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Sinus reaction: Decongestants vs. Antihistamines

Sinus Infections | AAFA.org

A “sinus” is simply a hollow space. There are many sinuses in the body, including four pairs inside the skull. These are called the “paranasal sinuses.” They lighten the skull and help give your voice its tone. Sinusitis is when your sinuses become infected or congested.

The sinuses have the same kind of tissue that lines the inside of the nose. The same things that can cause swelling in the nose can also affect the sinuses, such as allergies or an infection. When the tissue inside the sinuses swells, mucus increases. Over time, air trapped inside swollen sinuses can create painful pressure inside the head. This is a sinus headache.

What Causes Sinusitis?

A viral infection causes most cases of sinusitis. Colds, bacterial infections, allergies, asthma, and other health conditions can also cause sinusitis. If your sinuses are blocked for a long time, you may get a bacterial infection. This secondary infection is caused by bacteria that are normally present in the respiratory tract. These bacteria multiply and cause a sinus infection when they are unable to drain out of the blocked sinuses.

Irritants like smoke, strong odors, and air pollution can also cause sinus swelling. If you are frequently exposed to certain irritants, they can cause sinusitis.

What Are the Types of Sinusitis?

There are two types of sinusitis.

Acute sinusitis is a temporary swelling of the sinuses. The mucous membranes inside your nose, sinuses, and throat swell. This could happen when you have a cold or allergies. The swelling blocks the sinus openings and prevents normal mucus from draining. This causes mucus and pressure to build up.

Chronic sinusitis occurs when symptoms become more frequent or worse. Sinus infections may cause long-term sinus inflammation and symptoms. If you have more than three sinus infections in a year or have symptoms longer than 12 weeks, you could have chronic sinusitis.

What Are the Symptoms of Sinusitis?

When a sinus infection results from blocked sinuses, symptoms may include:

  • Thick white, yellow, or greenish mucus from your nose or drainage down the back of your throat (called postnasal drip)
  • Bad breath from postnasal drip
  • Blocked or stuffy nose
  • Tenderness and swelling around your eyes, cheeks, nose, and forehead
  • A reduced sense of smell and taste
  • Fever
  • Fatigue
  • Ear pressure/fullness
  • Headache
  • Cough
  • Pain in your teeth

These symptoms may be similar to some respiratory viral infections. They may require different treatments.

What Is the Treatment for Sinusitis?

The first step to treat sinusitis is to clear your nasal passages. This helps your sinuses drain properly. Draining your sinuses helps flush out a bacterial infection. If you have a bacterial infection, your doctor may also prescribe an antibiotic to fight it.

Here are a few common treatment options for sinusitis:

Nasal rinse or inhaling steam: To clear your sinuses, you rinse your nose with warm saline solution (salt water) using a neti pot or a special rinse bottle.

Use lukewarm distilled or boiled water that is stored in a clean container. You can buy nasal saline packets in most pharmacies. You can also follow a recipe to make your own nasal saline rinse from the American Academy of Allergy, Asthma & Immunology.

Or you can breathe hot steam through your nose for 10 to 15 minutes, three to four times a day. Do not use steam if it triggers your asthma or makes it hard to breathe.

Nasal corticosteroid sprays: These are topical nasal sprays that contain steroids that help decrease swelling. Use your nasal spray as directed by your doctor to avoid side effects. Point it toward your ear when you spray it into your nose and away from your nasal septum (the cartilage and bone in your nose that separates your nasal cavities).

Allergy treatment: If allergies are causing sinusitis, allergy treatment may help. These treatments may include nasal saline rinses, antihistamines, nasal steroid sprays, leukotriene modifiers, and immunotherapy (allergy shots or tablets). An allergist can test you for allergies and help you come up with a treatment plan.

