Is Sinusitis Linked to COPD?

Sinusitis (also known as a sinus infection) and chronic obstructive pulmonary disease (COPD) are closely linked. On the one hand, COPD increases the risk of sinusitis and can make symptoms worse. On the other, sinusitis can trigger COPD exacerbations and worsen breathing problems you already have.

COPD places you at risk of sinusitis by lowering your immune defenses and causing hypersensitivity in the upper respiratory tract, including your sinuses. Medications commonly used to treat sinusitis can help ease symptoms and avoid triggering a COPD flare-up.

The article describes the symptoms of COPD-associated sinusitis and why they occur. It also explains how sinusitis is diagnosed and treated if you have COPD.

Symptoms of COPD-Associated Sinusitis

Typically, sinusitis causes congestion, runny nose, sore throat, headache, sinus pressure, cough, phlegm, fatigue, trouble sleeping, and fevers. These symptoms can be amplified when coupled with COPD symptoms.

Sinusitis can not only trigger a COPD attack but also compound COPD symptoms, leading to wheezing, chest tightness, and tachypnea (rapid breathing).

By way of example:

• COPD is characterized by excess mucus production and difficulty clearing mucus from the airways. The phlegm produced from sinusitis can add to this.
• People with COPD often have shortness of breath that leaves them easily fatigued. Sinusitis also causes shortness of breath along with nasal congestion and stuffiness that can leave you gasping for air if you have COPD.
  

Possible Complications

An episode of sinusitis usually starts as a mild infection limited to the sinuses. With COPD, the infection can sometimes spread to the lower airways, causing bronchitis or pneumonia.

Even in the absence of bronchitis or pneumonia, frequent sinus infections can lead to more frequent COPD exacerbations. This places the lungs under an increased inflammatory burden, speeding the progression of COPD and the destruction of lung tissues.

Sinusitis can make COPD worse to the point where hospitalization is needed.

How COPD Causes Sinusitis

There are many explanations as to why COPD and sinusitis are so closely linked.

Among them, COPD is associated with impaired immunity as well as difficulty clearing infections. This alone can increase your vulnerability to sinusitis by making it harder for you to fight common infections like the cold. It can make infections harder to clear and more likely to recur.

Sinus symptoms also tend to be worse if you have COPD. This is because COPD causes airway hyperreactivity, making your sinuses extra sensitive to temperature or anything else you might inhale (like perfumes, deodorants, smoke, or dust).

Because of this, symptoms can linger as inhaled irritants become trapped in congested sinuses, extending the illness beyond what someone without COPD might experience.

How Sinusitis Is Diagnosis if You Have COPD

Sinusitis can be difficult to distinguish from a COPD exacerbation, and vice versa, Even so, there are ways to differentiate the two.

For example, fever, nasal congestion, sinus pressure, and a non-productive ("dry") cough are hallmarks of sinusitis. With COPD, the hallmarks are shortness of breath, wheezing, and a productive ("wet") cough.

To this end, if you have a fever and nasal congestion but are otherwise breathing OK, your healthcare provider may suspect that sinusitis is the cause.

On the other hand, if you have difficulty breathing but no fever or nasal congestion, your provider might reasonably assume that you are having a COPD exacerbation.

As part of the evaluation, your healthcare provider may perform the following tests and procedures to make the diagnosis:

• Auscultation: This means listening with a stethoscope. The healthcare provider can check for irregular lung sounds more consistent with COPD.
• Oral examination: This includes looking at the back of your throat for pus that may be leaking from the sinuses. The provider may also tap on your sinuses to check for tenderness or fullness.
  
• Temperature: A low-grade fever is possible with a COPD exacerbation, while a high-grade fever is more common with a viral respiratory infection.
• Throat culture: This involves the swab of your throat to check for any viruses or bacteria in a lab culture.
• Blood tests: A complete blood count (CBC) can check for high white blood cells, a sign that your body is fighting an infection.
• Sinus X-ray: While usually not necessary, this imaging study can provide evidence of sinus inflammation and congestion if there is any doubt about the cause.

How to Treat Sinusitis if You Have COPD

There are a few lifestyle changes you can make to ease sinusitis symptoms and prevent the worsening of COPD:

• A healthy diet: Nutrition can help your body better fight infection.
• Ample hydration: Drinking plenty of fluid can thin mucus and make it easier to breathe.
• Avoidance of irritants: This includes cigarette smoke, dust, perfumes, and other irritants that can amplify sinus symptoms and trigger COPD.
• Using a humidifier: These devices can reduce irritants or allergens circulating in the air.
• Sinus irrigation: By rinsing your nasal passages with a neti pot, you may avoid the need for sinus medications.

If medications are needed, your healthcare provider may prescribe:

• Oral or nasal decongestants, like Sudafed (pseudoephedrine) to reduce congestion
• Antihistamines like Claritin (loratadine) that can help ease symptoms even in the absence of an overt allergy
• Nasal steroid sprays like Nasacort (triamcinolone) to reduce inflammation
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) to reduce fever and sinus pain
• Antibiotics if you have a bacterial infection

Summary

COPD can increase the risk of sinusitis by lowering your immune defenses and making you more sensitive to inhaled irritants. On the flip side, sinusitis can trigger COPD exacerbations and make COPD harder to control, contributing to the progression of the disease.

By treating sinusitis appropriately and taking steps to avoid future episodes, you can better control COPD and avoid disease progression.