Why our body produces mucus?

Medical columnist, Mitchell Hecht, wrote an interesting article about " Why the need for phlegm and mucus?"

Excerpts of the article are reproduced below for your convenience:

[Phlegm is just an accumulation of thick mucus secreted by cells that line the nasal and respiratory tracts. It's usually clear/white/yellow in appearance and is spit out with coughing.
Mucus keeps the respiratory and nasal tissue moist and lubricated so it doesn't dry out, and traps small particles of dust and other foreign matter so that they don't enter the tiny air sacs of the lungs (alveoli).

Along with the mucus, there are millions of tiny hairlike structures called cilia that line our upper respiratory tract. They beat and sweep away allergens, bacteria, and irritants trapped in mucus at a rate of 10-20 times per second in the direction of the mouth. Smoking causes cilia hairs to fall out, which is one reason why smokers get more respiratory infections than nonsmokers.

Normally, mucus is thin and watery, but in certain inflammatory situations like a cold or bronchitis, there's an excess of thick mucus (phlegm). Allergies, sinus infection, or irritants like cigarette smoke are triggers, which may cause an overproduction of mucus and a post- nasal mucus drip.

Chronic lung disease also can be a frustrating cause of phlegm. Postnasal mucus drainage on the back of the throat is very irritating and often causes a sore, scratchy throat by morning. During sleep, saliva production decreases, resulting in less clearing of mucus. When awake, you'll drink liquids to thin the irritating mucus and wash it away; you'll also swallow much more often. That's why you'll notice that your scratchy/sore throat is much better after drinking liquid (hot or cold), and as the day goes on.

Gargling also helps to bathe and rehydrate the irritated tissues. Thinning mucus with guaifenesin (e.g.- Robitussin, Mucinex) makes it easier to cough up and clear. If you're producing abundant phlegm and it's not clearing up, get it checked out by a doctor.]

It is important to be able to distinguish between normal mucus and sinus infection mucus. Learn how to tell the difference between sinus infection symptoms and what remedies are effective for sinus infection treatment.

Understanding Sinusitis

A recent article by Dr. Paul Lim Vey Hong explains very clearly what and how you get a sinus infection and the types of surgery available to chronic sinus infection sufferers.

Excerpts from his article as follows:

Sinuses are normally air-filled spaces connected to the nose and lined
by a thin lining called mucosa that is continuous with the lining of
the nose. The openings of the sinuses into the nose are tiny holes
called ostia (ostium=singu-lar) and the diameter of each ostium is
usually only a few millimetres wide.

The mucosa of the sinuses and nose contains mucous glands and numerous
microscopic finger-like or hair-like projections called cilia. These
cilia beat in a specific direction and transport the mucous produced
from the mucosa of the sinuses into the nose through their respective
ostia.

Everyday, the mucosa of our nose and sinuses produce approximately one
litre of mucous which is moved to the back of the nose by these beating
cilia and then swallowed subconsciously. Any condition that adversely
affects the mucosa, cilia or ostia will cause problems for the sinuses.

Being closely connected to each other, conditions affecting the nose
can easily affect the sinuses.

Inflammatory conditions

When inflammation occurs in the nose and sinuses, the cilia stop
beating and fail to transport the mucous, which then builds up in the
sinuses. At the same time, the mucosa lining swells up and blocks up
the ostia of the sinuses. The infection then changes the mucous from a
colourless fluid to greenish pus in the affected sinuses.

Sinusitis refers to this condition when the mucosa of the sinuses is
inflamed. Sinusitis and inflammation of the nose, known as rhinitis,
occurs as a result of allergy, infection, irritation from chemicals and
dust, or a combination of any of these. In some cases, the swelling of
the mucosa becomes severe and bulges outwards to form polyps, which are
like balloons filled with fluid. Such polyps can “grow” up to sizes of
several inches and obstruct the sinuses and nose.

The presence of polyps usually implies severe inflammation and allergy.
Individuals who suffer from asthma and allergic rhinitis are at higher
risk of developing polyps in their noses.

Sinusitis is typified by symptoms of blockage or stuffiness of the
nose, discharge from the nose, phlegm in the throat, loss of sense of
smell, headaches or/and pain of the affected sinuses. Infection of the
sinuses could be due to viruses, bacteria and fungus. “Colds” and flu
are due to virus infection of the upper airways.

