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How can sinusitis be treated?

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In brief: Treatment of sinusitis

Acute sinusitis - Often sinusitis can be treated with home treatments.
Rest, inhalation of steam from a bowl of hot water, and over the counter medicines should help. A pharmacist will be able to advise you on a suitable choice. Ibuprofen or paracetamol help to relieve pain and lower temperature. Decongestants, such as pseudoephedrine (tablets or linctus, e.g Sudafed tablets), and menthol, which can be inhaled, reduce the swelling in the nose and allow the sinuses to drain. Decongestants should not be used for more than a week, as prolonged use can actually aggravate nasal blockage. A doctor should be consulted if symptoms don’t improve after a week of trying home remedies. The doctor will probably prescribe a course of antibiotics for 3-10 days.
Chronic sinusitis - Steroid nasal sprays (e.g. beclometasone Beconase), available from pharmacists and on prescription, are helpful in two ways. If long–term infection is present they help to reduce swelling of the nasal lining and open up the drainage holes, and if allergy is involved they also reduce inflammation. Antihistamines such as loratidine (Clarityn) might also help. In severe cases, the doctor may recommend short courses of steroid tablets. These are only available on prescription. Endoscopic nasal surgery may be needed as a last resort. Tubes and instruments passed down the nasal endoscope are used to wash out the sinus and widen the drainage hole. This can be done under general or local anaesthetic. It is a routine and generally safe procedure, but all surgery does carry some element of risk. Complications include minor damage to the lining of the nose or sinuses, or damage to the skull bone. Other types of surgery sometimes required to treat chronic sinusitis include correcting a bent nasal cartilage (septoplasty) or removing nasal polyps.

In brief: Treatment of sinusitis

Acute sinusitis - Often sinusitis can be treated with home treatments.
Rest, inhalation of steam from a bowl of hot water, and over the counter medicines should help. A pharmacist will be able to advise you on a suitable choice. Ibuprofen or paracetamol help to relieve pain and lower temperature. Decongestants, such as pseudoephedrine (tablets or linctus, e.g Sudafed tablets), and menthol, which can be inhaled, reduce the swelling in the nose and allow the sinuses to drain. Decongestants should not be used for more than a week, as prolonged use can actually aggravate nasal blockage. A doctor should be consulted if symptoms don’t improve after a week of trying home remedies. The doctor will probably prescribe a course of antibiotics for 3-10 days.
Chronic sinusitis - Steroid nasal sprays (e.g. beclometasone Beconase), available from pharmacists and on prescription, are helpful in two ways. If long–term infection is present they help to reduce swelling of the nasal lining and open up the drainage holes, and if allergy is involved they also reduce inflammation. Antihistamines such as loratidine (Clarityn) might also help. In severe cases, the doctor may recommend short courses of steroid tablets. These are only available on prescription. Endoscopic nasal surgery may be needed as a last resort. Tubes and instruments passed down the nasal endoscope are used to wash out the sinus and widen the drainage hole. This can be done under general or local anaesthetic. It is a routine and generally safe procedure, but all surgery does carry some element of risk. Complications include minor damage to the lining of the nose or sinuses, or damage to the skull bone. Other types of surgery sometimes required to treat chronic sinusitis include correcting a bent nasal cartilage (septoplasty) or removing nasal polyps.
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Dr. William Forsythe
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