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Why Do We Suffer From
Nasal And Sinus Discomfort?
The body's nasal and sinus membranes have similar responses to
viruses, allergic insults, and common bacterial infections.
Membranes become swollen and congested. This congestion causes pain
and pressure; mucus production increases during inflammation,
resulting in a drippy, runny nose. These secretions may thicken over
time, may slow in their drainage, and may predispose to future
bacterial infection of the sinuses.
Congestion of the nasal
membranes may even block the eustachian tube leading to the ear,
resulting in a feeling of blockage in the ear or fluid behind the
eardrum. Additionally, nasal airway congestion causes the individual
to breathe through the mouth.
Each year, more than 37 million
Americans suffer from sinusitis, which typically includes nasal
congestion, thick yellow-green nasal discharge, facial pain, and
pressure. Many do not understand the nature of their illness or what
produces their symptoms. Consequently, before visiting a physician,
they seek relief for their nasal and sinus discomfort by taking
non-prescription or over-the-counter (OTC) medications.
What Is The Role Of
OTC Medication For Sinus Pain?
There are many
different OTC medications available to relieve the common
complaints of sinus pain and pressure, allergy problems, and
nasal congestion. Most of these medications are combination
products that associate either a pain reliever such as
acetaminophen with a decongestant or an antihistamine. Knowledge
of these products and of the probable cause of symptoms will
help the consumer to decide which product is best suited to
relieve the common symptoms associated with nasal or sinus
inflammation.
OTC nasal medications are designed to
reduce symptoms produced by the inflammation of nasal membranes
and sinuses. The goals of OTC medications are to: (1) reopen to
nasal passages; (2) reduce nasal congestion; (3) relieve pain
and pressure symptoms; and (4) reduce potential for
complications. The medications come in several forms.
Nasal Saline Sprays:
Non-Medicated Nasal Sprays
Nasal saline is an invaluable
addition to the list of over-the-counter medications. It is
ideal for all types of nasal problems. The added moisture
produced by the saline reduces thick secretions and assists in
the removal of infectious agents. There is no risk of becoming
"addicted" to nasal saline. It should be applied as a mist to
the nose up to six times per day. Nasal saline can also be made
at home: contact your otolaryngologist for details.
Nasal Decongestant Sprays:
Medicated Nasal Sprays
Afrin nasal spray, Neo-Synephrine, Otrivin, Dristan nasal
spray, and other brands decongest the swollen nasal membranes.
They clear nasal passages almost immediately and are useful in
treating the initial stages of a common cold or viral infection.
Nasal decongestant sprays are safe to use, especially
appropriate for preventing eustachian tube problems when flying,
and to halt progression of sinus infections following colds.
However, they should only be utilized for 3-5 days because
prolonged use leads to rebound congestion or "getting hooked on
nasal sprays." The patient with nasal swelling caused by
seasonal allergy problems should use a cromolyn sodium nasal
spray. The spray must be used frequently (four times a day)
during allergy season to prevent the release of histamine from
the tissues, which starts the allergic reaction. It works best
before symptoms become established by stabilizing the nasal
membranes and has few side effects.
Decongestant Medications
Pressure and congestion are common symptoms of nasal passage
swelling. Decongestant medications are OTC products that relieve
nasal swelling, pressure, and congestion but do not treat the
cause of the inflammation. They reduce blood flow to the nasal
membranes leading to improved airflow, less breathing through
the mouth, decreased pressure in the sinuses and head, and
subsequently less discomfort. Decongestants do not relieve
drippy noses. Their side effects may include light headedness or
giddiness and increased blood pressure and heart rate. (Patients
with high blood pressure or heart problems should consult a
physician before use.) In addition, other medications may
interact with oral decongestants causing side effects. Both of
these are available as single products or in combination with a
pain reliever or an antihistamine. They are labeled as
"non-drowsy" due to a side effect of stimulation of the nervous
system.
Decongestant-Combination Products
Some medications are combined
to reduce the number of pills. Tylenol® Sinus or Advil Cold and
Sinus® exemplify products that join a pain reliever
(acetaminophen or ibuprophen) with a decongestant
(pseudoephedrine). These products relieve both sinus and
cold/flu symptoms yet retain all the attributes of the
individual drug including side effects.
Antihistamine
Medications
Antihistamines combat allergic problems leading to nasal
congestion. OTC antihistamines such as diphenhydramine
(Benadryl®), or clemastine (Tavist®) may be used for relieving
allergic symptoms of itching, sneezing, and nasal congestion.
They relieve the drainage associated with the allergic
inflammation but not obstruction or congestion. Antihistamines
have a potential for sedation causing grogginess and dryness
after use. Newer nonsedating antihistamines are available.
Antihistamine-Decongestant Combination Products
Antihistamines and decongestant
products are often combined to relieve multiple symptoms of
congestion and drainage and reduce the side effects of both
products. Antihistamines produce sedation; decongestants are
added to make them "non-drowsy." The combined allergy product
then relieves congestion and a runny nose.
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