Once infected, the mucosa of the nose and sinuses rapidly succumb to
secondary infection by bacteria. This is the reason for the change in
colour of the discharge of the nose and sinuses from the initial clear
colour to green when bacteria infection sets in. Most of the time, the
immune system fights off the infection and we recover after several
days when the cold or flu symptoms recede. Our noses clears up and the
discharge becomes increasingly less and clearer.

Sometimes the symptoms persist and we require a course of antibiotic
treatment to recover. When the duration of sinusitis lasts for days or
up to a couple of weeks, it is called acute sinusitis. When the
duration of an infection persists longer than a couple of weeks, it is
called chronic sinusitis.


Diagnosing sinusitis

The diagnosis of sinusitis can be made by simple clinical examination,
endoscopy of the nose, X-rays, computerised tomographic (CT) scans and
magnetic resonance imaging (MRI). Simple clinical examination involves
looking into the nose and if pus can be seen from the ostia of the
sinuses, then the diagnosis of sinusitis can be made. The method,
however is not very sensitive and sinus infections, polyps and tumours
can be missed.


CT scans of the sinuses give clear images of the sinuses and also show
the anatomy of the nose and sinuses in great detail. CT scans will pick
up minute changes in the sinuses and therefore its interpretation is
important with regard to the management of the patient.

The images consist of series of slices of the nose and sinuses from the
front to the back, like slicing a loaf of bread. Specialists rely on CT
scans as their maps of the nose and sinuses during surgery.

The limitation of CT scan is that the images captures are snap shots of
the state of health of the nose and sinuses at that point in time.
Therefore if a CT scan is done during or just after a cold, it will
show swelling and abnormalities in the nose and sinuses, even though
the nose and sinuses are normally healthy.

MRI is the newest imaging technology available. MRI is highly accurate
and reliable for information on the soft tissues of the nose and
sinuses. However, it is less favoured by specialists treating the
sinuses as MRI does not show the fine bone details and landmarks of the
sinuses. These bone details and landmarks are crucial during surgery to
guide the surgeon through the complex anatomy of the sinuses and skull
base, which has a high degree of variation from one patient to another.

Treatment

Infection and allergy are the main causes of sinusitis. Once sinusitis
is diagnosed, the treatment usually involves antibiotics to clear the
bacterial infection and topical decongestants to reduce the
inflammation and swelling. Where allergy is suspected to co-exist,
steroids and anti-histamines are used to further reduce swelling due to
the allergic reaction.

In the vast majority of cases of acute sinusitis, this treatment will
resolve the sinusitis. It must be stressed at this point that all
prescribed courses of antibiotics should be completed, with the
exception of allergic reactions to the antibiotic or when serious side
-effect occurs.

In cases where the sinusitis persists after a course of antibiotic
treatment, the choice of antibiotic used needs to be reviewed and a
different antibiotic should be prescribed. This is due to the ability
of bacteria to develop resistance to a particular antibiotic if the
antibiotic had been used frequently or injudiciously in the past.

For cases of chronic sinusitis or where medication and antibiotics have
failed to treat the sinusitis, surgery or sinus washouts will be
employed. A sinus washout can only be used for maxillary sinusitis and
involves a large needle being pushed from inside the nose and through
the thin bone of the sides of the nose into the maxillary sinus. Once
inside the maxillary sinus, any pus or mucous is sucked out and saline
is flushed through the needle into the maxillary sinus to wash mucous,
pus or debris out through the ostium of the sinus. This is therefore
only possible if the ostium of the sinus is patent and not obstructed
by polyps or soft tissue swellings.

This procedure can be done under local anaesthesia in the clinic or
under general anaesthesia in the operating theatre. Sinus washout is a
simple procedure but it does not correct any underlying abnormality of
the sinus as it serves only to flush out the infected sinus. For this
reason, sinusitis may relapse after sinus washouts.

Surgery of the sinuses for sinusitis basically involves re-establishing
drainage and aeration of the sinuses. It involves widening of the ostia
of the sinuses, removing solidified debris, pus or fungal material from
the sinuses, and removal of polyps or tissues obstructing the drainage
routes of the sinuses.

