AYURVEDIC MANAGEMENT OF SINUSITIS

MODERN DISEASE EXPLANATION

Sinusitis, also known as a sinus infection or rhinosinusitis, is inflammation of the sinuses resulting in symptoms.. Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection.

CLASSIFICATION

1.    Acute rhinosinusitis – A new infection that may last up to four weeks and can be subdivided symptomatically into severe and non-severe. Some use definitions up to 12 weeks.

2.    Recurrent acute rhinosinusitis – Four or more full episodes of acute sinusitis that occur within one year

3.    Subacute rhinosinusitis – An infection that lasts between four and 12 weeks, and represents a transition between acute and chronic infection

4.    Chronic rhinosinusitis – When the signs and symptoms last for more than 12 weeks.

5.    Acute exacerbation of chronic rhinosinusitis – When the signs and symptoms of chronic rhinosinusitis exacerbate, but return to baseline after treatment

All these types of sinusitis have similar symptoms, and are thus often difficult to distinguish. Acute sinusitis is very common. Roughly ninety percent of adults have had sinusitis at some point in their life.

SYMPTOMS

At least two of the four primary signs and symptoms of chronic sinusitis must be present with confirmation of nasal inflammation for a diagnosis of the condition. They are:

·       Thick, discolored discharge from the nose or 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 in adults or cough in children

·       Other signs and symptoms can include:

Ear pain

·       Aching in your upper jaw and teeth

·       Cough that might worsen at night

·       Sore throat

·       Bad breath (halitosis)

·       Fatigue or irritability

·       Nausea

Chronic sinusitis and acute sinusitis have similar signs and symptoms, but acute sinusitis is a temporary infection of the sinuses often associated with a cold. The signs and symptoms of chronic sinusitis last longer and often cause more fatigue. Fever isn't a common sign of chronic sinusitis, but you might have one with acute sinusitis.

DISEASE- AYURVEDA CONCEPT

As per Ayurveda the root cause of sinusitis is a improper digestion. Due to mand Agni – low fire, food is not properly digested. It creates the nasal inflammation, low immunity etc. agni is the fire element, the jathar agni contributes the metabolic process of the stomach and the upper part of the small intestine jathar agni resembles to the hydrochloric acid secretion by the stomach. With the enzymes secreted by the pancreas, it breaks down the food into small particles and decompose it into absorbable substance. Insufficient secretion of the digestive fluids may be described as a mand agni. the digested food is absorbed by the lower part of the small intestine and the large intestine, and the undigested part is excreted out of body in the form of stool – mala. Ama is useless excreta, it should be excreted otherwise contributes to phlegm.

Due to weak agni of digestive system kapha gets unbalanced and overburden of fluid. . the weaker secretion mechanism for excess fluid creates imbalance of kapha. The un secreted fluid accumulates at several sites of sinuses. Kapha is responsible for dosha of phlegm. The accumulation of phlegm disturbs the vata. The prahna vata agitated by obstruction of phlegm unable to regulate smooth flow. Due to the disturbance to the smooth flow it is transferred in to agitated flow, it is a disease inducing factor.

Pitta is a transporter of the metabolic nutrients with energy for metabolism. The pachak pitta resembles with the bile secretion of gall bladder and spleen. It is responsible for creating digestive fire. Deficiency of is a dosha of fire, which looses control on digestive fire the agni. Excessive kapha and disturbed vata leads to manifestation of mucus and breath. All these three doshas contribute to sinusitis.

Among various causes (common for all the type of Shiro-Roga’s), the below said may be considered causative towards Sinusitis –

Raja – Exposure to dust (allergens)

Tushara – Fog, Dew

Ambukreeda – Playing in water (swimming etc)

Atisvapna – Excessive sleep

Atijagara – Excessive awakening at night

Utsedha – Swelling / inflammation in the sinuses

Atipurovata – excessive exposure to breeze

Bashpanigraha – Habit of controlling tears

Rodana – Excessive weeping

Atyambupana – Drinking lot of water (when not needed, like while hungry)

Atimadhyapana – Excessive consumption of alcohol

Krimi – Affliction / infection by microorganisms

Upadhana – Sleeping with elevated pillows (using many pillows and sleeping with high head position)

Asatmyagandha – unwholesome smell / irritating odours

Dushtaanna – Contaminated / unwholesome foods

TREATMENT PROTOCOL

General line of treatment:

External treatment –

·       Lepa – Application of medicinal pastes

·       Seka – Stream pouring of medicated liquids

·       Upanaha – Poultices

·       Kavala / Gandusha – Gargles

Internal treatment –

Nasya therapy: Nasya means nasal instillation of medicaments.

