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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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Grass Pollen Allergy

If the smells of freshly cut lawns make you sneeze, you may have a grass pollen allergy. Grass pollen is a common cause of allergy. Every spring and summer, plants release tiny pollen grains to fertilize same species plants. Grass pollen can trigger allergic reactions.

If you are experiencing these symptoms, grass pollen may be the trigger:

  • Runny nose
  • Sneezing
  • Itchy nose, eyes, ears and mouth
  • Stuffy nose (nasal congestion)
  • Red and watery eyes
  • Swelling round the eyes

 Since grass pollen grains may not be visible to the eye, your body may react even to tiny amounts of pollen in the air. With Oklahoma’s strong winds, pollen is distributed across the state.

Also known as hay fever, allergists refer to pollen allergy as seasonal allergic rhinitis.

What grasses cause allergy symptoms?

Fortunately, only a few grasses cause allergic symptoms. Where you live also plays a factor in grass allergy.

The most common grasses causing allergies are:

  • Bermuda
  • Johnson
  • Kentucky
  • Orchard
  • Rye
  • Sweet Vernal
  • Timothy

Living in Oklahoma, grass can pollinate through most of the year. Tiny, light and dry – grass pollen grains can travel for hundreds of miles.

“The first step is to get tested and diagnosed,” said OAAC Allergist Dr. Bret Haymore. “Once your allergist knows what specific allergens causing your symptoms, then we can work with you to create a treatment plan.”

Options for treatment include over-the-counter medicines, liquids or nasal sprays and prescription pills (also known as antihistamines, decongestants and nasal steroids). These can help reduce or prevent grass allergy symptoms.

“Grass allergy pollen medicines work best when you start taking them before pollen season begins,” said Dr. Haymore. “This will allow the medicines to prevent your body from releasing histamine and other chemicals that cause your symptoms.”

Another option if those medicines are no longer helping, may be immunotherapy or allergy shots. There are two types of grass allergy immunotherapy – allergy shots and allergy tablets. 

“Immunotherapy is a long-term course of treatment that can reduce or even prevent the severity of allergic reactions,” he said. “Allergy shots usually take a one-to-three-year commitment and can modify the body’s immune response to allergens.”

Allergy shots or subcutaneous immunotherapy (SCIT) are given at the OAAC clinics. Patients are monitored for any type of reaction to the shot. Most common side effects include local reactions at the injection site – redness, itching, swelling, tenderness, and pain. Less common reactions may include generalized redness, hives, itching, swelling, wheezing and low blood pressure.

Allergy tablets or sublingual immunotherapy (SLIT) can be done at home. This therapy involves placing a tablet containing the allergen under the tongue for one to two minutes and then swallowing it. Treatment must begin before grass allergy season and continues throughout grass allergy season. Taking the daily tablets may reduce grass allergy symptoms. There can be some side effects, and some can be serious. Please discuss with SLIT therapy with your OAAC provider about treatment options.

The post Grass Pollen Allergy appeared first on Oklahoma Allergy and Asthma Clinic.

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