Surgery of the sinuses can be broadly divided into two types, the
“external” or “internal” approach through the nose. The “external”
approach invariably requires an external incision on the face or in the
mouth, thereby creating a scar while the “internal” approach avoids an
external scar by approaching the sinuses from the interior of the nose.

Surgery to drain the maxillary sinus “externally” through the mouth was
first described in 1743 in France by Lamorier and since then, various
external approaches to the sinuses had been described and widely
practised.

Following surgery, care of the wound in the nose and sinuses is
important. If wound care is less than optimal, the healing can be
complicated by excessive scar tissue formation that can obstruct the
sinuses again.

Likewise, infections can occur after surgery and this will need adequate treatment with the appropriate antibiotics to prevent re-infection of the sinuses and excessive scarring.

As we can see from the above article, sinus infection, if left untreated can cause a lot of pain and suffering. In particular, chronic sinus infection sufferers will understand the pain and suffering they have to go through and indeed, the quality of life suffers too!

What you can do to maintain good sinus health?

You just need to read up on home remedy for sinus infection and nasal irrigation. Adopt nasal irrigation in your daily routine and you will not succumb to the common cold and influenza so easily!

Balloon Sinusplasty for Sinus Infection Treatment

Balloon Sinuplasty can and will help those with Chronic Sinusitis caused by narrow sinus passages.

A recent article by Leslie Toldo explains why this is so. Excerpts of the article are as follows:

A new procedure recently approved by the FDA can clear the sinuses of both children and adults and have them on their feet the next day.

Sinus surgery can be hard on grownups, and even harder on children. So, this new procedure -- with less down time and pain than traditional sinus surgery -- may be a more kid-friendly solution.

For Andre Martinez, homework isn't a bore. It's the challenge that makes it fun every time. But for years, Andre was the puzzle. He suffered from severe headaches that sometimes landed him in the emergency room.

"I just had to like take some Tylenol and go to my room, shut the windows, close the door, and just bury my head under the pillow," he explained.

Trips to the pediatrician, neurologist and allergist offered no solutions. Finally, the answer came from an ear, nose and throat doctor. Andre's headaches were caused by sinus infections, which were worsened by his very small sinus openings.

The National Institute of Allergy and Infectious Diseases estimates 37 million Americans are affected by sinus infections -- or sinusitis -- every year. This adds up to $5.8 billion spent each year on health care costs related to the condition. Sinusitis takes place when the cavities around the nasal passages, or sinuses, become inflamed and swollen, tracking mucus and causing infection.

Since the sinuses aren't fully developed until the age of 20, sinusitis is more difficult to diagnose in children. In addition, children are more prone to sinus infections in the first few years of life since their immune systems are immature. If a child remains ill beyond the usual week to 10 days of a cold, a serious sinus infection is likely the cause of the symptoms.

Because antibiotics didn't work, Andre needed surgery. Surgeons used a new scalpel-free procedure to open up Andre's sinuses. Balloon sinuplasty involves inserting a tiny balloon through a catheter into the sinus cavity. That balloon is inflated to open up the passageway and then deflated and removed. Many patients can resume normal activities 24 hours after the surgery.

Eight months after surgery, Andre says he is enjoying a migraine-free life. The procedure is for children who have chronic sinus disease or problems. The condition is often caused by the common cold, but other triggers include allergies and fungal infections.

The Mayo Clinic says if a sinus infection persists for more than eight weeks or is recurrent, it is considered a case of chronic sinusitis. Chronic sinusitis can also stem from growths in the sinuses called nasal polyps or a deviated septum, which is the partition between the two sides of the nose.

Risks of the procedure include brain fluid leakage and visual changes and infection -- the same as standard sinus surgery.

The American Academy of Otolaryngology, Head and Neck Surgery says parents should look out for the following signs of sinusitis:

" A long-lasting cold accompanied by a low-grade fever

" Thick, yellow-green nasal drainage

" A post-nasal drip that causes sore throat, a cough, bad breath, nausea and/or vomiting

" A headache (a symptom in children age 6 and older)

" Irritability or fatigue

" Swelling around the eyes

The following articles may also be helpful in understanding sinus infection:

1. Sinus Infection in children

2. Are sinus infections contagious?

3. Eustachian tube dysfunction

4. Home remedies for sinus infection

5. Nasal irrigation

For more resources, please visit Sinus Infection Help.

