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| Welcome to the May edition of the National Allergy E-Mail Newsletter! This month, we will discuss the growing problem of Chronic Sinusitis and hopefully answer questions you may have about this condition. We are thankful for the information and advice provided for this article by Dr. Donald P. Dennis, an Atlanta-area otolaryngologist (Ear, Nose and Throat specialist). He and other ENT professionals have spent countless hours doing research on the subject of chronic sinusitis and developing effective treatments.
In this issue we address the following topics:
The National Allergy Newsletter Team
Some Basic Facts About Sinusitis
Your sinuses are the openings in the bones around your nose. Everyone has four pairs of sinuses that are connected to the nasal cavity by small openings. They are lined with the same type of membranes that line the inside of the nose, and when they are working properly, air flows in and out of the sinuses and fluid and mucous drains from the sinuses into the nose. Inflammation of one or more of the cavities inhibits this process so the mucous and membranes become infected and sinusitis results.
There are two general types of sinusitis ” acute and chronic. The main difference between the two is the frequency and length of infection. Acute sinusitis happens sporadically, lasts only a few weeks, and often follows a respiratory infection such as a cold. Chronic sinusitis is defined as sinus inflammation that persists for two months or longer. Although acute sinusitis symptoms are often more severe, sufferers of chronic sinusitis run a higher risk of sinus tissue damage.
Is It Sinusitis, Or Just A Cold?
"It's hard to tell the difference between a cold and sinusitis," says Dr. Erica Thaler, a University of Pennsylvania Medical School otorhinolaryngologist. While some may think they have sinusitis, they are really only suffering the symptoms of a bad cold; however, Dr. Thaler cautions that "if you don't treat it, it can become a chronic condition."
So how do you know if your recurring cold-like symptoms are becoming chronic sinusitis? If you have what seems like a cold that never quite goes away, sometimes lasting several months, you may have chronic sinusitis. Another sign to look for is thick, yellow-green mucous that signals a bacterial infection in the sinuses. Other persisting symptoms are headaches that occur in the front of your head and around the eyes; facial pain around the eyes, forehead and/or cheeks; pain in the roof of the mouth or teeth; and a persistent cough. If you regularly experience two or more of the above, you should see a doctor for a further diagnosis.
Treating Chronic Sinusitis
The goal for treatment of chronic sinusitis is to cure the infection and relieve the symptoms. Many doctors still prescribe antibiotic sprays or oral antibiotics to treat the bacterial infection that has resulted from the inflammation. Topical steroids such as nasal sprays are often recommended to treat chronic sinusitis related to allergies. In some cases, surgery may be needed to clean and drain the sinuses. These are some of the common existing treatments. What follows are some of the newest ways that medical professionals are finding to diagnose and treat chronic sinusitis.
Exciting New Research About The Causes And Treatment Of Chronic Sinusitis
It has always been assumed that chronic sinusitis is caused by a bacterial infection within the sinuses; thus, patients have been treated with antibiotics to fight the infection. However, a recent study by the Mayo Clinic appears to refute the bacterial infection hypothesis. In fact, the Mayo Clinic stated that "antibiotics don't help chronic sinusitis in the long run because they target bacteria, which are not usually the cause of chronic sinusitis."
So if a bacterial infection is not the root problem causing millions to suffer from chronic sinusitis, then what's to blame? Fungus or mold (words used interchangeably), said the Mayo Clinic study. While mold is a known allergen that many of you are likely sensitive to, this study shows that mold in the air and in the nose is directly linked to sinus inflammation. Further research to support this discovery was just published by Dr. Donald Dennis who, between 1989 and 2003, studied 639 of his chronic sinusitis patients. Using a variety of treatments, he found that those patients who were treated with a well-rounded protocol to eliminate fungus from their nose and environment saw significant results in their chronic sinusitis conditions. In fact, the aforementioned Mayo Clinic study demonstrated that 93% of all chronic sinusitis was caused by mold.
Here is what Dr. Dennis has to say about the development of chronic sinusitis:
"In order to achieve and maintain wellness, it is necessary for you to understand why you have sinusitisúHow Does Chronic Sinusitis Happen? You breathe airborne mold particles that are in the air. Then you have an allergic reaction to these mold fragments. This reaction causes small pits to form in the membranes that line the sinuses. These pits trap mucous so that it cannot drain. The stagnant mucous gets infected, which causes nasal polyps [benign growths within the nasal passages] and thickening of the lining which obstructs the outflow of mucous. The polyps then cause more infection and the infection causes more polyps. Thus, there is a vicious cycle which perpetuates itself. If you get rid of the mold in the nose and in the air you breathe and establish drainage in blocked sinuses you can get long term relief."
This new research has also changed the way some doctors go about treating patients with Chronic Sinusitis. The exciting part is that since mold is an environmental problem, many of the steps suggested by Dr. Dennis and others are non-invasive, practical healthy-home solutions.
