chronic sinus disease and post-nasal drip.
I love the internet. The reason I love the internet is because I can describe my symptoms on my blog, and an actual doctor from cyberspace can find it, read it, and provide some help!
His comment deserves to be a post here so that others having problems with sinus infections, sinusitis and post-nasal drip can find relief. Thank you, Dr. Davidson, wherever you are!
Hi there,
First of all, I’m sorry to hear about everything you’ve been through. It sounds terrible. I’m a physician who also specializes in allergies, asthma and immunology. I see many patients with acute and chronic sinus infections, and these infections can be very difficult to tolerate. I just wanted to offer some advice as you go forward, as you mentioned that you’re still experiencing some post-nasal drip.There’s a big difference between acute sinusitis (a new sinus infection) and chronic sinusitis (a long-term sinus infection). We generally believe that acute sinusitis is due to a bacterial infection that often shows up at the end of a cold. This sounds very much like your story. Antibiotics are often used, but Azithromycin (Z-pack) is really not the best 1st choice for such an infection. I know that the Z-pack was given for your sore throat, but that was probably the beginning of your sinus infection, and not a cold. Then you received some Augmentin, which is notorious for causing significant diarrhea. The reason it’s used is that it works well for sinus infections, but the side effects can be difficult, especially after a Z-pack. Remember, these antibiotics not only kill the sinus infection, they kill many of the bacteria that we normally have in our stomach and intestines — these antibiotics help us digest our food. Without them…well, you experienced significant intestinal symptoms (diarrhea, hemorrhoids, etc.) largely because of the antibiotics. Sometimes we even tell people to eat lots of yogurt while taking these antibiotics. This helps to repopulate the normal bacteria that we all need.
Chronic sinus infections, those that last <6 weeks, or occur <4 times per year, are largely considered to be non-infectious. That is, bacteria are not the problem. It’s a problem of inflammation, or the body’s response to a virus or bacteria. You can give all the antibiotics in the world to a patient with chronic sinus infections, and they won’t get better. That takes us to the next issue: rinses, nasal sprays and antihistamines.
These medications are much more helpful for people with chronic sinus disease, and they even help people with acute symptoms as well. These medications will likely come in handy for you, much more so than the Augmentin or Z-Pack. The sinus rinses are very basic — they help move the mucous, viruses, bacteria, allergens out of the nasal cavity. If one or more of these triggers are making the sinusitis worse, it’s easy to understand why nasal rinses can help. They also moisturize your nasal passage that prevents congestion from occurring.
The one type of medicine that may offer you the best benefit is a nasal steroid. These are medications like Nasonex, Veramyst, Flonase, that we’ve all heard of. This class of medications is VERY effective for sinusitis patients because they decrease the inflammation or swelling and stop the drainage at the same time. Bottom line: If you’re looking for a fix without antibiotics, I’d start with a salt water sinus rinse and follow up with a nasal steroid. You’ll find that the post-nasal drip will get better, along with all the diarrhea caused by antibiotics.
I hope this all helps! If you have any other questions, or are looking for additional information, please take a look at my website: www.davidsonallergy.com or even email me at joshua.davidson at me dot com.
Take care,
Dr. Davidson
That is awesome! Great information- except I would say all patients who take an antibiotic should be taking Probiotics, not just some. With our current nutrion deprived soils and foods and diets, most people already have unhealthy bacterial balances, so when you add an antibiotic, you can get yeast overgrowth very easily. Plus you can’t go wrong with Probiotics- the research shows they are essential to our immune system function and nutritional absorption.
Wow. How awesome! I don’t have any of those problems but certainly know many who do and will pass it on. Also, you might want to try taking acidophilous whenever you are on an antibiotic. It works more effectively than eating a lot of yogurt — you can get it at any health food store or Whole Foods.
Really good post. Sinus infections (especially chronic ones) are no fun at all and can definitely lead to other issues (not to mention pretty much take over your life).
Dealing w/ chronic sinusitis is another story. Sinus surgery has long been the only option when all else fails. However there are now some other ways to turn. Balloon sinuplasty is gaining traction – lots of info out there.
Anyway. Knowledge is power – do your homework and talk to your doctor. Find the solution that fits your condition best.
Take care.