How to tell if you have a sinus infection?

A recent article by Karan Minnis, covers the painful conditions brought by a sinus infection. Some excerpts from the article are reproduced below:

Coakley, 43, a resident of Grand Bahama, has suffered with acute sinusitis for a little over 10 years, which has forced him to undergo two surgeries to try to help solve his problems, on top of the multitude of medication he takes seeking some sort of relief.

"I have tried almost every medication out there, but nothing can really stop my issues," he said.

"In the past 10 years I have had two surgeries — one in 1998 and one in 2001, just to remove polyps from my sinuses which doctors said were causing my issues. About a year after each surgery, the issues would return."

The victim of chronic sinusitis, is fed up, and says he refuses to have another surgery, which he said have just been a waste of his money because he hasn't gotten a solution or relief to his problem."My issues came back every single time and I'm not about to waste more money for that to happen again. Instead I will just have to keep experimenting with medications until I find something that will actually work for a full day."

Sinusitis — an inflammation of the sinuses and nasal passages, is a common aliment that many people have to deal with. According to general practitioner Dr. Martin Brown at Kennedy Medical Centre, sinusitis sufferers know that the problem is not a joke.

"Sinusitis is really something that can ruin your day especially when the symptoms kick in because sinusitis, which is a sinus infection, can cause many issue like a headache or pressure in the eyes, nose, cheek area, or even on one side of the head and that can alone be painful.

Additionally a person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions and none of these things can be considered fun."
Once you experience sinus symptoms, he says you should seek medical help, and not the other way around, when symptoms get extremely out of hand.

"Your doctor is there to help you, therefore you should call your doctor once you are experiencing pain or pressure in the upper face accompanied by nasal congestion or discharge, postnasal drip, or ongoing bad breath unrelated to dental problems. That is a sign that you need medical help and help is available," said Dr. Brown.

He said there are even home remedies, that most people can use, but that your treatment will depend on the type of sinusitis your are experiencing, of which there are two — acute, also known as sudden onset or chronic, which is known as long term, with chronic sinusitis being the most common type.

Both have varying symptoms. With the acute form of sinusitis, which usually lasts less than eight weeks or occurs no more than three times per year with each episode lasting no longer than 10 days, sufferers will have off and on nasal congestion with discharge or postnasal drip when mucus drips down the throat behind the nose, pain or pressure around the inner corner of the eye or down one side of the nose, a headache in the temple or surrounding the eye, pain or pressure symptoms which become worse when coughing, straining, or lying on the back. A fever is also common.

Chronic sinusitis sufferers have symptoms which usually last longer than eight weeks or occurs more than four times per year. Symptoms usually last more than 20 days, comes with nasal discharge, obstruction, and low-grade discomfort across the bridge of the nose, with pain that is worse in the late morning or when wearing glasses or even with colds, flu, or allergies.

A fever can be a symptom of a sinus infection or a cold. Also simple congestion with a low-grade fever can indicate a cold and may not call for medications or antibiotics, but when you have these symptoms and are also experiencing facial pain or headaches it's more likely that you may have a sinus infection.

Find out what the top 10 sinus infection symptoms are and the major causes of sinus infection at Sinus Infection Help.

When are antibiotics needed for acute respiratory tract infections?

I think a lot of us do not like to take medications. Whenever, we are sick, we are not sure if we should see a doctor. This is because our immune system can help us overcome infections when our body is strong. Even doctors, can be in a dilemma as when antibiotics should be prescribed for their patients.

This interesting article touches on the various types of acute respiratory infections and excerpts are reproduced below:

COMMON RESPIRATORY TRACT INFECTIONS

The most common viral ARI is an upper respiratory tract infection (URI), also known as the common cold. Most URIs are caused by viruses, with rhinovirus, parainfluenza virus, coronavirus, adenovirus, respiratory syncytial virus, and influenza virus accounting for most cases.

