Swelling, infection,heavy mucus generation or irritation of the sinuses' lining for more than 12 weeks causes chronic rhinosinusitis or CRS. The drainage of the mucus can become stuckbecause of the swollen lining of the sinuses.

Chronic Rhinosinusitis

Other than lasting for at least 12 weeks, two out of the following symptoms are caused by chronic rhinosinusitis or CRS:

  • Congestion in the nasal cavity.
  • Dripping down of mucus discharged down via the throat.
  • Fullness, pressure and facial pain.
  • The sense of smelling will be diminished.

Chronic Rhinosinusitis or CRS is a unique forms of rhinosinusitis (acute rhinosinusitis) normally a temporary rhinosinusitis occurring post having colds.

The approach for treating chronic rhinosinusitis or CRS is specific due to its persistence. The symptoms slowly progresses and more subtle and thus healthcare providers and patients sometimes overlook this situation.

The probability of having chronic rhinosinusitis or CRS can be high if you have had multiple symptoms stipulated above. Ask your doctor of the possibility other continuing with multiple antibiotics.

Deviated nasal septums, growths that are abnormal at nasal polyps (sinuses) are some of the causes of chronic rhinosinusitis or CRS in some patients. Children can also be affected despite the fact that middle aged adults and the young adults are the most affected.

Nasal Polyp and Chronic Rhinosinusitis or CRS: Growth that is abnormal in the nose of the patients with chronic rhinosinusitis or CRS is known as nasal polyps. The clogging of the sinuses by polyps can occur when they are numerous and grow abnormally large. The formation of the nasal polyps has not yet been discerned by scientists. The polyps can be treated through surgical removal and shrinking. Sometimes both procedures are needed in some patients.

Causes of Chronic Rhinosinusitis or CRS

The following are the major causes of chronic rhinosinusitis or CRS:

  • CRS caused by allergies: People in the general populace are less affected by allergies than those with chronic rhinosinusitis or CRS. This is more elaborate in allergies that are commonly around like molds, cockroaches, animal dander and dust mites. Symptoms of chronic rhinosinusitis or CRS can be worsened by these allergens.
  • Viral infections: Repeated viral infection in some individuals leads to the development of chronic rhinosinusitis or CRS. Despite the fact that it cannot be ascertained, common cold is such a viral infection.
  • Deviated Sputum: The separation that divides the two nose channels is known as septum and it might not be straight in some people. A deviated septum is the term given to this condition. Injury to the nose later in life may give rise to this situation and it can also be from birth. Chronic rhinosinusitis or CRS is not caused by this condition of the nose but blockage will result.
  • CRS due to airborne irritants and tobacco exposure: Risks of chronic rhinosinusitis or CRS can be increased by environmental toxins like, formaldehyde and exposure to cigarette smoke.
  • Disorders of the human immune system: Majority of those with chronic rhinosinusitis or CRS have immune systems that are normal. Increase of risk is higher to those with chronic rhinosinusitis or CRS. Chest and ear infection can also occur.
  • Nasal Polyps: The sinuses or nasal polyps can be blocked by growths of tissues.
  • Face Trauma: Sinus passage can be blocked by a broken or fractured facial bone.
  • Other medical conditions: Nasal blockage can occur owing to cystic fibrosis complication, HIV, gastroesophageal reflux, amongst other diseases that are immune system related.

Signs and Symptoms of Chronic Rhinosinusitis or CRS

Signs and symptoms for acute rhinosinusitis and chronic rhinosinusitis or CRSare the same but the fact that acute sinusitis is an infection that is temporary and always occur due to cold. Chronic rhinosinusitis or CRS diagnosis must be ascertained through the occurrence of two of the following symptoms:

Symptoms for Acute Rhinosinusitis

  • You will have a drainage that is yellow thick/greenish discharge from your nose or back through throat.
  • Obstruction or congestion of the nasal makes it difficult to breath via the nose.
  • Eye, cheeks, nose even forehead pain, swelling and tenderness.
  • The sense of smell and taste is reduced.

