What is sinusitis?

Pharmacists play a crucial role in providing advice and recommendations for managing sinusitis. They can suggest suitable over-the-counter medicines, including:

1. Decongestant Nasal Sprays or Drops: These medications can help alleviate nasal congestion by shrinking the blood vessels in the nasal passages. However, they should not be used for more than one week without seeking further medical advice, and children under 6 years old should avoid decongestants.
2. Saltwater Nasal Sprays or Solutions: Nasal irrigation with saltwater can help rinse out mucus and allergens, providing relief from congestion and promoting sinus drainage.

When should you seek medical treatment?

While many cases of sinusitis improve with self-care measures, there are instances where medical treatment becomes necessary. It is advisable to consult a GP if:

1. Your symptoms persist or worsen after attempting self-care measures for an extended period.
2. You experience a high fever that does not respond to over-the-counter medications.
3. You develop eye pain, especially with eye movements, or notice eyelid swelling and redness.
4. You experience double vision, severe headaches, confusion, decreased consciousness, or neck stiffness.

How is sinusitis treated by a GP?

A GP may recommend additional treatments to manage sinusitis symptoms. These may include:

1. Steroid Nasal Sprays or Drops:Steroid nasal sprays or drops are commonly prescribed by GPs to help reduce the inflammation and swelling in the sinuses. By administering these medications directly to the nasal passages, they can effectively alleviate congestion, facial pain, and pressure. It is important to note that using steroid nasal sprays or drops may cause mild side effects such as throat irritation, sore throat, or nosebleeds. However, these side effects are generally temporary and outweighed by the benefits of reducing sinus inflammation.
2. Antihistamines: If allergies are identified as the underlying cause of sinusitis, antihistamines may be recommended. These medications work by blocking the histamine response, reducing allergic reactions and associated symptoms such as nasal congestion and sneezing.
3. Antibiotics: In cases where a bacterial infection is suspected, and the individual is severely unwell or at risk of complications, antibiotics may be prescribed. However, it is important to note that sinusitis is typically caused by a viral infection, and antibiotics are not always necessary. It is essential to follow the GP's guidance regarding the appropriate use of antibiotics to prevent the development of antibiotic resistance.

When might surgical intervention be required?

In certain situations, when sinusitis persists despite conservative treatment or specific complications arise, a GP may refer the individual to an ear, nose, and throat (ENT) specialist. The ENT specialist will further evaluate the condition and determine if surgical intervention is necessary.

Some indications for surgical treatment of chronic sinusitis include:

1. Sinusitis that persists for more than three months despite medical management.
2. Recurrent episodes of sinusitis that significantly impact the individual's quality of life.
3. Symptoms primarily affecting one side of the face.
4. Structural abnormalities or blockages in the nasal passages or sinuses.

The surgical procedure commonly performed to address chronic sinusitis is called functional endoscopic sinus surgery (FESS). FESS is a minimally invasive procedure performed under general anesthesia. During the surgery, the ENT specialist will use a thin, flexible tube with a light and camera (endoscope) to visualise the nasal passages and sinuses. The surgeon may remove obstructive tissues, clear blockages, or widen the sinuses to promote better drainage and alleviate symptoms. In some cases, a tiny balloon may be inflated in the blocked sinuses to help expand them before removal.

It is important to note that surgery is typically reserved for cases where conservative treatments have been ineffective, and the benefits of surgery outweigh the potential risks. The decision to undergo surgical intervention will be carefully discussed between the individual and their healthcare provider.

Prevention of chronic sinusitis

While it may not always be possible to prevent sinusitis, there are certain measures that can help reduce the risk of developing chronic sinusitis:

1. Smoking Cessation: Quitting smoking or avoiding exposure to secondhand smoke can significantly decrease the likelihood of developing chronic sinusitis.
2. Asthma Management: If you have asthma, ensure that it is well-controlled with appropriate medications and regular follow-up with your healthcare provider. Proper asthma management can help reduce the risk of chronic sinusitis.
3. Allergy Management: If you have known allergies, work with your healthcare provider to develop an effective management plan. By minimising exposure to allergens and following recommended treatment strategies, you can reduce the risk of sinusitis.
4. Hygiene and Handwashing: Practicing good hygiene, such as regular handwashing, can help prevent the spread of viral infections that may lead to sinusitis.

Conclusion

Sinusitis, or sinus infection, is a common condition characterised by inflammation and swelling of the sinuses. While most cases of sinusitis can be managed with rest, self-care measures, and over-the-counter medications, it's important to seek medical attention if symptoms persist or worsen.

Treatment options such as steroid nasal sprays, antibiotics, or surgery may be recommended by healthcare professionals. Additionally, practicing good hygiene, addressing underlying conditions like asthma and allergies, and avoiding smoking can help prevent chronic sinusitis.