Ask the Doctor: Sinusitis
by John Zettelmaier, MD
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My sinuses are killing me. What can I do? And what are sinuses for anyway?
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There are four pairs of sinuses: frontal (forehead), ethmoid (the area between the eyes), sphenoid (behind the nose, deep in the head), and maxillary (cheekbone area). The sinus and nose mucous lining produces one to two liters of fluid a day. The purpose of this mucous blanket is to defend the body against infection. It traps bacteria and particulate matter that we breathe in, and then sends them down our throat and into our stomach where the stomach acid destroys the invaders. In addition, the sinuses humidify and warm the air we breathe in. The sinuses drain into the nose and any blockage of these small passages predisposes us to the symptoms of sinusitis.
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Sinusitis is conveniently divided into two categories: acute and chronic. Acute sinusitis lasts less than one month; chronic or recurrent sinusitis longer than one month. The acute type is generally caused by viral infections, bacterial infections, or allergies. Other causes do exist but are much less common. The viral variety can improve with a trial of self-treatment. The bacteria-caused sinusitis requires antibiotics, so see your doctor. The allergic type also requires a physician’s evaluation.
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Symptoms and signs of sinusitis include pain in the eyes, ears, or nose area; fever; headache; fatigue; runny or stuffy nose; post-nasal discharge; decreased ability to smell or taste; cough; dental pain in the upper teeth; halitosis; and tenderness in the sinus areas.
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If you are not running a high or prolonged temperature and don’t have severe pain, over-the-counter (OTC) drugs such as acetaminophen or ibuprophen can provide symptomatic treatment of pain and low-level fever. For the cough, an OTC dextromethorphan may provide some relief, and decongestants can help with the stuffy and runny nose. Thick secretions can yield to guaifenesin or nasal irrigation with normal saline solutions, but if you use nose drops, don’t exceed three days. If you go longer, your nose membranes can become “addicted” to the nasal decongestants and won’t work normally without them, yielding a dependence on nose drops to open the nasal passages.
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For the fatigue, get plenty of extra rest. And you may find that humidification helps the dry or burning nose sensation.
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If you are having severe or persisting symptoms, it’s time to see your doctor. The doctor may prescribe antibiotics or order X-rays or other special procedures.
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Good luck!
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John Zettelmaier, MD is a graduate of the University of Michigan Medical School, a member of the Beta Beta Beta Biological Honor Society, an American Board of Family Practice Diplomate, an American Academy of Family Physicians Life Member and Fellow, and a Life Member of the Michigan Academy of Family Physicians.
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Caffeine and Coffee May Reduce the Risk of Depression
by Mark A. Moyad, MD, MPH
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The world’s most frequently consumed central nervous stimulant is caffeine and the vast majority of it comes in the form of coffee. However, until recently, few studies of caffeine, coffee, and depression had ever been completed. A large nurses’ health study released this year included over 50,000 women, with a mean age of 63 years, who did not have depressive symptoms at the beginning of the study. Coffee consumption was estimated from validated questionnaires that the nurses filled out every few years. During the 10-year study follow-up, there were over 2,600 cases of depression identified. Women consuming moderate amounts of caffeinated coffee (2 to 3 cups daily) had a significantly lower rate of depression (20 percent lower) as compared to the women who consumed 1 or fewer cups of coffee per week. A similar result was demonstrated for caffeine consumption from sources other than coffee, but the result was not found among decaffeinated coffee drinkers.
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This study really shows how foods that are attacked in the news media for their negative qualities can later be shown to also have beneficial properties. Remember the egg? Shouldn’t eat them a few years ago and now they are found to provide benefits! How about chocolate? Can’t eat it and now it shows health benefits! The micro-dissection of our diets has become somewhat absurd, causing anxious people to contemplate and analyze every single food or beverage, without being able to consume comfort foods! This study shows that it is time to relax and consume (or continue consuming) coffee and caffeine.
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As an interesting note, several past studies have found a relationship between increased consumption of coffee and a decreased risk of suicide. Moderate coffee and caffeine intake is also associated with greater attention, energy, memory, and perhaps even enhanced mood. Finally, caffeine is associated with a lower risk of liver diseases and it is being studied to determine if it lowers the risk of Alzheimer’s and Parkinson’s disease.
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I understand that some individuals cannot tolerate caffeine or coffee because they have bladder sensitivity issues, but this is a minority of people. And, I am concerned that the concentrated caffeine drinks that you can down in 2 seconds provide too much stimulant going into the body too quickly. But, in summary, those who consume up to moderate caffeine amounts daily should celebrate this study. Pass the diet Mt. Dew!