Other signs and symptoms of chronic rhinosinusitis or CRS include:

  • Ear pain
  • The teeth and upper jaw will ache
  • Worse coughs at night
  • Throat soreness
  • Bad breath
  • Irritability or fatigue
  • Nausea

Despite the fact that the symptoms of chronic rhinosinusitis or CRS are the same as those of acute sinusitis, the duration of chronic rhinosinusitis or CRS is much longer and fatigue being more significant. Fever is minimal in chronic rhinosinusitis or CRS than in acute sinusitis.

Risk Factors for Chronic Rhinosinusitis or CRS

Increased risks of having recurrent and chronic rhinosinusitis or CRS increasing include:

  • Abnormality of nasal passage, example nasal polyps and deviated septum.
  • Respiratory symptoms caused by aspirin.
  • Disorder of the immune system for example, cystic fibrosis or HIV /AIDS.
  • Allergic condition affecting your sinuses or hay fever.
  • Asthma. 20% of patients with chronic rhinosinusitis or CRS are asthmatic.
  • Pollutants like smoke from cigarette with regular exposure.

Complications in Chronic Rhinosinusitis or CRS

Complications of chronic rhinosinusitis or CRS are:

  • Asthma flare-ups. Asthma attack can be triggered by chronic rhinosinusitis or CRS.
  • Meningitis. The fluids surrounding the spinal cord and the brain are inflamed by chronic rhinosinusitis or CRS.
  • Vision problems. Permanent blindness if not reduced vision, can result with the spread of the infection going to the eye socket.
  • Blood clots or aneurysm. Veins that surround the sinuses can be blocked which causes blood insufficiency in the brain posing the danger of stroke.

Tests to Diagnose Chronic Rhinosinusitis or CRS

Tenderness on your throat or nose should be detected by your doctor first to confirm cause of symptoms of chronic rhinosinusitis or CRS. In order to observe the inside of your nasal, he/she may:

  • Hold open the nose using a tool.
  • Constriction of blood vessels in the nose by applying medication.
  • Fluid and inflammation detection can be used when by shining light to the nasal cavity.

Other abnormalities or nasal polyps are physical conditions that can be ruled out through visual inspection. Chronic rhinosinusitis or CRS can also be screened by your doctor through other viable methods:

  • Nasal endoscopy. The inside of the sinuses can be inspected by the doctor using endoscope (thin, flexible tube) with fiber-optic light. It is also known as rhinoscopy.
  • Imaging studies. Use of MRI (magnetic resonance imaging) or CT (computerized topography) to take images showing in details the sinuses and the nasal location. Detection of hidden physical obstruction or deep inflation can be detected.
  • Sinus and nasal cultures. No need to diagnose chronic rhinosinusitis or CRS using cultures. Unresponsiness to treatment or progress, it might be necessary to use cultures for bacterial and fungal detection.
  • Allergy test. A skin allergy test might be recommended by your doctor if he/she suspects it to be the cause of the condition. Allergy can be pinpointed the cause of your nasal flare-ups via a skin allergy test since it is quick and safe.

Treatment for Chronic Rhinosinusitis or CRS

The aim or purpose of chronic rhinosinusitis or CRS treatment is to:

  • Reduction of sinus inflammation
  • Keeping nasal passage draining
  • Eliminating the underlying cause
  • Reduction of amount of sinusitis flare-ups

Treatments to Relieve the Symptoms of Chronic Rhinosinusitis or CRS

Chronic rhinosinusitis or CRS symptoms can be relieved when your doctor recommends. These include:

