Treating sinusitis

Most people with sinusitis don't need to see their GP. The condition is normally caused by a viral infection that clears up on its own.

Your symptoms will usually pass within two or three weeks (acute sinusitis) and you can look after yourself at home.

If the condition is severe, gets worse, or doesn't improve (chronic sinusitis), you may need additional treatment from your GP or a hospital specialist.This can be difficult to treat and it may beseveral months before you're feeling better.

Looking after yourself at home

If your symptoms are mild and havelasted less than a week or so, you can usually take care of yourself without seeing your GP.

The following tips may help you feel better until you recover:

• Take over-the-counter painkillers such as paracetamol and Painkillers, ibuprofen to relieve a high temperature and pain check the leaflet that comes with your medication first to check it's suitable, and never give aspirin tochildren under 16 years of age.
• Useover-the-counter decongestant nasal spraysor drops to help unblock yournose andallow you to breathe more easily these shouldn't be used for more than a week at a time.
• Apply warm packs to your face to soothe your pain and help mucus drain from your sinuses.
• Regularly clean the inside of your nose with a salt water solution to helpunblock your nose and reduce nasal discharge.

Cleaning inside your nose

You can clean the inside of your nose using either a home-made salt water solution or a solution made with sachets of ingredients bought from a pharmacy.

To make the solution at home, mix a teaspoon of salt and a teaspoon of bicarbonate of soda into a pint of boiled water that has been left to cool. To rinse your nose:

• wash and dry your hands
• stand over a sink, cup the palm of one hand and pour a small amount of the solution into it
• sniff the water into one nostril at a time

Repeat these steps until your nose feels more comfortable (you may not need to use all of the solution). You should make a fresh solution each day. Don't re-use a solution made the day before.

Special devices you can use instead of your hand are also available for pharmacies. If you choose to use one of these, make sure you follow the manufacturer's instructions about using and cleaning it.

Treatments from yourGP

See your GP if your symptoms are severe, don't start to improvewithin 7 to 10 days, or are getting worse. They may recommendadditional treatment with corticosteroid drops or sprays, or antibiotics .

If these treatments don't help, you GP may refer you to an ear, nose and throat (ENT) specialist for an assessment and to discuss whether surgery is a suitable option.

Corticosteroid drops or sprays

Corticosteroids,also known assteroids, are a group of medications that can help to reduce inflammation.

If you have persistent symptoms of sinusitis, your GP may prescribe steroid nasal drops or spraysto help reduce the swelling in your sinuses. These may need to be used for several months.

Possible side effects include nasal irritation, a sore throat and nosebleeds .

Antibiotics

If your GP thinks your sinuses may be infected with bacteria, they will prescribe a course of antibiotic tablets or capsules to treat the infection.

You'll usually need to take these fora week, although sometimes a longer course may be prescribed.

Possible side effects of antibiotics include feeling and being sick, diarrhoea and abdominal (tummy) pain .

Surgery

If your symptoms don't improve despite trying the treatments mentioned above, a type of surgery called functional endoscopic sinus surgery (FESS) may be recommended. This is a procedure to improve the drainage of mucus from your sinuses.

FESSis usually carried out under general anaesthetic . During the procedure, the surgeon will insert an endoscope into your nose. This is a thin tube with a lens at one end that magnifies the inside of your nose. It will allow the surgeon to see the opening of your sinuses and insert small surgical instruments.

The surgeon will then either:

• remove any tissues, such as nasal polyps (growths) , that are blocking the affected sinus
• inflate a tiny balloon in the drainage passages from your sinuses to widen them, before the balloonis deflated and removed (this is known as a balloon catheter dilation)

Potential side effects and risks of these procedures include temporary discomfort and crusting inside the nose, bleeding from the nose and infection. Make sure you discuss the risks with your surgeon beforehand.

The ENT UK website has more information about functional endoscopic sinus surgery . The National Institute for Health and Care Excellence (NICE) also provides information about balloon catheter dilation for chronic sinusitis .