Health & Wellness
New Ways to Keep Your Sinuses Healthy and Clear

New Ways to Keep Your Sinuses Healthy and Clear

Allergy experts weigh in on new treatments and advances
By Sarah E. King

While the springtime brings flowers and warmer weather, it can also bring itchy eyes, a runny nose and sneezing. If you've lived in Atlanta a while you are familiar with these symptoms. Whether you've just developed them or have struggled with them for most of your life, there are constant advancements happening in the allergy and sinus field to help give you some relief.

Finding the Source

When the sneezing and sore throat first set in, it can be difficult to determine an allergy symptom versus something more. Dr. Stanley Fineman of the Atlanta Allergy and Asthma Clinic says a viral infection, like a cold, is usually associated with congestion, coughing and sometimes a low-grade fever. An allergy, however, when triggered by a true allergic reaction, can display the same symptoms of congestion. "It is typically not associated with fever and people can feel run down, but it's not the same achiness as the virus," he says. "People tend to get more of the sneezing and itching. Allergies also last more than five days and usually last as long as you are exposed to the allergen."

It is also important to clarify the difference between allergies and asthma. "Generally, when people talk about allergies, they are referring to nasal allergy symptoms," Dr. Fineman says. "When people talk about asthma, they talk about chest symptoms. They can both be triggered by the same allergens, like a pollen or dust or an animal."

One way to identify an allergen, versus an infection, is to pay attention to when you start to feel ill. Once you begin to recognize certain symptoms, an allergy skin test is an ideal way to pinpoint the cause. An infection, however, can mask itself as an allergic reaction. "Differentiating between an upper respiratory infection and nasal allergies can be quite difficult because they share many of the same symptoms," says Dr. Rodney Johnson of Atlanta ENT, Sinus and Allergy Associates. "In addition, if one has chronic nasal allergies, this can often lead to sinus infections." Once you've determined your allergy symptoms, the next step is finding the right course of action.

Getting the Treatment

Dr. Eugene S. Hurwitz, medical director for the Center for Allergy and Asthma of Georgia, says many people who have allergies often suffer unnecessarily during peak seasons. "There are a variety of treatment options available to patients with allergies that can control their symptoms and bring relief," he says. "Avoidance is the best allergy treatment and should be continued even when taking medication or receiving allergy shots." Dr. Hurwitz also recommends taking antihistamines, decongestants and inhaled medications to control symptoms like sneezing, watery eyes, runny nose and congestion. "Today's medications for allergies are better than ever and many do not cause side effects," he says. "These include prescription nose sprays and new antihistamines."

Allergy shots and immunotherapy are also effective in gradually decreasing sensitivity and building immunity to allergy triggers. Dr. Hurwitz says allergy shots often reduce and can eliminate the need to take medication and are "recommended for patients when medications are not effective, if they experience side-effects from medications or are having frequent problems related to their allergies, including repeated episodes of sinusitis and asthma."

According to Dr. Johnson, allergy shots are the only treatment that alters the immune system in a semi-permanent manner. "It's the only treatment that makes you less allergic. It is kind of a 'partial cure,' which means after you complete the allergy shot regimen, you can still benefit and have allergy symptom relief for years to come, even though you are not still receiving the shots," he says. Allergy shots require a commitment of three to five years, after the initial build-up period. For common infections and throat ailments, Dr. Johnson says people can prevent respiratory infections by using good health habits and common sense.

Treatments You Need to Know About

Balloon sinuplasty
This minimally invasive procedure "is designed to enhance the normal anatomy of the sinuses to improve patient function," Dr. Elaina George, owner of Peachtree ENT Center, says. "It relieves facial pressure and congestion, and eliminates the number of sinus infections and the duration of sinus infections. It's like angioplasty for the sinuses." The FDA approved procedure has been around for four years and is growing in popularity. It requires no down time and provides immediate relief often before the procedure is over and is a fraction of the cost for invasive surgery. "There is no damage to the natural anatomy,"

Dr. George says. "All you are doing is making the natural openings of the sinuses larger. There is no trauma, which is why the recovery time is so fast." Patients who suffer from current sinus infections more than three to five times a year, or those who have been on antibiotics or treatment for allergies and are not getting relief, are good candidates for this procedure.

