This article was originally published in the spring of 2016.
Spring is finally here, and with it comes not only flowers and rain but possibly runny noses, watery eyes, and sneezing.
Yes, it’s allergy time again. But is it really allergies, or something more?
Dr. William Johnson, an otolaryngologist with ProMedica Physicians, sheds light on allergies, sinusitis and when it’s time to see a physician for your symptoms.
HealthScene Ohio: As patients, we often self-diagnose when spring comes and we start sneezing and coughing. Are most of our symptoms seasonal allergies?
William Johnson: Often, there can be a significant overlap in the symptoms of allergic rhinitis (seasonal allergies) and sinusitis. Sometimes, it’s difficult for the patient to tell whether or not he or she has something more than seasonal allergies because the symptoms are so similar.
HSO: How similar are the symptoms of seasonal allergies and sinusitis?
WJ: They can be extremely similar. Sneezing, watery eyes, an itchy nose, and an itchy throat tend to be caused more often by seasonal allergies. However, nasal congestion, rhinorrhea (runny nose), postnasal drip, cough, sore throat, and facial pressure can be seen in both seasonal allergies and sinusitis. Fevers tend to only be associated with sinus infections (sinusitis), but not present with seasonal allergies.
HSO: Can seasonal allergies actually cause sinusitis? If so, how?
WJ: Allergies, either untreated or poorly controlled, can make an individual more susceptible to sinus infections. Allergies can also cause inflammation in the nose and sinus cavities, preventing the sinuses from draining properly. A collection of mucus then develops in an enclosed, humid space, which is very conducive to the growth and proliferation of bacteria.
HSO: What can we do at home to alleviate the symptoms of sinusitis and allergies?
WJ: Treatment of seasonal allergies with antihistamines and nasal steroid sprays can be helpful. Sinusitis can be treated with antibiotics, and irrigations with a neti pot can be useful to alleviate symptoms as well for both seasonal allergies and sinusitis. Warm, moist air may also help to treat the symptoms, so vaporizers and steam are also worth trying. However, while antihistamines, over-the-counter remedies, and nasal irrigation all alleviate the symptoms, they won’t actually cure sinusitis or allergies.
HSO: How does the physician diagnose the condition?
WJ: Sinus conditions are diagnosed based on the patient’s symptoms and the findings of a very thorough exam of the ears, nose and throat. The physician may also look for any facial swelling that may be present. Further treatment is then based on the findings of the exam. Other diagnostic tests may include allergy testing, mucus cultures and/or X-rays.
HSO: Is there a long-term solution for allergies and/or sinusitis?
WJ: For occasional sinus infections, antibiotics tend to work very well if the infection is bacterial. Sinus infections sometimes mimic a cold, so if the symptoms start to dissipate after 7-10 days, the problem is most likely viral, and no antibiotics are needed. When symptoms last beyond this time period, antibiotics are usually indicated. Sinus infections that last beyond 12 weeks would be considered chronic, and further treatment would most likely be necessary. Sometimes, multiple courses of antibiotics will be effective; however, if the patient has been on multiple courses of antibiotics and symptoms still persist, sinus surgery may be an option.
With allergies, ongoing treatment may be necessary depending on the severity. Regular immunotherapy (allergy shots) can be effective in lessening the symptoms of allergies over time by exposing the body to the allergens and therefore helping it to become used to the allergens themselves. This is not a cure for allergies, but long-term, it may help lessen the symptoms, allowing the patient to experience some relief.
HSO: If it’s determined that sinus surgery is needed, what benefits does the surgery provide?
WJ: The objective of the surgery is to enlarge the natural sinus openings and recreate the natural drainage passageways. Once passageways are widened, mucus is able to drain as it should, and the patient should experience fewer infections. Surgery has the benefit of keeping sinus problems better controlled since any required medications will be more effective after the affected membranes have been opened properly during the operation. Patients normally feel much better.
HSO: How is the surgery performed, and what does it entail?
WJ: Sinus surgery is now mostly done endoscopically, meaning a very small telescope (endoscope) is inserted into the nasal passage so the surgeon can view the sinuses. Then, the surgeon will open or enlarge the sinus openings. General or local anesthesia can be used for the surgery, and the patient can usually return to normal activities in about a week.
Melanie Dickman is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. William A. Johnson is a board-certified otolaryngologist with ProMedica Physicians in Northwest Ohio. He earned his medical degree at the University of Michigan and completed an internship and residency at The University of Chicago Medical Center. Johnson is a member of the American Academy of Otolaryngology-Head and Neck Surgery.