Leukotriene modifiers: This is a medicine taken in pill form. It prevents your body from making or activating leukotrienes, which can cause swelling of your nose and sinuses. It may be helpful if you have allergies. The Food and Drug Administration (FDA) has strengthened existing warnings about serious behavior and mood-related changes with montelukast (Singulair® and generics).

Antibiotics: Your doctor may prescribe an antibiotic to fight a bacterial infection. Many doctors will prescribe antibiotics if your symptoms have not improved in about 10 days.

Antibiotics are not always needed to treat sinusitis. Talk with your doctor about whether or not you need antibiotics. The overuse of antibiotics can lead to antibiotic resistance if you take them when you don’t need them.

Decongestants: This medicine reduces stuffiness by shrinking swollen membranes in the nose. Pseudoephedrine is a common decongestant. You can buy it over the counter in pill, liquid, and nasal spray form. It is also sometimes included with combination cold and allergy medicines that contain an antihistamine or mucolytics.

Talk with your doctor about using decongestants because of their side effects. For example, they can raise your blood pressure. If you have high blood pressure or heart disease, you may want to avoid them.

If you use nasal decongestant sprays more than three days in a row, they may cause the swelling and stuffiness in your nose to get worse. This can happen even after you stop using the medicine. This is called a rebound reaction.

Mucolytics: Mucolytics are a type of medicine that thin mucus and make it less sticky. This can make it easier to clear from your nose and lungs. You can buy them over the counter. Guaifenesin (Mucinex®) is a common mucolytic. It can also come combined with a decongestant and/or antihistamine.

Oral corticosteroids: Your doctor may prescribe oral corticosteroids for severe chronic sinusitis. These are powerful medicines that treat inflammation but can have major side effects. These medicines are usually only prescribed when other medicines failed.

Sinus surgery: If your chronic sinusitis symptoms will not go away with these medical treatments, your doctor may recommend a consultation with an ear, nose, and throat (ENT) specialist to talk about sinus surgery. There are two common types of sinus surgery: functional endoscopic sinus surgery and less-invasive balloon sinuplasty. Both surgeries open up blocked sinuses, restore normal sinus drainage, and may significantly help reduce symptoms.

How Can I Prevent Sinusitis?

Experts don’t know a lot about how to prevent sinusitis. But the following tips may help:

  • Avoid contact with allergens or irritants that trigger your nasal allergies.
  • Keep your nose as free and clear as possible by taking your allergy medicines – including topical nasal steroid sprays – and using a nasal saline rinse.
  • Avoid infections by washing your hands often during common cold season. Also avoid touching your face.
  • Talk with your doctor about lifestyle changes that may help you prevent repeated sinus infections. These may include changes to your diet, maintaining good hydration, performing regular exercise, and reducing stress.

Medical Review: April 2021 by Sarah Goff, MD, PhD, and August 2022 by John James, MD

Sinus infection: 11 symptoms and treatments

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A sinus infection, also called sinusitis, is a common and painful condition that causes stuffy, painful pressure in the nasal cavity.

Sinusitis affects around 31 million people in America each year. Most cases of sinusitis are due to a virus and will go away on their own. Viral sinusitis is contagious, so a person should take steps to avoid passing it on to others.

Bacteria, and in rare cases a fungus, might also cause sinusitis.

It can be challenging to tell sinusitis apart from a cold or allergy, so knowing the symptoms of a sinus infection can help a person find the best treatment.

This article looks at the symptoms and treatments of sinusitis and explains how to tell the difference between a sinus infection and a cold.

The characteristic symptoms of a sinus infection include:

1. Sinus pain and pressure

Fluid trapped in the sinuses can fill the sinus cavities, causing intense pain and pressure. The sinuses may be sensitive to the touch. A person may have an urge to sneeze but be unable to do so.

The pain can be in the cheeks, around the eyes and nose, or in the forehead because these areas are where the sinuses are. Bending over may make the pain worse.

Sometimes, the pressure and pain are intense enough to interfere with sleep.