Oral Immunotherapy (OIT)
This on-the-horizon therapy is a treatment for food allergies. "Until recently, the only therapy was avoidance of the particular food and carrying an epinephrine auto-injector at all times in case of accidental exposure," Dr. Johnson says. "OIT is similar to allergy shots in that there is a build-up-time of increasing doses of a food until one reaches full dose."

However, Dr. Johnson says to note that this procedure is not widely practiced in clinical allergy tests, "as many experts and researchers in allergy and immunology currently feel that too little is known about the proper dose, frequency of dose, and safety for it to be used routinely."

Allergy Drops
Allergy drops will be a convenient way for patients to administer allergy doses at home. These drops are not yet approved by the FDA, and are not yet covered by insurance. "We offer them to patients who cannot come in for shots for some reason, such as those who travel frequently," Dr. Hurwitz says. "For many patients, they are very effective and offer a new solution."

Rush Immunotherapy
This procedure is more recognized in the treatment of allergic rhinitis and venom allergies such as honeybee, wasp and fire ant. "When allergy shots are started, there is a build-up period of time of weekly shots that can take up to six months to reach full dose," Dr. Johnson says. "During this build-up time, there is not much benefit in allergy symptom reduction. Rush Immunotherapy is a faster method to build-up one's immune system to tolerate the higher doses required to induce clinical benefit so that allergy sufferers feel better faster." After performing Rush Immunotherapy, a patient can reach maintenance allergy shot doses in six weeks.

What's Wrong with Me?

When the sniffles hit, it is important to know what you're dealing with.

SINUS INFECTION – an inflammation of the sinuses, the hollow cavities within the cheekbones, around your eyes and behind your nose

Cause: According to the Atlanta Allergy and Asthma Clinic, a sinus infection is caused by a bacterial infection, such as a cold, when something blocks the mucus in these cavities from draining normally.
Symptoms: Thick nasal discharge, congestion, cough, headache, pain in the teeth and postnasal drip.
Prevention: Dr. Johnson of Atlanta ENT says sinus infections can be prevented by covering your mouth and nose when coughing or sneezing and frequent hand washing.

COLD – a group of symptoms in the upper respiratory tract caused by a large number of different viruses

Cause: More than 200 viruses can cause the common cold.
Symptoms: Dr. Fineman of Atlanta Allergy and Asthma Clinic says symptoms include congestion, coughing, sometimes a low grade fever, and aching.
Prevention: According to WebMD, the best prevention for the common cold is frequent hand washing – more than 80 percent of contagious diseases are transmitted by touch.

INFLUENZA – the "flu" is an extremely contagious respiratory illness

Cause: Influenza is caused by the influenza A and B viruses.
Symptoms: Coughing, headache, chest discomfort, high fever, fatigue and weakness.
Prevention: One of the best ways to prevent the flu, according to WebMD, is to get vaccinated. Good hygiene, eating a balanced diet and staying healthy also help support the immune system.

STREP – a bacterial infection in the throat and the tonsils

Cause: Caused by streptococcal bacteria.
Symptoms: Symptoms include a sudden and severe throat pain when you swallow, fever, swollen tonsils and white or yellow spots on the back of a bright red throat.
Prevention: Dr. Johnson says the prevention for strep throat is similar to preventing a sinus infection.

THRUSH – a yeast infection that causes white patches in the mouth and on the tongue

Cause: Certain illnesses, stress or medications can disturb the delicate balance of the fungus candida, which are present in the mouth and digestive tract, and causes the candida to grow out of control.
Symptoms: A burning feeling in the mouth and throat, white patches that stick to the mouth and tongue, and difficulty tasting food.
Prevention: Follow good hygiene practices, brush your teeth twice a day, limit the amount of sugar and yeast-containing foods and visit your dentist regularly.

Editorial Resources
Dr. Eugene S. Hurwitz, Center for Allergy and Asthma of Georgia,
Dr. Elaina George, Peachtree ENT Center,
Dr. Rodney Johnson, Atlanta ENT, Sinus and Allergy Associates,
Dr. Stanley Fineman, Atlanta Allergy and Asthma Clinic,