Sinusitis is the inflammation of the sinuses (“holes” that we all have in the vicinity of the nose and above the eyes, primarily) which exist not only to reduce the weight of the skull but also to produce the secretion that lubricates the nose and thus retains impurities. In sinusitis, this secretion (“phlegm”) becomes trapped, concentrated and viscous, thus compressing the walls of the sinuses, causing inflammation and causing pain. It turns out that the more this secretion accumulates, the more it becomes “old” and fetid because it is infected by microorganisms (most commonly viruses - studies show that less than half of sinusitis is of bacterial etiology). In other words: what mainly improves the symptoms of sinusitis is to make it possible for this phlegm to leave the sinuses and, only when necessary, to kill the infectious agent that is living and multiplying in the retained secretion (remember that antibiotics are generally used to fight bacteria, not viruses).
The main causes of sinusitis, therefore, are all those that lead to the retention of secretions in the sinuses:
- Drinking too little waterbecause phlegm is mostly made up of water - without it, it becomes too thick and much harder to get out
- Inhaling too much smoke/dustdirt in general, which will thicken the secretion, make it harder to get out and make it even more inflammatory
- Excessive exposure to air conditioning: excessive cold “thickens” phlegm and worsens its elimination
- Poorly treated allergies or recurrent contact with the allergy factor
- Malformations: anatomical flaws that could compromise secretion drainage.
Once this has been explained, there are suggestions that can improve the results of the treatment prescribed by your doctor:
1 - Drink water properly - LOTS of water and regularly!
2 - Removing the causal factors (Whenever possible).
3 - Rinse the nasal cavity with saline solution several times a day, especially after exposure to strong odors or odors known to cause flare-ups. Two good tips to help with this:
a) A good tip to help with this is this device: http://lota.com.br
b) Use “saline solution” sprays under pressure several times a day (such as Maresis, Fluimare, Marimer and similar), according to the technique explained on their leaflets.
4 – Tilt your head back and drip 3 to 5 drops of hydrogen peroxide into each nostril., as this video explains.
5 - Constant vaporization: take a pan of water and put it on to boil. When it's boiling, turn it off and breathe in the steam. This steam kills most of the microorganisms and improves the outflow of secretions, relieving symptoms.
6 - Humidification - Sinusitis is more common in dry climates and, in these cases, a humidifier in the room can be very beneficial, especially during sleep.
7 - Anti-inflammatories: They are generally used when there is severe pain, whether or not associated with other inflammatory signs.
8 - Antipyretics (Paracetamol/Dipyrone/Ibuprofen): Sometimes recommended when there is a lot of pain or a high fever.
9 - Antiallergic: I only recommend them if your allergies are VERY “bad” (and you have to be careful with them because they dry out the secretions a lot and thus impair their exit from the sinuses, which is why they have the potential to “chronify” sinusitis).
10 - Antibiotics: I only recommend antibiotics when there is a strong suspicion of a bacterial infection (remembering that this is the minority of cases), confirmed or not by tests, but usually associated with a high fever. Antibiotics act on the whole body and have the potential to greatly damage beneficial bacterial flora in the intestines, mouth, vagina, urinary tract, etc. And this often makes the patient more prone to infections in these places in the near future. Add to this the fact that many antibiotics have difficulty penetrating the sinuses and effectively reaching the infection in the phlegm...
11 - Immunostimulants: In my opinion, very welcome... Garlic (and onions, which are natural antibiotics with hundreds of good studies proving their anti-inflammatory properties), ginger, copaiba, vitamin C, zinc, Epicor, Echinacea purpurea, Leucogen (the latter 3 mainly in chronic cases and on prescription).
12 - Light physical exercise (Walking, for example) - Indicated because they help to increase the temperature of the face and thus improve the drainage of secretions from the sinuses.
13 - Corticoids, In my opinion, they should be avoided as much as possible, whenever possible, because they worsen the functioning of the immune system.
14 - Syrups: As long as they are fluidizing or expectorant (especially the former), such as acetylcysteine (and many other more natural options), acebrophylline or even ambroxol. Otherwise, I don't see how they can help much...
Unfortunately, however, a common mistake made by many medical colleagues is to focus treatment on the use of medication, most of the time with exaggeration; but I leave it to the reader to reflect on this.
Português do Brasil 
English 