  • Saline nasal irrigation that is sprayed on the nose for rinsing nasal passage
  • Inflammation is prevented and treated by these nasal sprays. Baclomethasone (beconase AQ), mometasone (Nasonex), fluticasone (Flonase), budesonide (Rhinocort aqual) and triamicinolone (NasacortAQ).
  • Injected or oral corticosteroids. Nasal polyps might cause severe sinusitis and these medications can reduce it. Methylprednisolone and prednisone are the examples. Due to the side effects that might occur due to long term use of oral corticosteroids, they are only used to treat symptoms that are severe.
  • Decongestants. The availability of this medicine is OTC (over-the-counter) and it is nasal sprays, capsules and liquid forms. Actifed and Sudafed are examples of OTC decongestant. Nasal spray example is Oxmetazoline (Afrin) which a nasal spray. Rebound congestion (more severe returning congestion) can result if these medications are used for a long time. Thus it is recommended to be used for a few days.
  • Ibuprofen (Advil, Motrin IB, others), Aspirin or Acetaminophen (Tylenol, others) are examples of OTC pain relievers. Anyone below the age of 18 risks getting Reye's syndrome that is more life threatening when they take aspirin. Chronic rhinosinusitis or CRS can also be worsened by some of this medication and medical advice from your doctor should be sought prior to taking pain relievers.
  • Aspirin desensitization treatment can be applied for those having reaction to aspirin which can cause sinusitis. Only specialized medical centers and clinics offer this treatment.

Studies are still underway on the effective mode of medication deliverance to the chronic rhinosinusitis or CRS.

Antibiotics for Treating Chronic Rhinosinusitis or CRS

Bacterial infections and sinuses might require antibiotics sometimes. Antibiotics do not apply since chronic rhinosinusitis or CRS is not caused by bacteria.

Immunotherapy for Chronic Rhinosinusitis or CRS

Reducing the allergic reaction of the body is recommended when allergy is the main contributing factor of chronic rhinosinusitis or CRS. Thus, the use allergic shots (immunotherapy) treat the condition.

Surgery for Treating Chronic Rhinosinusitis or CRS

The valid option if incase of resistance of CRS to medication or treatment is endoscopic sinus surgery. An endoscope is a thin tube that is flexible and light attached in order to explore the sinus passage. If the nasal blockage is caused by polyp, then the doctor can shave it away or remove the tissue. Drainage can also be promoted through enlargement.

Managing Chronic Rhinosinusitis or CRS

Managing and relieving symptoms of chronic rhinosinusitis or CRS can be achieved through these self-help steps:

  • Rest. Speed recovery will be attained and also boosting the body to fight inflammation.
  • Water and juice are fluids that have to be used. Drainage can be enhanced and also its secretion. Alcohol and caffeine can be dehydrating and thus beverages of such sort should be avoided. The swelling in the sinuses lining and nose can be worsened by alcohol.
  • Moisturizing the sinus cavity. Use a bowl of medium-hot water for vapor while you have draped your head with a towel. The vapor shall be directly adjourned to your face. Or breathe the moist air when you are taking a shower. Mucus will drain and also the pain will ease.
  • Warm-compress your face. Facial pain can be eased by placing a damp towel on the cheeks, eyes and nose.
  • Rinse the nasal passage. You can rinse your nasal passage with the following; saline canister, neti pot and squeeze bottle (sinus rinse, others). You can clear sinuses by using home remedy known as lavage. Use water that is free from contamination if you are making the rinse (distilled, boiled and cooled, sterile filtering with filter that does have pores that is 1 micron or lesser. The device that you use for irrigation shall be rinsed after each use with water free from contamination and leave it in the open to dry.
  • Sleep while you have elevated your head. Congestion of the chronic rhinosinusitis or CRS will be reduced because it will drain.

Home Remedies for Chronic Rhinosinusitis or CRS

Honey as a Natural Treatment for Chronic Rhinosinusitis or CRS

Bacterias are easily killed byhoney in all dimensions more so to the drug resistance biofilms which is the reason for difficulty in treating chronic rhinosinusitis or CRS.
In a research study it was found out that biofilms-grown bacteria and planktonic homey proved to be more effective than antibiotics that were commonly used in eleven isolates out of three separate biofilms.

