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Sinus congestion

If I were to charge friends and family for all the medical advice I give, I’d be able to shop at Sephora a lot more often (which, in retrospect, probably is not a good thing). My last medical question went something like this “so this sinus infection has my face and teeth hurting for a week. What do I do? ”

When our nasal passages and sinuses get congested, all of a sudden you have a greater appreciation for your sense of smell, don’t you?  And now you’re a mouth breather, you have a headache, your nasal passages are taking turns being blocked…UGH.

Usually around this time of year, congestion can be caused by a number of things:
1. An upper respiratory infection (90% of the time viral, not bacterial btw)
2. Irritation from dry, cold air
3. Seasonal allergies

Figuring out the underlying cause of congestion is important to be able to target underlying problem, but in general the regimen for clearing up your sinuses is the same:

1. Saline irrigation (either from OTC spray, or an irritation system like a neti-pot). P.S only use purified or distilled water!
2. Oral or topical (spray)  decongestant – some of these may not be safe for those with cardiac issues so ask your doc.
3. Humidifier – if dry air is exacerbating symptoms

A Word on Antibiotics

Often when patients come to the office complaining of congestion, the conversation inevitably leads to the “do I need an antibiotic for this?”.  And the answer 90% of the time is “you definitely do not”. As I mentioned before, congestion can be caused by things other than infection, and  only 10% of actual sinus infections are bacterial. However, there IS a time and place for antibiotics in some cases.  Based on the guidelines; I may break out the prescription pad if someone has:
– Fever
-Facial pain
-Symptoms ongoing > 2 weeks despite conservative treatment, or initially improved then suddenly worsened again (which can suggest a superimposed bacterial infection).

So for example, for my friend I mentioned in the beginning, since she was experiencing a lot of facial pain ,she might be an appropriate candidate for an antibiotic, in addition to the other methods for decongestion.