Nasal Congestion – Do You Have Sinusitis?

If you are like a lot of individuals in the Washington, DC, Northern Virginia, and Maryland metropolitan area, then you may suffer from allergies. There is an old adage that says that if you move to the Washington, DC area and you do not have allergies, you eventually will! This is not true of course, however, many individuals in the area (whether or not they grew up or moved to the Washington, DC area) do in fact have allergies, particularly allergic rhinitis (i.e., hay fever).

The classic symptoms of allergic rhinitis as well as non-allergic rhinitis may include any or all of the following: nasal congestion, runny nose, post-nasal drip, itchy nose, sneezing, itchy throat, itchy eyes, watery eyes, red eyes, puffy eyes, snoring, fatigue, sinus congestion, headaches, and dark circles under the eyes. Allergies commonly trigger asthma as well. Affected individuals may experience chest tightness, wheezing, coughing, and/or shortness of breath.

It should also be noted that allergies increase the risk of sinus disease, sinus infections, and nasal polyps. Sinus infections can be categorized into 3 distinct types: acute, chronic, and recurrent. It is important for the allergist to be able to distinguish between the three, as the treatment is different for each type.
Acute sinusitis: This type of sinus infection is the most common of the three types and often presents with nasal congestion, sinus pressure and/or pain which can radiate to the teeth, discolored nasal discharge, and a post-nasal drip. Occasionally, a fever may be present in some individuals with acute sinusitis. The diagnosis is usually made by a detailed history and a physical examination. Treatment may necessitate the use of antibiotics, nasal corticosteroids, saline irrigation of the nose, and/or decongestants. Rarely, it may be beneficial to use oral corticosteroids is severe cases.

Chronic sinusitis: The common manifestations of a chronic sinus infection generally include nasal congestion, facial pressure/pain, headache, discolored nasal discharge, post-nasal drip, cough, loss of taste and smell, and/or malaise. The diagnosis requires a comprehensive history of onset and progression of specific symptoms, a detailed physical examination, and imaging studies such as CT scans and/or sinus X-rays. The management of chronic sinusitis usually entails a prolonged course (e.g., 30 days) of antibiotics in addition to nasal corticosteroids, saline irrigation of the nose, and/or decongestants. It may be necessary to give another prolonged course of antibiotics in recalcitrant cases. Surgical intervention may also be necessary if medical therapy is unsuccessful. It is important to note that some individuals may only present with chronic nasal congestion as their only symptom.

Recurrent sinusitis: This type of sinus condition is merely repetitive acute sinus infections. Individuals that get repeated episodes of acute sinusitis may have an immune disorder or a weakened immune system. It is thus important to see a board certified allergist/immunologist like the ones at Black & Kletz Allergy. Blood tests to assess a patient’s immune system are often ordered in individuals who suffer from recurrent sinusitis in order to rule out or diagnose an immune defect. Patients who are found to have an immunodeficiency are then treated with appropriate therapy depending upon their specific immune defect. In addition, the sinus infection is treated with antibiotics, topical nasal corticosteroids, saline irrigation of the nose, and/or decongestants.

The prevention of sinusitis includes identification of specific allergen sensitivities by allergy testing by a board certified allergist. Allergy testing may be done by skin testing or blood testing depending upon the circumstance and age of the patient. The aggressive treatment of allergic seasonal and/or perennial rhinitis (i.e., hay fever) promotes proper sinus drainage and improves upper airway function.

Therapies used to treat allergic rhinitis may include antihistamines, nasal corticosteroids, nasal antihistamines, saline irrigation of the nose, decongestants, leukotriene antagonists, and/or allergy immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization, allergy hyposensitization). Allergy shots are effective in 80-85% of patients who take them. They have been used in the U.S. for more than 100 years and are used in both children and adults.

The board certified allergists at Black & Kletz Allergy have been diagnosing and treating sinusitis for more than 50 years. We treat both adult and pediatric patients. Black & Kletz Allergy has offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All 3 of our offices have on-site parking. For further convenience, our Washington, DC and McLean, VA offices are Metro accessible. Our McLean office location offers a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. For an appointment, please call our office or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. If you suffer from allergies and/or sinus-related symptoms, we are here to help alleviate or hopefully end these undesirable symptoms that have been so troublesome, so that you can enjoy a better quality of life. Black & Kletz Allergy is dedicated to providing the highest quality allergy care in a relaxed, caring, and professional environment.