Important clinical implication might be held in such findings regarding the process of combating refractory chronic rhinosinusitis or CRS. This the common chronic infection in North America and people who are affected annually in the United States add up to 31 million.

Neti Pot/Nasal Irrigation for Chronic Rhinosinusitis or CRS

Neti pot the most famous method of irrigation despite the fact that there are a couple of other methods (Aladdin's magic lamp and a plastic or ceramic with the portrait of a cross between teaspoons that is small. Neti pot as a form of nasal drainage is still being known in the US despite being around for centuries. The origin of neti pot is yoga/ayurvedic treatment tradition.

In order to clear away the nasal cavity after sinus surgery, the surgeons of ear, nose or throat, may recommend that one undergoes neti pot irrigation method for chronic rhinosinusitis or CRS. Use of neti pot is now wide since those who have sinus symptoms from environmental irritants and allergies. Facial pain and pressure have been elevated through the use of neti pot and other devices because of the drainage enhancement mechanism. When used with the standard treatment of sinus, nasal irrigation helps in relieving sinus symptoms, according to research. Some speculate that nasal irrigation is enough to relive sinus symptoms without requiring medication.

The mucus is thinned and flashed out with the use of Neti Pot. That is the basic explanation.

Biologically approaching Neti Pot usage for chronic rhinosinusitis or CRS, it can be elaborate that how it works is that the tiny hair-like structures, known as cilia lining the sinus and nasal cavities. The cilia waves back and forth and in the process pushes mucus to the throat where you can swallow or at the front where you can blow easily. Coordination and the speed can be enhanced through the use of saline solution because movement will be more effective and thus allergens and irritants causing sinus problem will be removed.

Natural Treatments for Chronic Rhinosinusitis or CRS

Chronic Rhinosinusitis or CRS can be treated using several approaches that are non medicinal and people can use. Mineral and vitamin support should be basic that should be emphasized and ensured. Vitamins should be A, C and E while minerals include Zinc and Selenium. Overall health can be enhanced through these supplements and thus normal people can also use.

Impairment of the cell membrane can result due to radicals and these vitamins (antioxidants) helps cells to avoid such damage. The body does not produce sufficient antioxidants to rid the free radicals. Supplements are required in this consideration.

People tend to over eat minerals and vitamins. Continuous use will result in damage to our system. Diarrhea can result owing to too much intake of vitamin C. Gastrointestinal track is recommended to be cleaned despite the fact diarrhea can throw electrolyte levels to go array.

Nutritional health food is available in big town but below is mineral and vitamin supplements that you can get from your pharmacist or local grocery store.

  1. Bromelain. Used to relieve chronic rhinosinusitis or CRS symptoms. Serves as anti-inflammatory and mucolytic.
  2. Urtica dioca or stinging nettle. Reduces inflammatory pain associated to chronic rhinosinusitis or CRS.
  3. Essential fatty acids. Omega 3 is an example to be taken by patients and healthy individuals. This helps in lubrication of the membranes and joints. It helps in the elimination of toxins and waste products with efficiency. Mucus membrane will be running accordingly and thus this is attributed to alleviation of symptoms of chronic rhinosinusitis or CRS.
  4. Quercetin is a bioflavonoid reducing inflammation and boost immunity. It blocks production of histamine which hinders production of mucus attributed to swelling and mucus production in allergic reaction for chronic rhinosinusitis or CRS.
  5. N-acetyl cysteine is altered form of amin acid serving as an antioxidant. Prescription has been for the elimination of congestion of cystic fibrois and thus it can eliminate sinus congestion.
  6. Garlic and Olive leaf extract. Candida or yeast is killed by these. Chronic rhinosinusitis or CRS has been linked to be caused by yeast. Elimination of Candida may indicate the cause of chronic rhinosinusitis or CRS is eliminated paving way for patients to recover.

Written, Edited or Reviewed By:


Last Modified On: November 10, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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