CRS Treatment
Back Maintenance treatments Nasal Rinsing There are many ways to manage CRS. Maintenance treatments focus on reducing inflammation and irritation, clearing mucus, and improving breathing through the nose. One of the key therapies for CRS is nasal rinsing with saline (salt water). This simple solution can: Help clear out your nasal passages and sinuses Help prevent secretions from dripping into your throat Wash away allergens and irritants that might be making your symptoms worse Using a rinse before applying other medications to your nose (like corticosteroid sprays) can also help those medicines work better by allowing them to reach the inside of your nose more effectively. Nasal rinsing with saline has few side effects, except that you need to learn how to do it properly to avoid discomfort. Nasal rinsing should be done daily and preferably twice a day. Saline solutions can be easily prepared at home by mixing clean, previously boiled, lukewarm water with unionized salt (9 grams of salt with 1 litre of water, or 3 grams in a nasal rinsing device) and pouring into a nasal rinsing device. These devices are available over-the-counter. Always prepare a fresh saline solution before use. https://youtu.be/BhsC_Pv_om4https://youtu.be/wnpsJfeYJFAhttps://youtu.be/qspu4wb9ZSghttps://youtu.be/qfzrDpdj_90 Nasal corticosteroids An additional effective option is nasal corticosteroid sprays or drops. These sprays: Help reduce inflammation inside your nose and sinuses Reduce stuffiness over time They work by calming down inflammation in your nasal passages and sinuses. Corticosteroid sprays are safe to use in the long term. Some people can experience side effects like irritation, nose bleeding or dryness. However, a correct spraying technique can prevent most of the discomfort. Some of these sprays are available over the counter, but in some countries, you might need a prescription to get them. Your doctor might also advise you to dissolve this drug into your saline solution for nasal rinsing. This is sometimes referred to as corticosteroid irrigation. Keep the spray by your toothbrush so as not to forget. If you suffer from allergies, your physician may also prescribe anti-allergic pills or sprays (also called antihistamines). These medications can typically be bought over the counter at your pharmacy. Short-term relief therapies Sometimes your doctor might recommend a treatment for short term use. These therapies are not recommended for a long period or for frequent use due to adverse effects. Decongestant sprays/drops: These nasal sprays/drops can quickly shrink swollen tissues inside your nose, making it easier to breathe. But if you use them for more than a few days in a row, they can backfire by making your nose feel even more stuffy when you stop using them. This is called rebound congestion, which means your nose becomes dependent on the spray to stay clear. To avoid this problem, you have to use these sprays only as directed and for a short time. If you are already relying on them to breathe, it is important to talk to a doctor, who can guide you on how to stop safely and explore other treatment options. If prescribed by your doctor, it is important to: Use the spray only for the recommended time (no more than 7 days in a row). Schedule a follow-up visit with your doctor to check progress. Understand that it does not treat the inflammation that is causing your symptoms. Decongestant pills: These pills contain pseudo-ephedrine, which is sometimes prescribed for short-term relief for a blocked nose. However, there is no recommendation for long term use due to adverse events (like cardiac risk). Corticosteroid tablets or pills: These are sometimes used for a short time alongside nasal sprays to quickly reduce swelling. They work fast, are strong, and are affordable. However, their benefits do not last long, and long-term or repeated use can lead to several side effects. If it is prescribed for CRS, it should be done under specialist care. Antibiotics: In some cases, the doctor might prescribe antibiotics for a short or longer period. Some antibiotics (like azithromycin) are given by a ENT specialist for a longer period because they can help reduce inflammation. The use of short-term antibiotics is usually not helpful in CRS and frequent short-term courses of antibiotics increase the risk of bacteria to become resistant making the drug less effective. Antibiotics may cause side effects like diarrhoea and fungal infections, along with other side effects, depending on the type of drug you get. Additional options: Surgery What is sinus surgery? If symptoms don’t improve with nasal rinsing or corticosteroid sprays, there are additional options. One of the options your ENT specialist can consider is surgery. The goals of sinus surgery are to: Open up the sinuses to improve drainage of secretions and access to nasal irrigations with salt water and/or delivery of medications like nasal sprays. Remove nasal polyps if they are present and improve nasal passage/breathing May have positive effects on your lower airways Surgery is typically recommended only after trying the combination of nasal rinsing and nasal corticosteroids. What to expect from sinus surgery?: Most nasal symptoms improve after surgery, but it doesn’t cure the condition, because CRS is caused by chronic inflammation of the nose and sinuses. Recovery can take up to several months, though this varies from person to person and depends on the specific procedure done. Sinus surgery is a complex procedure, and complications can happen during surgery. Talk to your doctor to discuss the pros and cons that are relevant to you. If symptoms worsen again, your doctor may need to review your treatment plan and consider more medical or surgical options. Additional options: Biologics What are biologics and when are they used? In cases where symptoms persist after surgery and impact your daily life greatly, biologics can be considered. Biologics are only added to your current treatment after your doctor has made a detailed evaluation of your condition and the type of inflammation you suffer from. This process of figuring out the specifics of your condition is something your specialist may refer to as “endotyping” or “phenotyping”. This is important
