Getting Sinusitis Under Control

Thirty-four-year-old Amy* was at the tail end of a flu when she started feeling congested again. Her throat felt sore, she suffered from headaches, there was an uncomfortable pressure in her ears, and she felt pain around the cheek area.

While several of her symptoms – her sore throat nose and cough, for example – were non-specific and could have indicated a second bout of the flu or a cold, the pressure behind her eyes and cheeks were dead giveaways of another common respiratory ailment: sinusitis. An inflammation of the sinus cavities that can develop from a virus, sinusitis affects between 10 per cent and 30 per cent of Europeans, and 15 per cent of Americans each year1, with women more often affected than men.

While sinusitis cannot be “cured” in the traditional sense of the word, or prevented from recurring, seeking treatment could mean a shorter recovery time and fewer recurrences. More importantly, it could help prevent a relatively mild condition from developing into something more serious.

Identifying the root cause

Traditional Chinese Medicine (TCM) practitioners believe that sinusitis can be caused by external or internal factors, as well as by diet and stress. In TCM, external factors can be linked to the environment – a cold and windy winter, for example – or external pathogens. There are six categories of external pathogens – wind, heat, damp, fire, dryness and cold – that act alone or in combination. Sinusitis is most often caused by two combinations: wind-cold and wind-heat, which are also the main culprits in cases of the common cold and flu.

Internal factors linked to sinusitis include qi deficiency in the lungs, spleen and stomach, and latent heat in the lungs as a result of body constitution. “Individuals with a ‘heaty’ constitution are more susceptible to having latent heat toxins accumulate in the lungs when pathogenic factors invade the body,” explains Eu Yan Sang physician Benjamin Xiao. Diets high in fat and fried food can also lead to heat dampness and sinusitis, he adds, as can stress and an inability to regulate emotions.

Sinusitis can be acute or chronic, with the latter taking much longer to resolve. “Acute sinusitis is usually triggered by external pathogenic factors such as wind-heat or wind-cold and takes less than a few weeks to resolve,” says physician Xiao. Chronic sinusitis, which develops when there are underlying problems with the structure of the nasal passages or the presence of nasal polyps, can last much longer.

“Chronic sinusitis can also be attributed to internal factors such as body constitution and deficiencies in certain organs. Internal factors often lead to chronic conditions when timely treatment is not given,” says physician Xiao.

Managing sinusitis

Treatment for sinusitis can differ from patient to patient, depending on the cause, body constitution and age of the patient. Generally speaking, where a particular pathological factor, or combination of pathological factors, are to blame, the common therapeutic principle would be to remove it, for example, through herbal remedies. A commonly used herbal formula to eliminate wind-heat and latent heat toxins in the lungs, is 苍耳散 (Cang Er San).

Herbs like桑叶 (Sang Ye or Mulberry Leaf) and 菊花 (Ju Hua or Chrysanthemum Flower) can also be used to expel wind-heat pathogens from the lungs and nasal passage, preventing the accumulation of heat toxins. These can be brewed into a tea, cooled, and sipped throughout the day (see box).

When internal factors are to blame, treatment is aimed at nourishing qi in the lungs and spleen, for example with 参苓白术散 (Can Ling Bai Zhu San).

Beyond treating the immediate cause of the illness, TCM is also focussed on boosting immunity, particularly if the patient is a child, says physician Xiao.

Herbal formulas can help to improve lung and spleen function, both of which are immature in children, while tui na along the spine and the abdomen area promotes balance in the body and improve overall health.

Aid from acupuncture

In adults, acupuncture is also an increasingly popular treatment option, both in isolation and in combination with TCM therapies like herbal medication.

A 2005 randomized controlled trial conducted by the World Health Organization (WHO) Collaborating Centre for Traditional Medicine and RMIT University in Melbourne, Australia, found acupuncture to be an effective symptomatic treatment for persistent allergic rhinitis.2 Eighty patients between 16 and 70 years of age were involved in the trial.

Mulberry leaf (桑叶, Sang Ye) and Chrysanthemum Flower (菊花, Ju Hua) Tea

Sang Ye 9g
Ju Hua 9g
Honey, to taste

Add boiling water to the herbal ingredients and brew for 15 to 20 minutes.
Add honey to taste once the tea has cooled.

Studies also support its use as complementary treatment with western medication to alleviate the symptoms of sinusitis and strengthen the immune system. A 2012 study where acupuncture was used in conjunction with herbal and nutrient medicine, and dietary modification to treat chronic rhinosinusitis found significant symptom relief and quality of life improvement.3 Patients who underwent weekly acupuncture sessions as well as counselling on dietary modification, lifestyle changes, and acupressure for a total of eight weeks showed significant improvement.

Given the holistic nature of TCM, practitioners are also likely to advise those with sinusitis on dietary changes that can hasten recovery and reduce the chance of recurrence. According to physicianXiao, patients should abstain from deep fried and spicy food. “Consuming these foods will increase the chance that dampness and heat toxins will accumulate and disrupt the physiological balance in the body,” he says. He also advises those suffering from sinusitis to abstain from smoking and alcohol consumption, and to incorporate regular exercise into their lives. This will improve immune function and general well-being.

1 Middleton's Allergy: Principles and Practice By N. Franklin Adkinson, Jr., Bruce S. Bochner, Wesley Burks, William W. Busse, Stephen T. Holgate
2 https://www.ncbi.nlm.nih.gov/pubmed/17874980
3 https://www.ncbi.nlm.nih.gov/pubmed/22431875