Sinusitis (To Reduce)
Your doctor could be missing an important cause of your chronic sinusitis by only considering the usual reasons, such as allergy, bacterial infection, abnormal growths in the sinuses (nasal polyps) or a deviated septum (when the bone and cartilage of the nose that divides the nasal cavity in half is crooked). Sinusitis is defined as an inflammation of the air-filled cavities in the skull (behind the forehead, nasal bones, cheeks and eyes) and is classified as chronic when symptoms last for longer than 12 weeks. Chronic sinusitis is a common, frustrating disease that’s difficult to manage over the long term with traditional steroidal and antibiotic treatment, or even surgery.
BACTERIA OR FUNGUS?
In an article published in the Mayo Clinic Proceedings over a decade ago, it was first suggested that fungal sinusitis may be more commonplace than previously thought. Fungal growth was found in washings from the sinuses in 96% of people with chronic sinusitis. Although some of the individuals included in the study, who didn’t experience symptoms of chronic sinusitis, still had almost as much mucus as the people with chronic sinusitis and it contained activated eosinophils (a type of white blood cell involved in allergic and other reactions). These blood cells release major basic protein (MBP) into the mucus and, although it attacks and kills the fungi, it’s very irritating to the lining of the sinuses. It’s believed that MBP injures the lining of the sinuses and allows bacteria to flourish. The injury to the lining of the sinuses by the fungi and mucus led to the belief that treatment of chronic sinusitis should be directed at the fungi rather than the bacteria. However, the issue seems to be more complex and optimal treatment should also target the underlying inflammatory mechanisms. Recent studies suggest that the immune response to fungi, allowing eosinophils to enter the sinuses, may actually be the problem.
SENSITIVITY TO FUNGI
There’s been much speculation about why people develop sensitivity to fungi. Some believe that it’s as a result of extensive use of antibiotics, causing an overgrowth of fungi. Others contend that it’s the result of extensive exposure to mould and fungi in the environment. According to the Environmental Protection Agency (EPA), all moulds and fungi have the potential to cause ill health. The types of mould present; the extent of your exposure; your age and general health; and your existing sensitivities or allergies are factors which influence the extent to which mould affects your health.
People with health issues related to fungal exposure experience major medical problems, including muscle and joint pain, headaches, anxiety, depression, memory loss, visual and immune system disturbances, and fatigue, gastrointestinal problems and shortness of breath. The most common indoor places for mould to take hold are damp areas, such as:
- Bathrooms and kitchens, especially under sinks – particularly leaky ones
- Behind or under appliances that hide slow plumbing leaks (refrigerators, dishwashers, washing machines, etc.)
- Roof leaks
- Around windows where condensation collects.
Often, the first sign of a mould problem is a musty odour. You may also notice bowed or buckled floorboards, discoloured carpets, a new water stain on your wall, or black or white specks, all signs you could be developing a mould problem. Investigating hidden mould problems may be difficult and will require caution when the investigation involves disturbing potential sites of mould growth. If you believe that you may have a hidden mould problem, consider hiring an experienced professional.
The Mayo Clinic’s pioneering medical treatment for chronic sinusitis is designed to stop antigen release by administering antifungal medication. Without fungal antigens, the immune reaction doesn’t occur; eosinophils don’t enter the nasal mucus; MBP isn’t released; and damage to the nasal and sinus linings is eliminated.
At present, patients are being treated with irrigation using topical antifungals such as Amphotericin B. The Mayo Clinic has found that 75% of patients see an improvement, even though this treatment isn’t yet universally accepted.
Alternative treatments for chronic sinusitis would include antifungal herbals such as olive leaf and grapefruit seed extract, and anti-inflammatory agents such as quercetin, nettle leaf and butterbur. Careful attention to diet would also be supportive. As fungi feed on sugar, complete avoidance of sugar and food containing sugar, refined carbohydrates, packaged and processed food may be recommended.
Reducing carbobohydrates by moderating consumption of fruit, starchy vegetables and dairy may also be beneficial. Dairy products should be eaten in moderation only, as they have a propensity to increase mucus production.
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