Virechana – Therapeutic purgation

Vamana – Therapeutic Emesis

CLASSICAL MEDICINES

·       Amrithotharam Kashayam                                                  

·       Amritarishtam

·       Dasamoola Kadutrayam                                                       

·       Punarnavasavam.etc

·       Pathyashadangam.

·       Gulguluthikthakam.

·       Varanadi kashayam.

·       Indukantham Kashayam

·       Asaneladi Tailam.                                                               

·       Anu tailam                                                                           

·       Amrutadi Tailam.                                                                

·       Rasnadi churnam.

·       Nagaradi Tailam.                                                         

·       Taleesapatradi churnam.

·       Nirgundyadi Tailam                                                        

·       Sudarsanam churnam

AHARA VIHARAM

Tips to prevent Sinusitis:

·       Avoid Kapha aggravating foods and activities – Cold food, drinks and places, cold water shower or bath, especially head bath, day sleep, excessive sleep, sedentary life, foods which are oily, sweet, sour and salty in taste, heavy to digest foods, etc

·       Take seasonal fruits like pomegranate, orange, sweet orange, papaya, apple, pears etc

·       Avoid milk, sugar, coffee, fried products, refrigerated products, sweets, oily products, dishes prepared with flour, fast food, carbonated drinks, cigarette, chocolates, white flour, liquor, meat, bread, junks etc

·       Do good exercise and walking

·       Garlic and onion as a part of diet

·       Follow Vata-Kapha pacifying diet. They are responsible for accumulation / stagnation of morbidity in the body (sinuses in this case).

·       Eat foods that are neither too hot nor too cold.

·       Favour cooked warm meals that are light, nurturing and easy to digest.

·       Kichri (light and nourishing porridge) or Pongal (south) prepared with green gram, rice and kitchen spices like ginger, cumin seeds, turmeric, fennel seeds, pepper and cinnamon is good for sinusitis

·       Keep your bowels clear – Eat fibre rich vegetables (green leaves), organic fruits and vegetables, avoid brinjal (egg-plant), banana, tomato, curds etc which can clog your channels

·       Don’t skip or delay meals – They will disturb your gut fire (agni) and cause errors of digestion. This will supply less nutrition to your tissues and also will form lot of ama in the cells (intermediate products of metabolism with a sticky nature and capacity to block the body channels). Ama will further predispose to the formation of many diseases including sinusitis.

·       Best options in kitchen – Regularly use – Cinnamon, Black pepper, cumin seeds, mint, onion, basil, garlic, honey, coriander, rock salt, fennel, clove, turmeric, ginger, liquorice, etc

·       Use well fitting eyeglasses, if your glasses pinch your nasal bridge, your symptoms may get worse

Avoid:

·       Cigarette smoke

·       Air pollutants

·       Swimming in the pool treated with chlorine

·       Air travel – too is a risk factor for exacerbation of sinusitis since the air pressure changes. Take caution and some medicine during air travel

·       Rainstorm and damp weather – Symptoms of sinusitis worsen before a rainstorm due to changes in air pressure. Protect yourself during windy and rainy seasons.

·       Dust, mould, pollens or any known food allergies; know your allergies with the help of your doctor

·       Curds, banana, ice-cold drinks, beverages

·       Frequent head baths

·       Mosquito repellents

Pathya (beneficial / wholesome things) in Sinusitis

·       Swedana – fomentation / sweating treatment / sudation with medicated decoctions or processed milk

·       Nasya – Instillation of herbal decoctions, processed milk, powder, juices etc in the nose

·       Dhumrapana – Herbal smoking

·       Virechana – Therapeutic purgation

·       Lepa – Application of pastes made with medicinal drugs

·       Seka – Stream pouring of medicated fluids

·       Langhana – Fasting

·       Upanaha – Poultices

·       Purana ghrita – old ghee

·       Shali – rice

·       Yusha – Soups

·       Dugdha – milk

·       Patola – Pointed gourd

·       Shigru – Drumstick

·       Draksha – Raisins

·       Karavellaka – Bitter gourd

·       Amalaki – Indian gooseberry

·       Dadima – Pomegranate

·       Taila – oil

·       Takra – Buttermilk

·       Narikelakam – Coconut

·       Pathya – Terminalia chebula

·       Bhringaraja – Eclipta alba

·       Kumara – Aloe vera

·       Musta – Cyperus rotundus

Apathya (unwholesome things) in Sinusitis

·       Vega dharana – Forcibly controlling the impending urges (reflexes) of sneeze, yawning, tear, urine and faeces

·       Viruddha bhojana – Incompatible foods

·       Dugdha – Milk

·       Jalam – Water

·       Vibuddha jalamajjanam – Diving into water with head-down position

·       Dantakashtam – Brushing with brush made of herbal sticks (twigs)

·       Divaswapna – Sleeping during day time