Influenza is a systemic illness that involves the upper respiratory tract and should be differentiated from other ARIs, particularly during the months when the influenza virus is circulating. Influenza in adults is differentiated by acute onset, significant fever, and marked myalgias. Rapid antigen tests are available for diagnosing influenza, and antiviral therapy may be appropriate for certain patients.

Antibiotic treatment does not improve resolution of influenza infections or prevent complications. Only a small proportion of URIs become complicated by bacterial sinusitis or pneumonia; in these few cases, antibiotics may be useful. Most cases of uncomplicated URI resolve spontaneously within 1 to 2 weeks and require no treatment.

Acute sinusitis

Obstruction of the sinus ostia after a URI may result in rhinosinusitis or acute sinusitis. Bacterial and viral rhinosinusitis are difficult to differentiate clinically, and overdiagnosis of acute bacterial rhinosinusitis is common. The presence of yellow or green purulent secretions from the nares or throat, by itself, does not differentiate between a bacterial and a viral infection.

Generally, the diagnosis of acute bacterial sinusitis in adults should be reserved for patients who have symptoms for 7 days or longer, purulent nasal secretions, and maxillary facial or tooth pain. Symptomatic therapy is the preferred initial management for mild cases; the most narrow-spectrum antibiotic active against the likely pathogens, Streptococcus pneumoniae and Haemophilus influenzae, should be prescribed for patients with severe disease regardless of duration.

The dilemma in the treatment of URIs and sinusitis is the lack of a simple and accurate diagnostic test that reliably identifies rhinosinusitis; therefore, a clinical diagnosis is uncertain.

Pharyngitis

Many office visits to primary care providers are for pharyngitis. Viruses are the most common cause of acute pharyngitis, and the condition should be managed with supportive therapy that includes analgesics, antipyretics, and gargle.11 Group A streptococci (GAS) cause 15% to 30% of cases of acute pharyngitis in pediatric patients and 5% to 10% of cases in adults.

Patients infected with GAS, and a few other uncommon bacteria, will benefit from antibiotic therapy; therefore, the clinical goal is to identify those patients with a high probability of GAS infection. The most reliable indicators are fever, tonsillar exudates, tender anterior cervical lymphadenopathy, and absence of a cough.

Patients with two or more of these features (referred to as the Centor criteria) are candidates for antigen testing or culture; patients with fewer than than two criteria do not need to be tested as they are less likely to be infected with GAS. Clinicians may choose to treat patients with at least three of the four clinical criteria empirically with antibiotics. Penicillin is the treatment of choice for pharyngitis caused by a GAS infection.

Acute bronchitis

This ARI manifests as a cough with or without sputum production and lasts for up to 3 weeks. Chest radiography findings are normal. Respiratory viruses are the cause of most cases of uncomplicated acute bronchitis; however, pneumonia must be considered in the differential diagnosis when patients present with an acute cough illness.

Signs of pneumonia include fever, cough, tachypnea, tachycardia, and evidence of consolidation on chest auscultation. The presence of purulent sputum is not predictive of bacterial infection. Patients with uncomplicated bronchitis may benefit from beta-agonist inhalers and antitussives. Acute bronchitis, like other ARIs, usually does not require antibiotic therapy.

Many people have had good sinus health once they adopted nasal irrigation. Nasal irrigation with a neti pot can help prevent one from catching the common cold and reduce the incidents of catching viral influenza.

For more information, visit Sinus Infection Help.

Medical procedure for recurring sinus infection sufferers

Mike Snider has been suffering from chronic sinus infection for a while and, in his article, he shares his experience about the balloon sinuplasty procedure he went through.

Excerpts from his article as follows:

Time for sinus surgery

I, along with about 14% of the U.S. population, or 37 million Americans, had chronic sinusitis, inflammation of the linings of the sinuses bad enough to block the drainage of mucus into the nose.

My path to surgery involved more than a decade of on-again, off-again congestion, pressure, trouble breathing and fatigue. Over the years, any time I flew in an airplane I was likely to develop a sinus infection.

Colds and flu could also cause them. Despite preventive measures — nasal steroid sprays, allergy shots and twice-daily sinus rinses — I regularly got infections that required antibiotics to subdue.
At their worst, my symptoms affected my work and my outside activities. Sometimes I couldn't sleep and often didn't have the energy to exercise.

