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Sinusitis (Rhinosinusitis or Sinus Infection)

Sinusitis (Rhinosinusitis or Sinus Infection)

Sinusitis is a term meaning inflammation of the sinuses. Patients with environmental allergies can be at greater risk for sinusitis as they already have some inflammation present in their nasal passages. This baseline inflammation occurs due to a reaction to the environmental allergens around them.

When sinusitis has a duration of 4 weeks or less it is considered "acute" sinusitis. Sometimes relapses of symptoms or inflammation can occur, deeming the condition "recurrent." When symptoms last longer than 12 weeks, the condition is defined as “chronic” sinusitis.

Acute sinusitis is often due to a viral infection and usually resolves in 7-10 days with supportive symptom management (saline sinus rinses, decongestants, nasal sprays) and the body’s natural ability to fight off illness. If symptoms last longer than 10 days, there is more concern for a bacterial infection and an antibiotic may be prescribed. Interestingly, many cases of bacterial sinusitis may resolve without the use of antibiotics and complications rarely develop.

If your medical provider prescribes antibiotics and symptoms aren’t improving, follow up is indicated. Other serious symptoms that would require follow up include: fevers >102 F that persist longer than 3-4 days, swelling or redness around the eyelids, vision changes, facial drooping or facial muscle weakness, confusion, headache, or inability to move the head/neck.

Chronic sinusitis can develop after an upper respiratory infection, an acute sinusitis that fails to resolve, or slowly over months/years until it becomes a problem. Signs in adults can include: facial pain/pressure, decreased sense of smell, discolored anterior or posterior nasal mucous, nasal stuffiness or congestion. A persistent cough may also occur (especially in children).

Treatment for chronic sinusitis generally includes nasal washes, nasal steroid and possibly oral steroids and/or an extended course of antibiotics. In some cases, sinus surgery may also be needed.

Because chronic sinusitis is a complex disorder of inflammation in the sinuses, it can take a while to treat. If the chronic sinusitis does not improve, evaluation by an Ear, Nose and Throat specialist may be needed to evaluate for nasal polyps, blocked drainage pathways or other problems that predispose to chronic sinusitis.

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Don’t Forget the Drinks if you have Food Allergies

Managing food allergies requires constant avoidance of allergens, emergency preparedness and effective communication. Going out to eat with food allergies can be challenging but is completely doable. When it comes to avoiding allergens while out to eat, the focus in the minds of patrons and eating establishments is often the food, but it is important to keep in mind that beverages can contain allergens as well. Outlined below are key points and tips to consider before you take your sips.

Avoid Cross Contact
Remember that allergens can remain in someone's saliva for several hours after eating and for some people even small amounts of an allergen can cause a severe allergic reaction. To prevent the chance of cross contact drink from your own cup and don't share with others around you. Also remember cross contact can occur with drink stirrers, shakers and other utensils used to mix drinks as with condiments like sprigs of mint or slices of fruit.

Be Aware of All Ingredients Added to the Beverage
This is especially true in the case of mixed drinks. For example if you are allergic to dairy and cream is added to your pina colada, then this can cause an allergic reaction. Some drinks contain raw egg whites - the white 'fuzz' of a Pisco sour, for example, is from beaten egg whites. Raw eggs are particularly dangerous in people with egg allergies.

Know What Ingredients Are in the Beverage
The drink itself may have an allergen in it (for example, wheat in beer). Things to consider here are that since alcohol is not regulated by the Food and Drug Administration (FDA), beverage companies that are bottling alcoholic products do not need to follow current labeling laws and do not need to disclose allergens. In fact, many alcoholic beverages do not list ingredients at all. This certainly becomes an issue for those allergic to wheat, rye, and barley as well as those with celiac disease who need to avoid wheat, rye and barley because of gluten. Similar concerns can arise with wine. If ingredients are unclear then consider calling the company for a list of ingredients. Distilled alcohol is a bit less of an issue but still worth discussing with your healthcare team.

Consider Sulfites
Also, keep in mind that sulfites can exacerbate asthma and in rare cases can cause allergic reactions. Sulfites are commonly found in many alcoholic beverages including wine, beer, ciders and drink mixes added to the alcohol.

Know Alcohol’s Effects
Another issue to take into consideration is the effect of the alcohol itself. Alcohol can decrease our ability to make good decisions and communicate effectively. Other things to consider are that alcohol can decrease the threshold level to trigger an allergic reaction, can decrease the time to develop an allergic reaction, and increase severity. However, alcohol itself is an unlikely allergen.

If you have been prescribed an epinephrine autoinjector, remember to carry this with you at all times, even if you're just going out for a drink.

This article is for educational purposes only. Talk to your healthcare provider before any change in food allergy management.

Find out more about food allergies.

The post Don’t Forget the Drinks if you have Food Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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