Hay Fever

Sinus Allergies & Sinusitis

Nasal and sinus allergies result from an immune system reaction to allergens (e.g., pollen, mold) that enter the respiratory system through the body's airways, producing a response similar to an upper respiratory infection (cold virus).

White blood cells (leukocytes) mark the allergens as intruders and produce secretions that cause the nasal lining to swell, helping to combat the invading substances. The resulting sinus allergy symptoms—sneezing; allergic cough; watery, itchy eyes; and nasal symptoms (e.g., nasal congestion)—are the same symptoms produced by the common cold.

Since the symptoms of sinus allergies and colds are similar, chronic nose allergy sufferers often misidentify hay fever (allergic rhinitis) as a sinus cold. In most cases, this confusion is harmless, because sinus colds respond to the same treatment as allergies. Common sinus allergy remedies (e.g., antihistamines, nasal sprays) often work well for both sinus allergies and sinus colds, reducing swelling and providing nasal congestion relief.

In some cases, however, a cold virus causes inflammation and swelling in the mucosal membranes of the sinuses, limiting sinus drainage. Mucus then becomes trapped in the sinuses and results in sinus blockage, which allows bacteria that are present in the upper respiratory system (e.g., Streptococcus pneumonia, Haemophilus influenzae, pneumococci, staphylococci) to multiply and causing a sinus infection (sinusitis).

Each year in the United States, sinusitis affects about 15% of the population and compels 30 million people to seek treatment. In one-third of cases, sinusitis develops after an upper respiratory infection.

Once acute sinusitis sets in, additional symptoms include the following:

• Intense sinus pressure
• Headache
• Green or yellow nasal discharge
• Pain and tenderness behind the affected sinuses (e.g., behind the eyes, cheeks, or forehead)

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There are a number of ways to treat sinusitis. Treatment approaches include sinus irrigation, in which a sinus rinse is used to flush the sinuses and nasal passages, and using warm mist humidifiers, which add moisture to the air. Staying well hydrated (e.g., by drinking plenty of fluids) can help decrease the thick mucus trapped in the sinuses and provide nasal relief by encouraging sinus drainage.

Over-the-counter sinus medication (e.g., decongestants, antihistamines) can be used to reduce sinus pressure and encourage sinus drainage. Analgesics (e.g., ibuprofen) can help relieve discomfort and provide overall nasal relief for both sinusitis and regular sinus allergies.

When symptoms persist or worsen, consultation with a family physician or an otolaryngologist (ear, nose, and throat [ENT] doctor) may be necessary. Prescription treatments include antibiotics to fight bacterial infection and steroid nasal sprays to reduce inflammation. Chronic sinus problems may also be treated surgically.

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