Sinusitis may also cause the tissue in the nose to swell.

2. A headache

The pressure and pain of sinusitis can cause headaches in the front of the head. Some people find that the pain radiates elsewhere, causing more widespread problems or even neck pain.

3. Postnasal drip

Postnasal drip is mucus that drips from the nose down to the back of the throat. It can cause feelings of hoarseness and congestion or a sense of pressure in the throat or mouth.

4. Congestion

A sinus infection usually happens where there is fluid trapped in the sinuses in which viruses, bacteria, or fungus can grow. Because of the fluid buildup and inflammation, a person is likely to feel congested.

5. Coughing

A sinus infection can cause mucus and fluid to back up in the throat, which may make the throat itch or feel full. Some people repeatedly cough to try to clear the throat, but others experience uncontrollable coughing.

6. Fever

A fever is a sign that the body is fighting off an infection. Some people develop a fever with a sinus infection. Other symptoms associated with fever include chills, exhaustion, and muscle aches.

7. Brightly colored mucus

Viruses, bacteria, or fungus in mucus can change its color. People with sinus infections often notice that they cough up green or yellow phlegm or that the mucus they blow out of their nose is a bright color.

Sinusitis causes a lot of mucus production, and a person may find they are unable to clear the sinuses no matter how often they blow their nose.

8. Fatigue

Fighting a sinus infection demands energy from the body, so it is common to feel fatigued. Some people feel exhausted because they cannot breathe easily or are in pain.

9. Bad breath

The mucus associated with a sinus infection may have a bad odor, which can cause smelly breath or a bad taste in the mouth.

10. Tooth pain

Intense sinus pressure can cause pain in the gums, which can lead to toothaches, gum pain, or general pain in the mouth.

It can be difficult to tell the difference between a sinus infection and a cold as the symptoms can be very similar. Sinus infections often develop after a cold.

Sinusitis tends to last longer than a cold. Cold symptoms tend to get steadily worse, peaking at 3–5 days, then gradually get better. Sinus infections may last 10 days or more.

Some symptoms are more likely to be caused by sinusitis than a cold, including:

  • swelling of the tissue in the nose
  • bad breath
  • green discharge from the nose
  • a swollen or tender face

Unlike a cold, sinusitis can become chronic, which means it lasts longer than eight weeks. Chronic sinusitis causes swelling and irritation in the sinuses and usually develops after a person has had acute sinusitis. Sometimes the symptoms go away and then come back again.

Ongoing sinus symptoms — even if they get better and then come back — may indicate chronic sinusitis.

Sinus infections often go away on their own without medical treatment. There are, however, some things a person can do at home to relieve the bothersome symptoms.

To treat sinusitis symptoms with home remedies, try:

  • Applying a warm compress to the sinuses, which eases pain and pressure by loosening up the fluid in the sinuses.
  • Using a nasal wash or sinus rinse, such as a saline spray or neti pot, which are available from drug stores and online.
  • Taking antihistamine tablets to reduce inflammation in the sinuses. Antihistamines are available in supermarkets, drugstores, and online.
  • Using a nasal decongestant spray to help clear the sinuses and relieve pressure. These sprays are also available to buy in supermarkets, drugstores, and online.

Avoid using decongestants on a long-term basis without talking to a doctor first because they can make congestion worse if used for too long.

A person may wish to talk to their doctor if:

  • symptoms last longer than 10 days with no improvement
  • fever lasts longer than 3-4 days
  • the pain is very intense
  • a person with a suspected sinus infection has a weakened immune system due to a medical condition, drugs that suppress the immune system, or organ failure

Treatment depends on the cause. If bacteria is the cause of the infection and symptoms are severe or last more than a week, a doctor might prescribe antibiotics. Antibiotics do not work for chronic sinusitis or a sinus infection caused by a virus.

A doctor may also prescribe steroids to relieve pain and pressure. These can help whether the infection is bacterial or viral and may also help with chronic sinus infections.

