Allergic rhinitis can lead to complications including sinusitis.
However, the majority of sinusitis cases are viral in nature.
On this page we’ll explain:
- what sinusitis is
- how sinusitis is treated
- the recently updated NICE guidelines for sinusitis
- and how allergies and sinusitis might be related
What is sinusitis?
Sinusitis refers to inflammation in the sinuses. The sinuses are a collection of small pockets in the skull, near the nose. Under normal circumstances, when the sinuses produce mucus, this are drained via the nasal passages. However, if they become inflamed, then they can become blocked, resulting in pain or uncomfortable feelings of pressure.
Sinusitis can be an uncomfortable condition, but in most cases sinusitis symptoms clear up within two to three weeks. It is quite a common condition, often caused by viral infections of the upper respiratory tract, such as cold or flu. But it can also be caused by bacterial infections and allergies.
How is sinusitis treated?
This depends on the cause, and how severe the symptoms are.
Most people with sinusitis will not need to go to the doctors because the condition will clear up by itself within two to three weeks.
Treatment at home will usually involve:
- getting plenty of rest
- taking over-the-counter painkillers such as paracetamol if symptoms are causing discomfort
- cleaning the inside of the nose using a saltwater solution
- gently applying warm packs to the face, to help encourage normal nasal drainage
- or using over-the-counter decongestant nasal sprays or drops (these should not be used for more than one week)
If symptoms persist for more than 10 days or do not improve, then some prescription treatments, such as nasal decongestants or corticosteroids, may be able to help relieve symptoms.
The National Institute for Health and Care Excellence (NICE) has recently updated its guidelines for sinusitis.
According to the guidance, people presenting symptoms for 10 days or less should not be offered antibiotics; and these are unlikely to make a difference in most cases where treatment is required. (However, if there is evidence of a systemic bacterial infection in addition to sinusitis, then antibiotics may be recommended.)
The guidance states that only two percent of sinusitis cases are linked to a bacterial infection, and therefore the majority of people with sinusitis will not benefit from antibiotic treatment.
So, even if someone has previously received a prescription for antibiotics to treat sinusitis, they should not automatically expect to receive another prescription if they develop the condition again in the future. Under the new guidelines; antibiotics should only be prescribed when absolutely necessary, if someone is extremely unwell or if there is an increased risk of complications.
Why have the NICE guidelines been updated?
The use of antibiotics when they are not required contributes towards antibiotic resistance, which means that they will not work as well in the future.
Bacteria are developing a resistance to several (and in a small but growing number of cases, all) of the current antibiotics available. This could lead towards some illnesses becoming untreatable in the near future, and is a global concern among health experts.
Are allergies and sinusitis related?
Occasionally, yes. While most cases of sinusitis are caused by a viral infection, it can sometimes develop as a result of allergic rhinitis.
The inflammation of the nasal passages in allergic rhinitis can lead to blockages, and in turn sinusitis.
Corticosteroid and decongestant nasal sprays can be prescribed to treat allergic rhinitis and also to reduce the inflammation caused by persistent sinusitis. Some sprays may contain a combination of both a steroid and a decongestant agent.
It’s important to note though that these treatments are not recommended for everyone. Women who are pregnant may not be able to use them, and people with certain medical conditions such as diabetes or hyperthyroidism might be precluded from using them too. In any case, it’s better to speak to a doctor or pharmacist for specific advice beforehand.
Allergies trigger the release of certain chemicals in the body, when it comes into contact with an irritant. The body interprets this irritant as a threat, and the immune system releases a defensive chemical as a result.
Nasal corticosteroid treatment contains a synthetic hormone, which stops the tissue inside the nasal passages from releasing the defensive chemical (which causes inflammation and swelling).
This type of treatment should only be used for a short time; if symptoms continue, it is advisable to see a doctor for further help.