Sinusitis: The cold that won't go away

After three years of suffering a stuffed-up nose, postnasal drip and cough, Tracey Haddleton, a 31-year-old Toronto chartered accountant, finally learned she had chronic sinus infection--not allergies. Like Haddleton, many people attribute nasal congestion, head pain, postnasal drip, throat irritation, fever and cough to allergies or a cold that "just won't go away."

Rather than going to the doctor, many of us head to the nearest drugstore and treat our symptoms with over-the-counter cold and allergy remedies. But what we may really need is an antibiotic. "Anyone who develops pain and tenderness over a short period of time definitely needs medical help," says Dr. Holly Stevens, past president of the British Columbia Society of Otolaryngology, Head and Neck Surgery.

Many sinus infections start with a cold or allergies, which can make the tissues in the lining of the nose swell, preventing oxygen flow from the nose to the sinuses' tiny openings. A closed, warm moist environment provides an ideal breeding ground for bacteria, which, in turn, can lead to infection. Congested sinuses, whether caused by a cold, allergy or infection, can also result in fever, painful swelling in the face, and toothache.

Even doctors can mistake sinusitis for perennial allergy (the kind that lasts year-round). The tip-off that it's sinusitis and not a cold or allergy? Deeply colored mucus. "We all get some discharge when we have a cold or allergy, but dark green mucus--not just yellow--indicates sinus infection," says Dr. Stevens. And unlike colds or seasonal allergies, which eventually go away, sinus infections can last for weeks or months, even longer.

Although physician-prescribed antibiotics will get rid of sinus infection, you can help yourself by taking hot showers and inhaling steam, which will open sinuses and get them draining. Saline nasal solutions which help flush out the nose can be purchased at the drugstore or made at home with a half teaspoon of salt and a cup of water. Irrigating the nasal passages three or four times daily washes out excess mucus and bacteria, reduces swelling and eases breathing (use a rubber ear syringe to squeeze the solution up the nostrils, then let the liquid drain out into the sink).

Over-the-counter nasal decongestants are also useful during the first five to seven days of the infection, when sinus clogging peaks. But Dr. Stevens warns that prolonged use of such sprays can cause a "rebound" effect in which the nose becomes less responsive to the spray and ends up just as clogged as it was in the first place. After the first week, an oral decongestant can be substituted for the nose spray. Be aware that while an antihistamine will dry up the nose, it won't decrease the swelling of tissues which closes the sinuses off; for this you need a decongestant.

If you have a sinus infection, your doctor will probably prescribe a two- to three-week course of antibiotics. Sinus infections often require longer treatment than other types of infection simply because the sinus openings are small and tend to swell. Explains Dr. Stevens: "Although the infections may be sterilized after the first few days of antibiotics, if the swelling hasn't gone down sufficiently to let the sinuses reopen and drain, you risk another infection."