Control The Mold!
In accordance with the hypothesis that mold is the infection-causing culprit for much of our chronic sinusitis, the two most important factors to maintaining drainage in blocked sinuses are removing the mold in your nose and removing the mold in the air you breathe. Dr. Dennis emphasizes that a patient must strictly follow the protocol to remove mold from the nose and environment to see results. Space does not allow us to detail the entire sinus protocol; however, you can read more specific instructions at http://www.fungalsinusitis.com/articles/Treatment_CFS.doc. You can also view a pdf version of Dr. Dennis' recently published article, "Chronic Sinusitis: Defective T-Cells Responding To Superantigens, Treated by Reduction of Fungi in the Nose and Air."
Here is a brief overview of the sinus protocol used in the study. To control the fungal load in his patients' noses, Dr. Dennis administered saline nasal irrigation with an irrigator, like the Hydro Pulse, which removes fungi mechanically. He also had the study participants take antimicrobial nasal sprays. The second major step in getting his chronic sinusitis sufferers to feel better was to remove the mold from their environment. In fact, much of the treatment he uses is the same as what any allergy sufferer should do to avoid exposure to airborne mold particles.
The most important factor to remember is to locate and deal with the source of any incoming moisture. Look through our past newsletters on Mold and Indoor Air Quality (August and September 2003) and Dehumidification (April 2004) for specific tips on controlling mold in your home.
Can Chronic Sinusitis Be Prevented?
You may not be a chronic sinusitis sufferer, but remember that the process by which it can start leaves many people susceptible to sinusitis. Continued exposure to mold in your environment that lodges in your nose can inhibit the draining of mucous in the nose. Stagnant mucous can become infected and harbor bacteria, causing further infections. It is important to note that a deviated septum or other obstruction of the nose may create pockets of fluid in the nose that can become infected. Also, in some cases dental infections can spread into a sinus cavity and infect it directly. However, if you fear that mold may be at the root of your sinus irritation, it is important to know what kind and how much mold may be in your environment.
Many doctors recommend taking an air sample for mold using specialized collecting plates. Typically, such plates contain a substance such as agar, which allows mold to grow readily once collected. A plate should be placed in the bedroom, kitchen, living room and/or attic ” or wherever mold is suspected. The plates are to be exposed to normal airflow for 1 hour, then wrapped in foil and sent to a lab for analysis. If the lab analysis of your test plates shows airborne mold counts of more than four colonies then you should implement a mold-reduction regimen. During Dr. Dennis' clinical trials, patients were instructed to maintain environments with mold counts below 4 colonies. Those who maintained this level experienced dramatic improvement in their symptoms.
Some helpful tools for reducing mold counts in a room include using goodmorning Purifying Spray, which is odorless grapefruit seed extract - a natural enemy to mold. In lab tests, CitriSafe, which uses cartridges of filter solution, reduced mold counts in a 200 square foot area to safe levels. For larger areas, we recommend placing two Filter Solution cartridges with wicks exposed on top of or within a Whirlpool HEPA Air Cleaner, or other room air cleaner. This will ensure the solution is properly disseminated throughout the affected room.
Another helpful item for those concerned with airborne molds, germs and other bacteria is the Wein Personal Ionizer. Tests show that it reduces the number of mold colonies to zero within its area of coverage. The Wein Personal Ionizer is a convenient solution for anyone who wants clean air on the go ” in airplanes or other transportation, city streets, department stores, hotels, movie theatres, etc.
In order to wash out the fungus and bacteria in the sinuses and maintain healthy mucous production, many doctors recommend saline sprays and washes, as well as nasal irrigators, like the Hydro Pulse. Other irrigation options include the Nasaline Nasal Irrigator - a unique, syringe style delivery system that offers portable, positive-pressure irrigation. All of these irrigators use positive pressure to gently clean and moisturize the nasal cavities with saline solution. The SinuCleanse is a durable, convenient irrigator modeled after the same neti-pots that have been used for centuries for nasal cleansing. Our October 2003 newsletter focused on Nasal Irrigation if you'd like to read more.
We hope you have learned more about chronic sinusitis, and even determined whether or not you or a loved one may need to see a doctor about problematic sinus irritation. We strive to provide our readers with the latest information for helping you feel better. Always remember to follow your doctor's advice and treatment instructions. (If you would like your doctor to see more information about Dr. Dennis' research, direct them to www.fungalsinusitis.com/md). Finally, remember that mold could be the culprit for your sinus irritation. For you and your family's health and well being, keep your environment as cleansed as possible of mold and other sinus, allergy and asthma triggers.
If you have further questions about any of the products or material mentioned in this edition, please e-mail us at firstname.lastname@example.org and we'll do our best to help.
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