If you seem to have sinusitis and asthma symptoms in a continuous cycle, you’re not alone. Nasal and sinus diseases are the most common comorbidities of asthma, afflicting millions of people in the U.S. annually. But why do sinusitis and asthma occur together so often, and is there an actual scientific connection between the two?
What is Sinusitis?
Sinusitis is inflammation of the tissue lining the sinus cavities, which are located around the nose and eyes. Its characterization depends on the frequency and duration of symptoms. Acute sinusitis is often called a sinus infection and is brought on by a cold or virus. Acute sinusitis episodes typically last 7-10 days, but no longer than four weeks. Subacute sinusitis lasts 4-12 weeks. If you have acute or subacute sinusitis symptoms three or more times in one year, the sinusitis is considered to be recurrent. This is distinct from chronic sinusitis, which lasts more than 12 weeks and involves symptoms that may not improve even with treatment. Common symptoms of sinusitis include headache, sinus pain (some describe this pain as similar to a toothache), nasal congestion, postnasal drip, cough, facial pressure, diminished sense of smell, and fever in acute cases.
What is Asthma?
Asthma is a respiratory condition that involves inflammation of the airways. Acute asthma episodes can cause extreme shortness of breath, chest tightness, coughing, wheezing, and increased respirations. This is because during these episodes, the airways constrict while also producing excessive mucus, limiting the amount of air that can pass through. Just like sinusitis, asthma is categorized based on the frequency of symptoms. However, categorization also depends on how well the asthma symptoms react to treatment, as follows:
- Intermittent – symptoms occur less than two days each week and do not require daily medication to control. Usually, just a quick-acting inhaler is required for management.
- Mild Persistent – symptoms occur more than twice per week and even wake the patient up 3-4 nights each month. Everyday activities may be affected, and daily medication is usually required along with a quick-acting inhaler.
- Moderate Persistent – symptoms may occur daily and wake the patient up at least one night each week. Multiple daily medications, along with a quick-acting inhaler, are likely required, along with more strict activity restrictions.
- Severe Persistent – symptoms occur almost all the time and wake the patient up almost every night. Activities are extremely limited and multiple medications are required, including daily preventatives and quick-acting inhalers.
Another way asthma is categorized is as allergic or non-allergic. Allergic asthma is asthma symptoms triggered by an allergen, such as pet dander, dust, mold, pollen, and more. The symptoms of allergic asthma are the same as those listed above. The connection between allergies and asthma is still being explored.
How are Sinusitis and Asthma Similar?
Both sinusitis and asthma involve inflammation of parts of the respiratory system, affecting the patient’s breathing and overall quality of life. They can also share some common triggers, including allergens, respiratory irritants/pollution, and cold air. Finally, both sinusitis and asthma can be treated with topical (intranasal or inhaled) corticosteroids to open up airways and ease breathing.
How are Sinusitis and Asthma Different?
While some cases of sinusitis and asthma share a trigger, more often than not, these conditions have different causes. Asthma can be brought on by an overactive immune system, exercising, GERD, or even stress. On the other hand, sinusitis is most often caused by some type of infection, either viral or bacterial. That’s why sinusitis is sometimes called a sinus infection and frequently occurs after an active disease process, like a cold.
While symptoms of both conditions can be relieved with topical corticosteroids, treatments beyond this are quite different. As with any condition, smart treatment of sinusitis and asthma begins with identifying the cause of the symptoms. Acute sinusitis is often treated with saline sprays, nasal corticosteroids, decongestants, allergy treatments, pain relievers, and antibiotics if needed. Chronic sinusitis treatment can include all of these along with oral or injectable corticosteroids, aspirin desensitization treatments, antifungal or antibiotic prescriptions, or any treatment that intends to resolve the cause of the chronic symptoms.
Along with inhaled steroids, short-acting beta agonists (quick-acting bronchodilator inhalers), anticholinergic agents, and oral/IV corticosteroids are the standard treatments for acute asthma attacks. For asthma that requires daily preventative medication, inhaled corticosteroids, alone or in combination with (long-acting beta agonists or anticholinergic medications, leukotriene modifiers, or theophylline are preferred. For asthma triggered by allergens, resolving the allergies with immunotherapy or biologic agents is recommended. Finally, for asthma that doesn’t respond well to other treatments, bronchial thermoplasty may be an option.
Does Sinusitis Cause Asthma, or Vice Versa?
Even though we can see that people with sinusitis are frequently affected by asthma symptoms too, research has yet to reveal clear evidence that one of these conditions causes the other. However, chronic inflammation from allergies can contribute to both conditions. Just because we don’t yet know if sinusitis and asthma are directly linked doesn’t mean we can’t see how they interact to some degree.
An Undesirable Cycle
While a causative link between sinusitis and asthma has yet to be found, the two conditions contribute to each other. For example, postnasal drip is a common symptom of sinusitis. The constant irritation of the throat leads to coughing, which aggravates other asthma symptoms and causes breathing difficulties. This may be why sinusitis has been associated with more severe cases of asthma.
Treatment for Co-Occurring Sinusitis and Asthma in Tampa Bay
Are you miserable with symptoms of both sinusitis and asthma? If you’re in Tampa Bay, don’t waste another minute living with these debilitating conditions. Make the call to Allergy, Asthma & Immunology Associates of Tampa Bay at (813) 971-9743 to take the first step towards effective disease management and developing a treatment plan that gives you your life back.