Is It a Cold? Symptoms May Point to Sinusitis

Your head aches and feels congested. Your energy level is low, and your nasal drainage makes you an unacceptable movie partner.

You might chalk it up to a summer cold, but Denver physician Robert Ivker thinks otherwise. These four symptoms, he says, often point to sinusitis, an inflammation or infection of the air-filled cavities behind and around the nose and eyes.

Southern Californians are no strangers to this condition, which is worsened by smog and allergens. But the outlook has become less grim recently, according to Ivker and other experts.

What has made the difference?

“There is increased awareness by physicians to look out for the condition,” says Dr. Frederick Godley, an ear-nose-throat specialist at the Harvard Community Health Plan of New England, an HMO in Providence, R.I.

CAT scans are used by more doctors, notes Godley, whose update on chronic sinusitis treatment was published recently in the American Family Physician.

Treatment options have improved too, thanks to a new surgical technique and medicines. Such self-treatment measures as minimizing indoor air pollution can help as well, says Ivker, author of “Sinus Survival.”

Diagnosing chronic sinusitis isn’t easy--even for a specialist--because symptoms often mimic those of other conditions. Often patients think they have a cold but are diagnosed with sinusitis.

Others, convinced that they have sinusitis, have other nasal problems, tension headaches or allergies.

The sinuses are lined with mucous membranes and are connected to the nasal passage via thin ducts. Normally, the sinuses help filter and humidify air. Problems and pain begin when these membranes become inflamed or infected.

To pinpoint the diagnosis, Godley asks patients for a rundown of symptoms, listening for the telltale signs. Extreme fatigue, he finds, is the symptom patients are least likely to link with a sinus problem.

He speculates that as the infection lingers, it drains the body of energy. The timing of symptoms provides another diagnostic clue: Sinusitis patients are most likely to have headaches in the morning.

CAT scans can confirm the diagnosis better than traditional X-rays, Godley says. “On plain (X-ray) film, the entire skull shows up, and many structures overlap,” he says. But the CAT scan “sees” individual sinus chambers, allowing better detection of inflammation and infection.

Godley often relies on broad-spectrum antibiotics for treatment, picking from an arsenal of about 15 drugs. If there’s no relief after a month, some patients consider surgery. The use of an endoscope, a telescope-like device, helps make sinus surgery more effective, experts say.

The aim is to enlarge the natural drainage pathway without altering the anatomy.

Controlling the immediate environment and other self-help measures can help, too.

Ivker suggests the use of negative ion generators and other air cleaners, such as furnace filters, to purify indoor air.

And he recommends avoiding polluted air--more easily said than done in Los Angeles, which he dubs “the sinus capital” of the United States.

A variety of over-the-counter medicines are also available as sinusitis remedies, but be cautious, advises the American Academy of Otolaryngology-Head and Neck Surgery. It’s wise to confirm your symptoms with a doctor first.