A persistent inflammation of the sinuses can be caused by a number of causes, but allergies are the most common cause by far. The body's response to allergic rhinitis can vary but symptoms such as a constant pressure, tiredness and puffy eyes suggest a mucus build-up and a possible polyp formation.
Certain investigations might have to be carried out based on clinical findings. These include an X-ray of the paranasal sinuses, a CT scan of the sinuses and a nasal endoscopy.
The nasal endoscopy may simultaneously be diagnostic and therapeutic, as it will help clear the sinuses.
Rhinitis can be infectious in nature too, however symptoms are markedly different from those of allergic rhinitis. An infection will be accompanied by a fever, increase in the neutrophil and lymphocyte count, and mucus that is greenish in color.
A case of allergic rhinitis will be characterized by the lack of fever and purulent mucus. This is greenish in color while the uninfected kind will be clear in color. It is this over-activity of the sinus lining due to constant irritation that leads to a large amount of mucus being produced. This in turn causes a feeling of heaviness and increased pressure leading to tiredness.
A blood count showing increased counts of eosinophils and IgE will also be indicate an allergic reaction.
This condition can co-exist with an obstructive airway disease which can reduce the amount of oxygenation in the body and is typified by achieving quick sleep. This may or may not be related to the allergic rhinitis condition.
If the diagnosis is confirmed to be allergic in nature then there is no need for antibiotics even though they are commonly prescribed for sinusitis treatment.
The thing to remember with this treatment is that it will be long-term and in some cases continues for life. The treatment itself is not that complicated. An attempt will be made to identify the allergen that is causing these symptoms; however that is more than likely to end up with a non-specific answer.
There are far too many causes that can cause similar symptoms. The next mode of treatment will be to clear the sinuses and remove the polyp if it is formed in the sinuses.
This can be done by nasal endoscopy and is a relatively straightforward procedure. Symptom relief is immediate; however the tendency for polyps to recur is quite high.
Long-term management of the allergy will include anti-histamine drugs which should be preferably non-sedating in nature. This will help improve the quality of life that the patient can lead and prevent a constant feeling of tiredness.
Steroid nasal sprays and nasal decongestants will also form a part of the over all management of the problem.
If any evidence of obstructive sleep disorders is found that needs to be taken care of. The treatment for that can require surgery in rare cases.
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