If my congested six-year old self only knew what I know now about sinusitis!
The “head cold” that never seemed to go away.
The bursting sinus headaches I’d get while bending over to tie my shoes.
That disgusting thick yellow-green “sinus sludge” that never seemed to clear.
And the smell was awful!
I was on the “penicillin plan” consisting of at least 2-3 rounds of antibiotics per year.
Sound familiar?
Today’s article explores why medical treatments often fail in addressing recurrent sinusitis, the real reasons your sinus issues aren’t going away and how to go about getting you or your child long-term relief.
If you or your child suffers with chronic sinusitis, then this article is for you!
What Are The Symptoms Of Sinusitis?
- Pain behind the cheek bones or eyes, which may cause frontal headaches
- Pain in the teeth
- Copious clear, green or yellow discharge
- Nasal congestion or stuffiness
- Unpleasant odour – especially bacterial infection
- Fever
Why Conventional Treatments Don’t Resolve The Issue
Medical treatments for chronic sinusitis are limited to steroid sprays, nasal rinses, and antibiotics.
Steroid sprays will certainly work… until you stop using them. They are going to suppress the inflammation locally in your sinuses, which will only last as long as you take them.
Sinus drainage can be helpful in more severe cases but this procedure is invasive and often only helps for a time before symptoms return.
These treatments are often unsatisfactory for many because the inflammation is not just in your sinuses – it’s in your gut too!
It’s like trying to bail out a sinking ship with a beach bucket, no matter how much you drain, you keep producing more mucous. It’s a futile effort!
The Problem With Antibiotics
Antibiotic resistance, devastation of the microbiome and a lack of long-term benefit in chronic sinus sufferers are a few reasons why antibiotics may not be suitable for chronic sinusitis.
In fact, they may be part of the problem!
Antibiotics can lead to a disruption in your gut bacteria, known as dysbiosis. As we’ll discuss below, dysbiosis and something called biofilms can actually be a driving factor in the generation of chronic tissue inflammation in the mucous membranes. This includes the sinuses!
There’s certainly a time and a place for using antibiotics, especially during acute bacterial sinusitis but just know that this is unlikely to result in long-term resolution or prevention of symptoms.This is because you haven’t addressed the reasons why that inflammation and mucous persists in the first place!
Finally, it’s important to understand why you’re having chronic sinus issues so you can prevent them from ever happening.
So let’s dive in!
What Causes Sinusitis?
“Hold on, you said the inflammation is in my gut?!?”
As you know – and in case you don’t – over 70% of our immune system is located in the gut! One of the main components of this immune system is the gut-associated lymphoid tissue or GALT.
The GALT is a collection of specialized immune cells that work to protect our gut lining from the outside environment.
Analogous to airport security – they function not only to keep our intestinal borders safe but also keep the rest of the body from potential danger.
Now here’s the really interesting part:
The GALT is really the beginning of an extended network known as our mucosal associated lymphoid tissue or MALT. This functions much like our GALT and lines our mucous secreting surfaces like our eyes, ears, lungs and you guessed it: sinuses!
And you may be wondering “Hey, if sinus problems are related to the GALT and the GALT also effects the ears, nose, throat and lungs, then could issues in these tissues be related to problems with the GALT as well??
You smart cookie you!
Yes, in fact most people with asthma and chronic ear, nose and throat (ENT) issues have an over-active MALT, which stems from the gut!
So with that quick background, here are three IMPORTANT reasons you’re not getting relief.
Reason #1: Food Sensitivities
Food sensitivities play a big role in ENT issues like chronic sinusitis. This is something almost entirely disregarded by the medical community, but I’ve seen it time and time again.
Back to my snotty childhood for a moment…
You see, as a six-year old I loved drinking milk!
I drank it ALL the time! Something about the refreshing taste and my misguided notion of “milk is good for the bones” that echoed throughout much of my childhood years. Sadly this notion is still quite calcified in the minds of many parents today.
Milk certainly has nutritional benefits for growth – don’t get me wrong. They’re just overemphasized.
But the truth is, milk was a big trigger for me. For you it might be coffee, or gluten, or watermelon, who knows?? Everyone’s different! The point I’m trying to make here is that you need to find out what yours or your child’s specific food sensitivities are – not your mom’s or your friends’ dog!
How Does Food Effect Sinusitis?
Food sensitivities, not to be confused with allergies, promote a delayed mucosal response. Remember the GALT?
Food sensitivities promote GALT activation. This “activation” is then communicated to the MALT causing inflammation in distant tissues such as the sinuses.
Inflammation causes edema or swelling. Swelling equals moisture. Bacteria love environments filled with moisture. I think you get where I’m going with this!
When To Suspect A Food May Be Contributing
Watch for children waking up with a stuffed nose or sore throat that goes away during the day. I would look at investigating the role of foods – this can be accomplished by maintaining a food and symptom diary.
If you notice patterns of sinus stuffiness beginning shortly after meals, this is a glaring sign of food sensitivity. Be a keen observer!
Work with a professional to help you identify which foods may be contributing and to safely design a dietary approach that ensures adequate nutrients, minimizes food restriction and relieves symptoms.
A personalized approach is key here!
Reason #2 – Intestinal Permeability AKA “Leaky Gut” & Inflammation
Food sensitivities don’t develop in the presence of an intact intestinal barrier.
So along with identifying food triggers we need to adjust why your immune system is not reacting well to them.
Strict food elimination shouldn’t be a long-term strategy!
Figuring out which foods cause you problems and identifying how much of that food you can consume before you start feeling symptoms should be the main goal.
Here’s where people need to be patient with the process. A leaky gut doesn’t repair itself over night! Under most real-life circumstances it likely takes at least 6-12 months to restore the intestinal barrier. That means yeah, you might have to go without coffee, dairy or sugar for a while while you figure things out!
So it’s a process, one you shouldn’t try to rush!
Reason #3 Infections & Biofilms
It’s well documented that chronic rhino-sinusitis is associated with the formation of bacterial biofilms.
What Are Biofilms?
If we were to take a ride on the Magic School Bus through the nasal passages, biofilms would appear like a giant glue-like community of bacteria, viruses and fungi that stretch in one big continuous film.
Ms. Frizzle would then go on to enthusiastically explain that this “film” secretes a host of proteins and nutritive substances that anchor the organisms to the lining of our tissues. In addition, it helps the community grow while offering protection from our immune cells and especially against antibiotics.
“All for one, one for all” – it’s a brilliant mechanism!
Biofilms are a big reason antibiotics will fail – they can’t actually penetrate the community to kill off the organisms. What’s cool is that biofilms help facilitate the sharing of information regarding changes in the environment. This includes the sharing of genes that are resistant to antibiotics!
They should really be called “smartfilms”!
What Can You Do Next?
Investigating these three common causes with your healthcare provider is key to achieving long-term relief of symptoms.
A naturopathic doctor can help you design a personalized approach to help reduce GALT & MALT activation, identify food sensitivities, break up biofilms and improve intestinal barrier function.
While it’s too late for my six-year old self, thankfully it’s not too late for yours!
Naturopathic medicine is a wonderful tool to treat chronic ear, nose, and throat problems in the young and the old.
Book an appointment today and let’s tackle the rhino in the room!
References:
- Cesta, Mark F. “Normal structure, function, and histology of mucosa-associated lymphoid tissue.” Toxicologic pathology 34.5 (2006): 599-608.
- Fastenberg, Judd H., et al. “Biofilms in chronic rhinosinusitis: Pathophysiology and therapeutic strategies.” World journal of otorhinolaryngology-head and neck surgery 2.4 (2016): 219-229.