If other treatments are not effective, a doctor may recommend surgery to treat severe, chronic sinusitis. Surgeons can move the bones to open the sinuses or fix problems with bones surrounding the sinuses.

Some people may have nasal polyps that cause frequent sinus infections. A surgeon can easily remove these. Most surgeries for chronic sinusitis are outpatient procedures, which means a person can go home the same day as surgery.

Repeated episodes of sinusitis also can be a sign of an immunodeficiency disorder. A person experiencing repeated episodes should have a doctor check the immunoglobulin levels in their blood.

The outlook for most cases of sinusitis is good. Sinus infections often clear up on their own within a week or two. When they do not, the infection may be bacterial, and antibiotics can help.

Although rare, fungal sinus infections can be severe and hard to treat.

With proper medical care, most people with sinusitis recover well. However, if the infection does not get better after three months, a doctor might refer someone to an ear, nose, and throat specialist who can identify and treat the underlying cause of chronic sinusitis.

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Cardiac tachycardia – Treatment in Rostov-on-Don

If you have accelerated sinus rhythm or arrhythmia, contact a cardiologist to:

  • find out the cause of palpitations and tachycardia,
  • get rid of painful symptoms and return to a normal active life.

Sinus heart rate and sinus tachycardia

Normally, the heart rate is set from the sinus node, so the sinus rhythm of the heart is the norm. Sinus tachycardia is a rapid heart rate (more than 90 beats per minute), given, as expected, from the sinus node. Sinus tachycardia in children is established according to other heart rate indicators – according to the age norm, since the normal heart rate in children is higher than in adults.

Palpitations – a feeling of rapid or increased heartbeat. Often associated with tachycardia. Palpitations are a subjective symptom. Some people periodically feel even normal heartbeats, while others may not feel serious rhythm disturbances. Therefore, the sensation of a heartbeat is not a sign of heart disease.

Increased and increased heart rate is a normal response of the body to physical activity, stress, which is felt as palpitations and tachycardia. As a rule, this is sinus tachycardia, which occurs as a result of complex mechanisms of regulation of the cardiovascular system and, above all, an increase in sympathetic influence on the pacemaker – the sinus node. The accelerated sinus rhythm of the heart allows the tissues to be supplied with oxygen and nutrients more actively, since energy requirements increase significantly during exercise. Sinus tachycardia of the heart after rest goes away on its own and does not cause discomfort.

Only in combination with other symptoms can heartbeat indicate abnormalities. The symptoms that accompany palpitations depend on the disease they are a manifestation of.

CAUSES OF HEART PEAT AND TACHYCARDIA

Palpitation and tachycardia occur in the following diseases:

  • endocarditis, myocarditis,
  • myocardial dystrophy, cardiosclerosis,
  • arterial hypertension,
  • heart defects,
  • anemia,
  • neurosis,
  • vegetative-vascular dystonia,
  • endocrine diseases (thyrotoxicosis, pheochromocytoma, hypoglycemic conditions in diabetes mellitus),
  • feverish conditions,
  • climax.

Sinus tachycardia during pregnancy

Sinus tachycardia during pregnancy is normal if it does not cause pain or other discomfort in the chest. During pregnancy, the mother’s cardiovascular system must work for two, providing the fetus with all the necessary nutrients, and therefore the heart rate increases.

Sinus tachycardia – treatment

Sometimes, a sudden palpitation frightens a person, causing excitement, and consequently increasing palpitations and tachycardia. This creates a vicious circle that can greatly degrade the quality of life.

In some cases, the combination of palpitations and tachycardia with high anxiety, additional autonomic reactions (sweating, feeling short of breath, tremor of the limbs, lightheadedness) cause the patient to fear death and falsely believe that he has a serious, life-threatening disease. In such cases, the treatment of sinus tachycardia is carried out with the participation of a psychotherapist.