Ever since he was a kid, Kolby DeWitt has suffered from sinus problems.
The 21-year-old Sioux City man could find no explanation or relief for the facial pain, headaches, congestion and nasal drainage associated with his persistent sinus infections.
For a year, DeWitt even suffered from regular nosebleeds.
"I eat healthy. I exercise," said DeWitt, who once thought something in his office at Brokers Alliance might be contributing to his problems.
DeWitt made a trip to his family doctor, who referred him to an ear, nose and throat specialist, who found a simple over-the-counter solution to treat his sinus infections: a neti pot.
A neti pot is a container designed to rinse the nasal cavity with warm salt water. Ceramic and plastic models are available at big-box stores or local pharmacies. They retail for under $20.
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"I would totally recommend a neti pot to other people," DeWitt said.
To end his nosebleeds, DeWitt recently had his nose cauterized. He said the procedure has worked well for him.
Blockage leads to infection
Sinuses are hollow cavities in the boney facial skeleton that are lined with a thin layer of respiratory epithelium. They secrete fluid, which is moved by cilia through a narrow route from the sinuses into the nasal cavity.
In healthy sinuses, air circulates freely through the chambers and a thin layer of mucus drains into the nose. When sinuses are blocked, the mucus can't drain and the sinuses become infected.
David Wagner, a Sioux City ear, nose and throat specialist, said dust, pollution, smoke and aeroallergens can aggravate the nose, causing the tissue to swell and narrow the small passages in the nose and sinuses.
Everyone is unique in the way their lining responds to any given stimulant, according to Wagner. In some patients, he said, a pungent odor or a bite of a certain food will create a sudden and profound amount of nasal swelling and clear drip.
In addition to allergens and particles, Wagner said a cold or viral infection can also cause the lining to swell.
Headache, pressure in the face, nasal congestion, nasal drainage and sore throat are all symptoms that cold and sinus infections share.
How do you know if you have a sinus infection?
"The duration would be one way," Wagner said. "You could have recurrent acute sinusitis which comes and causes inflammation, is treated, and goes away. You can have chronic where it stays from six to eight weeks. If you go on antibiotics it might get slightly better, but it never resolves."
Reduce allergens
To prevent sinus problems, Wagner said patients need to control their environment by avoiding mold, dust mites or other matter that aggravates the lining of the nose.
"If they are exposed to those, one of the simplest things a person can do that can help clean the lining and prevent some of the reaction is to irrigate with salt water," he said.
Using a neti pot, Wagner said is a "very successful" way to moisten the nose and clean its lining.
A patient suffering from cold-like symptoms, Wagner said, might get some short-term relief from a decongestant, like Sudafed.
For long-range nasal and sinus inflammation, Wagner recommends a non-sedating antihistamine agent, such as Claritin or Zyrtec.
He said a nasal topical steroid spray can be placed in the nasal tissues daily to decrease swelling, redness and congestion.
"Even though it's a very mild medication, on a regular basis it could diminish some of the swelling in the tissues and keep the person from going on and having some of the trouble that would follow," he said.
If symptoms persist for more than four to six weeks, Wagner said it's probably time to see an ear, nose and throat specialist, who can examine the structure and lining of the nose and order a CT scan to view the inside of the sinus cavities.
Patients who suffer from sinus inflammation, infections that don't go away with medical therapy, or nasal polyps, Wagner said, might benefit from the opening and enlargement of the sinus cavities through surgery.
"Unfortunately there's 10 or 15 percent of patients who deal with chronic sinus trouble that may not get satisfactory relief," he said.
