Sinus Infections – How Fixing Your Gut May Fix Your Nose.

1. 40 million Americans suffer from Chronic Sinusitis (AKA Sinus Infections) each year.

Chronic sinusitis (also known as chronic rhinosinusitis, or CRS) is one of the most common human diseases, affecting 1 in 7 American adults. How do you know if you are part of that statistic? According to the Mayo Clinic, common symptoms are: 

·      Nasal inflammation

·      Thick, discolored discharge from the nose

·      Drainage down the back of the throat (postnasal drainage)

·      Nasal obstruction or congestion, causing difficulty breathing through your nose

·      Pain, tenderness and swelling around your eyes, cheeks, nose or forehead

·      Reduced sense of smell and taste

 

Over 20 percent of patients are unresponsive to drug therapy, including nasal corticosteroids and oral or injected corticosteroids, which can decrease inflammation from severe cases, especially those with nasal polyps. Antibiotics, which are used when bacterial infections are suspected, and Immunotherapy (allergy shots) are also a part of that unresponsive 20%. Up to 40 percent of patients do not respond to surgeryeither, which entails removing tissue from the sinus passages or shaving away a polyp that's causing nasal blockage. 

·      Oral or injected corticosteroids. These medications are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. Oral corticosteroids can cause serious side effects when used long term, so they're used only to treat severe symptoms.

2. CURRENT TREATMENT -Target potentially harmful bacteria that are causing CRS. 
The conventional viewpoint is that CRS is caused by the presence of certain harmful species of bacteria, such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.” 

3. THE LATEST FINDINGS – Help the Good Bacteria!

Recentstudiesfrom the Mayo Clinic even question the idea that chronic sinusitis is a bacterial disease and document the presence of fungal pathogens that are responsible for the inflammation and mucus response. 

Dr. Susan Lynch wrote a paperout of the University of California, San Francisco, drawing attention to a different catalyst for CRS. 

·       She noticed that "the primary difference between patients with CRS and control subjects was notthe presence of any particular pathogenic species (which both groups had in similar amounts), but the overall diversity of the sinus microbiome."



4. CONVENTIONAL ROUTE - Treatment towards a single pathogenic species.
Prescribe Antibiotics

Seek to eliminate a particular pathogen or species
Kill harmful species of bacteria, potentially further reducing microbial diversity

 HOLLISTIC ROUTE –Examine the environment in which the pathogen resides.  
Prescribe Probiotics 
Not driving treatment plan towards eradicating "a particular pathogen or species"
Restoring microbial diversity

·     Recent research has shown that "resident microbiota in a given niche can strongly influence the behavior of specific species, particularly pathogens …and represents an important contributory factor to disease etiology."

 

5. According to Chris Kresser’s article, "Chronic Sinus Problems: Another Role for Probiotics?"  it isn’t the presence of a particular pathogen that matters most, but rather the environment in which the pathogen is present. What does that mean? Kresser is suggesting we look into the environment of the specific biome. Let’s back up for a second. What is a biome and where is it located? First, “we have microbes in other areas of our bodies that play similarly important roles in maintaining health and preventing disease.” Our Skin, Mouth, GI Tract, Respiratory Tract, Sinuses & Skin of the penis and Urogential Tract all have biomes!

Second, “The human microbiome contains bacteria, but that’s not all. There are “human cells, viral strains, yeasts and fungi, but the bacteria have the most important role when it comes to controlling immune function and inflammation.”  According to Dr. Axe, we need more of the “good gut bugs” aka probiotics and less of the harmful ones to boost immunity and remain symptom free.  The SAD diet (Standard American Diet) of processed food and refined carbs, combined with stress and environmental toxins feed the “bad bugs” in the microbiome contributing to an increase of “potentially dangerous bacteria, fungus, yeast and pathogens.” An excess of pathogenic bacteria contributes to a lack diversityof the good protectivebugs in our guts. This lack of diversity concept is similar to Dr. Susan Lynch’s statement about the overall diversity of the sinus microbiome. Similar to the sinus cavity, an altered gut microbiome has health consequencesas well. It lends itself to the development of certain diseases such as infectious diseases, liver diseases, gastrointestinal cancers, metabolic diseases, respiratory diseases, mental or psychological diseases, and autoimmune diseases).

Luckily, we’ve got the current technology to differentiate between what normal and abnormal microbiomes look like. Looking at the conditions of these various biomes, and the sinus cavity in particular gives practitioners the ability to better grasp the causes of diseases like Chronic sinusitis. It also influences the types of treatment options that will be available. 

6. Now that we are clear about the beneficial role of probiotics should they be considered as part of the treatment for CRS? Should you be asking your practitioner questions about the role of Anti-biotics vs. Pro-biotics and how both positively or negatively impact the diversity of your gut? As stated above, the conventional route utilizes antibiotics, while a holistic route leans towards probiotics. What does the science say? 

·       "Probioticshave been shown to disrupt biofilms, which are present in CRS and difficult to eradicate through other means." 

·       "Bothhuman and animal studieshave shown that oral probiotics reduce colonization of the nose and upper respiratory tract by pathogenic bacteria(e.g., Staphylococcus aureus, Streptococcus pneumoniae, and β-hemolytic streptococci)." 

·       "Third, upper respiratory tract infections often precede the development of CRS, and probioticshave been shown to be effective in preventing them." 

 

7. Dr. Susan Lynch found that most patients with CRS are lacking in a particular species of bacteria called Lactobacillus sakei. These bacteria are naturally occurring within the nose, and are also found in fermented beverages like kimchi and sake. She is working on developing a nasal spray containing bacterial species, but it will need to be tested for safety and go through clinical trials before it's available on the market.

 

Now should we all go running out to buy fermented food and probiotic supplements? Sounds like that will boost our immune systems and stave off human diseases! When it comes to supplement recommendations that’s a question you should ask your practitioner. However, knowledge is power! I recommend reading up on these gut bugs so that you are capable of making informed decisions regarding your health. Searches for probiotic foods and probiotic supplements are a good place to start. We can’t depend solely on another person to tell us how to get better. Plus, nobody knows our bodies better than we do. Yes, they can guide and educate us, but we’re more than a mindless bunch of meat suits walking around!  We’ve got “skin in the game” and we have to be accountable for our own health. I just hope the efficacy of treatments will be high across the board regardless of whether a patient seeks a holistic or more conventional, western medical route.  

REFERENCES

Chronic Sinus Problems: Another Role for Probiotics?
https://chriskresser.com/chronic-sinus-problems-another-role-for-probiotics/

Eradicating Chronic Ear, Nose, and Throat Infections: A Systematically Conducted Literature Review of Advances in Biofilm Treatment
https://journals.sagepub.com/doi/abs/10.1177/0194599810391620

Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureusStreptococcus pneumoniae, and β-hemolytic streptococci) 
https://academic.oup.com/ajcn/article/77/2/517/4689718

Probiotics for preventing acute upper respiratory tract infections.
https://www.ncbi.nlm.nih.gov/pubmed/21901706

Probiotic manipulation of the chronic rhinosinusitis microbiome.
https://www.ncbi.nlm.nih.gov/pubmed/24415658

Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis.
https://www.ncbi.nlm.nih.gov/pubmed/22972842

The Human Microbiome: How It Works + a Diet for Gut https://draxe.com/health/gut-health/microbiome/

The Microbiology and Management of Acute and Chronic Rhinosinusitis.
https://www.ncbi.nlm.nih.gov/pubmed/11384550


Kimberly JonesComment