If you have ever suffered with sinusitis, you know how terrible it can make you feel. Breathing is difficult; smelling and tasting anything is impossible. What are the causes of sinusitis and what can you do about it? Joe and Terry talk with a leading physician who does research on how to treat sinusitis to find out how you can stop suffering with sinusitis.

At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While our goal with these conversations is to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

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Why Are You Suffering with Sinusitis?

According to the CDC, almost 30 million American adults have been diagnosed with sinusitis. What are sinuses and why do they cause so much trouble? We asked Dr. Zara Patel to explain.

She let us know that we have multiple sinus cavities within our skull filled with air and lined with mucus membranes. Sinusitis indicates that there is inflammation in those membranes. It might be caused by an allergic reaction or an infection. This may interfere with the ability to smell (and consequently, to taste). It might also lead to congestion, drainage or post-nasal drip. People feel crummy. They may have brain fog or low stamina. The cardinal symptom of sinusitis is a feeling of facial pressure. The suffering from chronic sinusitis is just as severe as that from heart failure or diabetes.

Sinuses Have Their Own Microbiome:

Just like most other parts of the human body, the sinuses are inhabited. Healthy sinuses have a microbiome of bacteria, viruses, fungi and archaea that stays in balance, more or less, and doesn’t cause trouble. When that microbiome gets thrown out of whack for one reason or another, the result can be an infection. To determine that, doctors occasionally culture the drainage. That’s not very accurate, however. A PCR test works better to find out what is in there that could be problematic.

Infections are not the only cause of sinusitis, however. The mucus linings may be reacting to environmental irritants or pollutants. Small particulates such as those in automobile exhaust or wildfire smoke (PM2.5) can lead to a lot of inflammation. People who develop polyps in their sinuses may be especially vulnerable to some of these triggers.

Irrigation to Stop Suffering with Sinusitis:

One way of managing sinus problems is irrigation with clean water. (That would mean distilled water or water that has been sterilized by boiling before cooling to room temperature.)

A neti pot is a very old-fashioned way of doing this, based on Ayurvedic medical tradition. That provides a low-pressure, high-volume irrigation in which water is poured into one nostril and exits the other, washing the sinuses along the way.

For her patients with chronic sinusitis, Dr. Patel recommends irrigation with a squeeze bottle. (NeilMed would be one example.) This offers high-pressure, high-volume irrigation that can be very helpful in calming inflamed sinuses. She urges people to stay away from motorized devices. They may seem tempting, but it is far too difficult to clean them thoroughly.

Other Medications That Can Help You Stop Suffering with Sinusitis:

Dr. Patel may prescribe or recommend other medicines for her patients with sinusitis. Topical steroids such as fluticasone can be useful. Antibiotics are useful when there is an acute infection. In other cases, a medication like ipratropium could be called for.

She warns, however, that some nasal sprays are bad for people with sinusitis. Decongestants could make a chronic condition worse, even though the immediate effect feels like relief.

There are cases when sinus surgery is appropriate to help a patient who has been suffering with sinusitis. This should generally be a last resort, though. The surgeon should take into account how patients responded to medical treatment before surgery and will want to visualize the sinus with nasal endoscopy or a CT scan. The patient needs to understand that post-surgical care with rinses and sprays will be crucial for at least six months.

This Week’s Guest:

Zara Patel, MD, is Director of Endoscopic Skull Base Surgery, Director of the Stanford Initiative to Cure Smell and Taste Loss, and Director of the Neurorhinology – Advanced Sinus and Skull Base Surgery Fellowship. She is Professor of Otolaryngology in the Dept. of Otolaryngology-Head and Neck Surgery at the Stanford School of Medicine.

You may be interested in her informational YouTube videos. Here is one on how to

rinse your nose and sinuses: https://www.youtube.com/watch?v=kBIvzfx7ulo

Zara Patel, MD, Stanford School of Medicine

Listen to the Podcast:

The podcast of this program will be available Monday, Oct. 13, 2025, after broadcast on Oct. 11. You can stream the show from this site and download the podcast for free.

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Transcript of Show 1448:

A transcript of this show was created using automated speech-to-text software (AI-powered transcription), then carefully reviewed and edited for clarity. While we’ve done our best to ensure both readability and accuracy, please keep in mind that some mistakes may remain. If you have any questions regarding the content of this show, we encourage you to review the original audio recording. This transcript is copyrighted material, all rights reserved. No part of this transcript may be reproduced, distributed, or transmitted in any form without prior written permission.

Joe

00:00-00:26

I’m Joe Graedon.

Terry

00:01-00:05

And I’m Terry Graedon. Welcome to this podcast of The People’s Pharmacy.

Joe

00:06-00:26

You can find previous podcasts and more information on a range of health topics at peoplespharmacy.com. Have you ever suffered from a sinus infection? It can interfere with both taste and smell. What can you do about it? This is The People’s Pharmacy with Terry and Joe Graedon.

Terry

00:34-00:44

Today, we’re talking with one of the country’s leading sinus experts. She’ll explain why we have sinuses and what can go wrong that results in sinusitis.

Joe

00:45-00:56

Sinusitis can linger for weeks and make people feel miserable. It’s not just the congestion, headache, and pressure. Some people develop troublesome post-nasal drip.

Terry

00:57-01:01

What treatments work? When should someone consider surgery?

Joe

01:02-01:07

Coming up on The People’s Pharmacy, how to stop suffering from sinusitis.

Terry

01:14-02:17

In The People’s Pharmacy health headlines, older individuals who feel that they have a purpose in life are less likely to develop cognitive impairment. The data comes from the Health and Retirement Study with more than 13,000 volunteers over 45 years old. They all had normal cognitive function at the beginning of the study and responded to a validated seven-item survey to measure purpose in life.

Over the course of the 15-year study, 13% of the participants developed cognitive impairment. Those who scored higher on the purpose-in-life measure were 28% less likely to become impaired. Purpose can vary. For some people, it consists of spirituality or faith, while for others it may be linked to work, volunteering, or helping others. Relationships with family or close friends can also provide a sense of purpose. One of the investigators notes, it’s never too early or too late to start thinking about what gives your life meaning.

Joe

02:18-03:04

Many chronic health conditions begin long before symptoms appear. The thickening of arteries leading to heart disease can develop many years b