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The Bottom Line
Caffeinated coffee consumption could be recommended to potentially improve quality of life by reducing the risk of depression.
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REFERENCES:
Lucas M, Mirzaei F, Pan A, et al. Coffee, caffeine, and risk of depression among women. Arch Intern Med 2011, 171:1571–1578.
Lara DR. Caffeine, mental health, and psychiatric disorders. J Alzheimers Dis 2010, 20 Suppl 1:S239–S248.
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This article was excerpted from Dr. Moyad’s Promoting Wellness Newsletter—Winter 2012. Sign up to receive free newsletters from Dr. Moyad and Spry Publishing here.
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Mark A. Moyad, MD, MPH, is the primary author of over a hundred medical articles and numerous books. He maintains a consulting practice on complementary medicine at the University of Michigan Medical Center, Department of Urology.
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Dr. Moyad’s Men’s Health Newsletter – April 2012
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Did you know that sleep restriction can temporarily reduce male testosterone levels by 10 to 15 percent? Dr. Mark Moyad discusses the importance of a good night’s sleep the April issue of Dr. Moyad’s Men’s Health Newsletter.
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Subscribe to Dr. Moyad’s Men’s Health Newsletter here.
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Download the April 2012 issue.
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Mark A. Moyad, MD, MPH, is the primary author of over a hundred medical articles and numerous books. He maintains a consulting practice on complementary medicine at the University of Michigan Medical Center, Department of Urology.
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The Benefits of Fish Oil
by Mark A. Moyad, MD, MPH
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Some preliminary evidence suggests that omega-3 fatty acids could reduce the risk of kidney stones or at least reduce oxalate levels in the body, which when elevated can increase the risk of a kidney stone. A total of 15 healthy individuals (7 women, 8 men) with an average age of 28 years were included in the study. Participants who had no history of stones or other medical conditions were followed for 30 days of testing. They ingested fish oil supplements with a total omega-3 content of 1500 mg (combination of 900 mg EPA and 600 mg DHA) per day. Upon completion of the 30-day fish oil supplementation, the study participants showed a significant reduction in oxalate levels. Presumably, the risk of calcium binding with oxalate in their bodies and forming a kidney stone was therefore reduced as well. Urinary calcium excretion and other urinary variables did not change significantly with use of the dietary supplement.
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The study suggests that calcium oxalate kidney stone formers could benefit from ingesting more omega-3 fatty acids. Fish oil supplements are some of the best selling supplements in both the United States and Canada because they actually have some positive overall health data, but perhaps also because they have received a good deal of media hype and are misunderstood. Fish oil probably has a positive role for those at a higher risk of heart disease and to reduce triglycerides (this use is FDA approved). Routinely, it is a positive sign when a supplement has both a pharmaceutical and over-the-counter option available and fish oil is a classic example. However, prescription fish oil is expensive and the over-the-counter options are dropping in price quite rapidly, perhaps making that a better option for some patients.
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One other indicator of fish oil’s positive role in reducing kidney stones—recent results from the US DASH diet study showed that an intervention to promote heart health through multiple dietary changes also resulted in a large reduction in kidney stone risk. Participants in that study were encouraged to increase their consumption of fatty, oily fish (not fried). This may indicate that dietary fish oil, as well as fish oil supplements, shows promise in reducing kidney stone formation. Possibly one more good reason to increase your consumption of salmon, tuna, herring, anchovies, or sardines! Talk to your doctor to see if eating more fish or fish oil supplements make sense for you.
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The Bottom Line
New research suggests that even 1 to 2 fish oil pills per day could reduce the risk of developing a kidney stone. Talk to your doctor, particularly if you are at higher risk of having a kidney stone.
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REFERENCES:
Siener R, Jansen B, Watzer B, Hesse A. Effect of n-3 fatty acid supplementation on urinary risk factors for calcium oxalate stone formation. J Urol 2011, 185:719–724.
Yasui T, Suzuki S, Itoh Y, et al. Eicosapentaenoic acid has a preventive effect on the recurrence of nephrolithiasis. Urol Int 2008, 81:135–138.
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This article was excerpted from Dr. Moyad’s Promoting Wellness Newsletter—Winter 2012. Sign up to receive free newsletters from Dr. Moyad and Spry Publishing here.
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Mark A. Moyad, MD, MPH, is the primary author of over a hundred medical articles and numerous books. He maintains a consulting practice on complementary medicine at the University of Michigan Medical Center, Department of Urology.
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