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Stomach Ulcers - 5 Ways They Can Be Managed!

Stomach Ulcers - 5 Ways They Can Be Managed!

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3867 people found this helpful

Stomach Ulcers - 5 Ways It Can Be Treated!

Stomach Ulcers - 5 Ways It Can Be Treated!

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers. If you wish to discuss about any specific problem, you can consult a Gastroenterologist.

1753 people found this helpful

How To Treat Erythrasma?

How To Treat Erythrasma?

Erythrasma is caused by a virus called bacterium Corynebacterium minutissimum. This type of infection is mostly found in the moist folds of the body such as the groin, knees, and armpits. They are visible in the form of reddish patches and are itchy in nature. Although Erythrasma doesn’t lead to anything serious, they have a tendency to spread, if not treated in early stages.

Causes of Erythrasma
Erythrasma often occurs to people who live in shabby conditions and do not maintain good hygiene. People living in the tropical region have a tendency to get this infection too. Some medical conditions that lead to this disease are diabetes, obesity, etc. Even low immunity and hyperhidrosis is known to cause this sort of infection.

Common symptoms of Erythrasma
Erythrasma shows unmistakable symptoms. It looks like a patch of pink to red skin with a well-defined border. With passing time, the coloration turns from reddish to brownish in color. The skin outside the patch or border is normal. This being said, if proper medication is not taken on time, this might spread and affect the healthy skin. Some other symptoms include:

  1. Mild to heavy itching in the affected area.
  2. Scaly patches in the affected area.
  3. The patches often look like typical ringworm infections
  4. A burning sensation in the affected area (especially, if the affected area is groin)

Diagnosis of Erythrasma
While this infection is one of the easiest to identify by any dermatologist, a doctor might prescribe the scraping culture test to be absolutely sure of the diagnosis. A wood’s lamp test can also be performed in order to diagnose the infection. This is a test in which a doctor passes the UV rays of the lamp on the infected area only to find a coral red coloration.

Treatment for Erythrasma
Doctors mostly suggest the intake of antibiotics such as erythromycin to kill the bacterial infection. Ointments containing imidazole and fusidic acid are also prescribed for controlling the infection. Drugs of antibacterial origin such as Clarithromycin and Erythromycin are prescribed depending on the severity of the infection and patient’s general health. A patient with a surgical wound and low immunity might develop some minor complications. It is strongly suggested to refrain from over the counter medicines for patients with this medical complication.

How to prevent Erythrasma?
Some common tips to stay away from bacterial infections such as these include the following:

  1. To ensure the folds of your skin is moist free
  2. Wearing cotton clothes in summer and avoiding tight fitting clothes
  3. Keeping basic hygiene intact such as wearing clean clothes, taking bath twice a day etc
  4. Sticking to a healthy diet and following a workout plan
     
8595 people found this helpful

Erythrasma (Skin Disorder) - Signs You Are Suffering From It!

Erythrasma (Skin Disorder) - Signs You Are Suffering From It!

Erythrasma is caused by a virus called bacterium Corynebacterium minutissimum. This type of infection is mostly found in the moist folds of the body such as the groin, knees, and armpits. They are visible in the form of reddish patches and are itchy in nature. Although Erythrasma doesn’t lead to anything serious, they have a tendency to spread, if not treated in early stages.

Causes of Erythrasma
Erythrasma often occurs to people who live in shabby conditions and do not maintain good hygiene. People living in the tropical region have a tendency to get this infection too. Some medical conditions that lead to this disease are diabetes, obesity, etc. Even low immunity and hyperhidrosis is known to cause this sort of infection.

Common symptoms of Erythrasma
Erythrasma shows unmistakable symptoms. It looks like a patch of pink to red skin with a well-defined border. With passing time, the coloration turns from reddish to brownish in color. The skin outside the patch or border is normal. This being said, if proper medication is not taken on time, this might spread and affect the healthy skin. Some other symptoms include:

  1. Mild to heavy itching in the affected area.
  2. Scaly patches in the affected area.
  3. The patches often look like typical ringworm infections
  4. A burning sensation in the affected area (especially, if the affected area is groin)

Diagnosis of Erythrasma
While this infection is one of the easiest to identify by any dermatologist, a doctor might prescribe the scraping culture test to be absolutely sure of the diagnosis. A wood’s lamp test can also be performed in order to diagnose the infection. This is a test in which a doctor passes the UV rays of the lamp on the infected area only to find a coral red coloration.

Treatment for Erythrasma
Doctors mostly suggest the intake of antibiotics such as erythromycin to kill the bacterial infection. Ointments containing imidazole and fusidic acid are also prescribed for controlling the infection. Drugs of antibacterial origin such as Clarithromycin and Erythromycin are prescribed depending on the severity of the infection and patient’s general health. A patient with a surgical wound and low immunity might develop some minor complications. It is strongly suggested to refrain from over the counter medicines for patients with this medical complication.

How to prevent Erythrasma?
Some common tips to stay away from bacterial infections such as these include the following:

  1. To ensure the folds of your skin is moist free
  2. Wearing cotton clothes in summer and avoiding tight fitting clothes
  3. Keeping basic hygiene intact such as wearing clean clothes, taking bath twice a day etc
  4. Sticking to a healthy diet and following a workout plan

    If you wish to discuss about any specific problem, you can consult a dermatologist.

3028 people found this helpful

Ways to Treat Stomach Ulcers

Ways to Treat Stomach Ulcers

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen. Also, check out Stomach Aches and Pains in Kids.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine. Consult a doctor for all stomach related problems.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

1832 people found this helpful

Stomach Ulcers - Know How To Deal With It!

Stomach Ulcers - Know How To Deal With It!

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways of treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However, it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

2639 people found this helpful

Ways To Treat Stomach Ulcers

Ways To Treat Stomach Ulcers

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers - 

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

3054 people found this helpful

Stomach Ulcers - How To Get Rid Of Them?

Stomach Ulcers - How To Get Rid Of Them?

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways of treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However, it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, liquorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

2672 people found this helpful

Stomach Ulcers - Ways To Treat It!

Stomach Ulcers - Ways To Treat It!

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen. Also, check out Stomach Aches and Pains in Kids.

Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:

  1. Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.

  2. Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.

  3. H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidineConsult a doctor for all stomach related problems.

  4. Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.

  5. Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.

Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers. In case you have a concern or query you can always consult an expert & get answers to your questions!

2040 people found this helpful

Sinusitis: Management and Prevention

Sinusitis: Management and Prevention

Sinusitis: Management and Prevention

Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which

Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:

New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● headache
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.

Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● cough
bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● fever
facial pain or pressure
● headache
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.

Cause
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria

A. Multiplication of bacteria
B. Secondary bacterial infection

Other predisposing factors
tumors
● polyps
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● allergies
asthma
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● rhinovirus
● coronavirus
● adenovirus
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).

Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis

Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● anaerobes

Differential diagnosis
migraine headache
cluster headache
● dental infection
trigeminal neuralgia

Workup
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
 

Guide therapy:
● transillumination
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
endoscopy
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.

Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%

● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,

Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.

Antimicrobial therapy
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of

Bacterial sinusitis.

antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the

Costlier second-line agents.

Surgery
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis

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