I sought out numerous doctors and had several CT scans. One doctor attributed my face pain to migraines, and another surgeon suggested that I wait until my case became unbearable, as corrective surgery had no guarantees.

New way to open nasal passages

Last summer, I got a sinus infection that lasted for four months despite aggressive treatment of steroids and antibiotics. During the treatment, my allergy doctor referred me to a different sinus surgeon who had been doing a new procedure called balloon sinuplasty, which uses a small, flexible balloon catheter to open nasal passages.
"It is the evolution of the minimally invasive sinus surgery. So instead of actually cutting or removing tissue or bone, you are expanding a small balloon in the opening (of the sinuses)," says ear, nose and throat surgeon Jack Williams, "much like they do to open up a partially clogged artery."

In my initial examination, Williams said that my sinuses were swollen shut with trapped fluid in the frontal sinuses. Having performed more than 100 balloon procedures, he considered me a good candidate, but he also planned to correct a crooked septum as part of the surgery.

Each year, about 500,000 patients undergo the more traditional functional endoscopic sinus surgery (FESS), in which a surgeon removes bone and tissue. I had been scared off those by horror stories of painful recoveries and repeat surgeries.
Williams described how balloon sinuplasty induces very little or no scar tissue and heals much better. "It's much less uncomfortable and takes a day or two recovery time."

Mike Snider is someone who is predisposed to getting recurring sinus infection. This is because he suffers from chronic nasal congestion as a result of the physical structure of his nose, a deviated septum and also very narrow nasal passages.

If you do not wish to go through sinus surgery, then one of the best home remedy for sinus infection is to perform nasal irrigation daily using a neti pot. For more information, please visit Sinus Infection Help.

A cautionary note to allergy sufferers with regards to self-diagnosis and medication

Dr. Sami Bahna, Chief of Allergy & Immunology at LSU Health Sciences Center in Shreveport, in recent article, mentioned that many people are resorting to self-diagnosis and medication for their allergies.

Excerpts from her article is as follows:

[ Dr. Bahna says it certainly brings more people into his clinic, there are still many more who self-diagnose the symptoms they're suffering, and that can lead to trouble.

"Allergies are the most commonly mis-diagnosed and the most commonly self-diagnosed." It's when patients try to self-treat that they might be missing out on a simpler approach - or making things worse all around. "Medications are well known, not just to any physicians, but even the patients know the names of the nasal sprays and the antihistamines and the eye drops," says Dr. Hanoi, who suggests a visit to the doctor is still the smartest approach - even when advice and experience from friends and family abounds, "Their knowledge alone is not the issue It's how to tune it up for that particular person, and sometimes, a little adjustment like that makes a BIG difference!"

Besides that, Dr. Bhana says some over-the-counter medications can actually make your allergy symptoms worse. "The over the counter nasal sprays are not good. it will relieve the obstruction, the blockage of the nose quickly - pleases the patient - and rebounds again like a rubber band!" While those saline nasal decongestants are fine in small doses at bedtime so you can sleep, they're not good for constant daytime use. Dr. Bhana says that can lead to allergy sufferers using them more often, which only end up increasing the symptoms.

Gone improperly treated for too long, all that drainage can turn into a sinus infection. You'll know it when the mucus becomes discolored. That means you have a secondary infection and you need to see your doctor and get an antibiotic to go along with your decongestant.

Here are some tips for surviving Spring allergy season:

1.Try to keep doors and windows closed.
2.Use the air conditioning in your house and car.
3.Stay inside when you can, especially on dry windy days.
4.Use a dehumidifier
5.Use high efficiency particulate air or HEPA filter in your bedroom
6.Avoid mowing the lawn or raking leaves.]

Effective allergy and sinus relief can take the form of over-the-counter medications and some proven sinus infection home remedies can work just a well too!

Usually, if you suffer from allergies often, it is highly possible that you get clogged ears regularly which may lead to Eustachian Tube Dysfunction.

For more information on sinus infection treatment and medical procedures for sinus infection such as balloon sinuplasty, please visit Sinus Infection Help.