bent Fingers? Diagnosed With Low T? Fibromyalgia & Exercise Child’s Hearing Loss? Insulin Pump Therapy Vaccines for All Ages Knee Pain Relief Depression & Adults Bipolar Disorder Facts Relapsing MS Help In-depth coverage: Psoriasis Treatment on Target?|Healthy Mouth Help|RA Assessment|Living Healthy Guide|Family & Pregnancy Toolbox|Check Your Heartburn Symptoms Find us on:URAC: Accredited Health Web SiteHonCode: Health on the Net FoundationAdChoicesAbout WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact UsMedscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD CorporateMedical Dictionary-->First Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

©2005-2012 WebMD, LLC. All rights reserved.

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

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What Causes Sinus Problems?

What to do when good sinuses turn bad. WebMD Feature

By Jennifer Nelson

Reviewed By Michael W. Smith, MD

If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?

Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

Interesting Sinus Facts

No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.

Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.

If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can’t drain, and you may feel pain.

There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.

Two sinus cavities are located in the forehead. Two are behind each cheekbone. Two sinus cavities are within the bones between your eyes. Two are behind each eye. Common Sinus Problems

Sinus Blockages

Each sinus has a narrow spot, called the transition space (ostium), which is an opening that’s responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, mucus backs up.

An Extra Sinus

About 10% of people have an extra sinus. The extra sinus “effectively narrows that transition space,” says Ford Albritton, MD, chairman of otolaryngology at Presbyterian Hospital of Dallas.

Deviated Nasal Septum

Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or injury, in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have sinus issues. A deviated septum can also lead to obstructed breathing and snoring.

Narrow Sinuses

More often, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. “It’s pure genetics, since it’s the way we’ve inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked,” Albritton says.

Sinus Sensitivity and Allergies

Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.

Your doctor can prescribe medications to control your symptoms. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.

1 2 #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em;} Sinus Problems Colds and Sinus Allergies Sinus Pressure Sinus Headaches Sinus Problems: Causes Home Remedies Sinus Action Plan Sinus Glossary Neti Pots Natural Help Slideshow Videos: Sinus Relief Health Solutions From Our Sponsors Vaccine Questions? Low Testosterone? Diabetes Care for Kids Birth Control for Moms Blood Sugar Control Bent Fingers? Diagnosed With Low T? Fibromyalgia & Exercise Child’s Hearing Loss? Insulin Pump Therapy Vaccines for All Ages Knee Pain Relief Depression & Adults Bipolar Disorder Facts Relapsing MS Help In-depth coverage: Psoriasis Treatment on Target?|Healthy Mouth Help|RA Assessment|Living Healthy Guide|Family & Pregnancy Toolbox|Check Your Heartburn Symptoms Find us on:URAC: Accredited Health Web SiteHonCode: Health on the Net FoundationAdChoicesAbout WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact UsMedscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD CorporateMedical Dictionary-->First Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

©2005-2012 WebMD, LLC. All rights reserved.

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

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