Chronic Fatigue, Pain Linked to Sinusitis

Many internists are unaware of the connection, new research says

Janice Billingsley

Janice Billingsley

Published on August 15, 2003

(HealthDay is the new name for HealthScoutNews.)

FRIDAY, Aug. 15, 2003 (HealthDayNews) -- Feeling worn out and achy and don't know why?

You could have sinusitis, one of the most common chronic health problems afflicting Americans.

That's the conclusion of new research out of Georgetown University that appears in this week's issue of the Archives of Internal Medicine.

Dr. Alexander Chester, an internist at Georgetown University Medical Center, surveyed almost 300 of his patients and found that those who reported unexplained chronic fatigue were nine times more likely to have sinusitis symptoms than those who felt rested and well.

Also, patients who said they had unexplained body pain were six times more likely than the pain-free patients to have such symptoms of sinusitis as facial pressure, heavy-headedness or frontal headache, Chester says.

Doctors who specialize in sinusitis -- otolaryngologists -- know that almost one-third of sufferers experience severe fatigue and pain, Chester says, but the news hasn't trickled down to the general practitioner. As a result, he adds, many patients may not be getting treatment for sinusitis that could alleviate their fatigue or pain.

"It is known that sinusitis can make a person fatigued, but general medical doctors are less aware of this because the literature is largely aimed at the otolaryngologists," Chester says. "But all doctors should keep in mind that sinusitis might cause fatigue and pain. It should always be looked for when a person is exhausted or achy."

For the study, Chester surveyed 297 of his patients, selecting men and women who were under the age of 41 -- the mean age was 30. This was done to minimize the variables of other illnesses that might appear in an older population.

Sixty-five (22 percent) of the patients reported unexplained chronic fatigue, described as a sleepiness unrelieved by rest. And 33 (11 percent) reported unexplained body pain, which consisted of achiness or pain in almost all areas of the body. Although there were more men than women in the study (54 percent versus 46 percent), more women than men reported unexplained chronic fatigue (60 percent versus 42 percent).

When compared to a control group of people without unexplained chronic fatigue or body pain, those with unexplained chronic fatigue were nine times more likely to have sinusitis symptoms. And those who reported unexplained body pain were six times more likely to have sinus symptoms than the control group, the study found.

"People are unaware of how global the effects can be from sinusitis," Chester says. "They can feel a general sense of malaise even without direct sinus symptoms. My hope is to raise awareness among internists as to the fact that unexplained chronic fatigue can be caused by sinusitis."

Fatigue is one of the "top five" symptoms of sinusitis, says Dr. Philip Perlman, a New York otolaryngologist. The others are pain, facial pressure, nasal congestion and fever.

"To say that everyone with unexplained chronic fatigue should be worked up for sinusitis is pushing it a bit," Perlman says. "But a few easy questions -- like, 'Do you have a history of sinusitis?' or 'Do you feel facial pressure or have frontal headaches?' -- could pick out those patients who do have sinusitis."

Sinusitis is one of the most common chronic health problems in the United States, affecting an estimated 34 million people a year, according to the National Institute of Allergies and Infectious Diseases (NIAID). More women are afflicted than men.

It's characterized by inflammation of the nasal passages that can be caused by any number of triggers, from a cold to allergies to a fungal infection, doctors say. The inflammation narrows the nasal passages so mucus can't drain properly, causing discomfort and sometimes infection.

Left untreated, sinusitis can become chronic, lasting from weeks, to months or even years, according to NIAID.

The good news: There are now treatments that include nasal sprays, as well as intranasal nebulized antibiotics, certain antihistamines, and topical antifungals and antibiotics that target the specific fungi and bacteria that often plague sinusitis sufferers.

More information

An explanation of sinusitis can be found at the National Institute of Allergy and Infectious Diseases. For a medical description of what happens when you have sinusitis, visit The American Rhinologic Society.

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