Chronic obstructive pulmonary disease or COPD is a lung disease that causes difficulties in breathing. A person with this disease may experience chronic cough, chest tightness, wheezing, and increased sputum production. They may also suffer from medical conditions that may be connected to the nose. Sinusitis is the swelling of the sinuses that seems to have a link with COPD. The chronic inflammation associated with lung disease can impact the entire respiratory tract, including the sinuses. On World Chronic Obstructive Pulmonary Disease Day, observed every third Wednesday of November, here's the link between chronic obstructive pulmonary disease and sinusitis.

What is chronic obstructive pulmonary disease?

It is a progressive lung disorder, which is characterised by respiratory symptoms as well as airflow limitation. "The disease involves a combination of chronic bronchitis, which is the inflammation of the airways, and emphysema, which is the damage caused to the air sacs in the lungs," explains pulmonologist Dr Navneet Sood. It is the fourth leading cause of death across the globe, causing 3.5 million deaths in 2021, according to the World Health Organization. About 600 million people, aged 25 and older, are expected to have COPD globally by 2050, as per a study published in JAMA Network Open in 2023.

COPD cases are expected to rise. Image courtesy: Shutterstock

"The condition primarily affects middle-aged and older adults, particularly those with a history of smoking, but it can also occur due to long-term exposure to pollutants," says the expert. Exposure to dust, chemicals, and fumes, as well as indoor smoke from burning fuels can lead to COPD.

What are the symptoms of chronic obstructive pulmonary disease?

• Often accompanied by mucus (phlegm), the cough is persistent and may worsen over time.
• People frequently experience breathlessness, especially during physical activity.
• Wheezing, which is a whistling or rattling sound while breathing.
• A feeling of pressure in the chest.
• The body produces more mucus, which can be difficult to expel.
• Constant breathlessness and poor lung function can lead to a feeling of exhaustion.

Chronic obstructive pulmonary disease and sinusitis: Here's how COPD can affect sinuses

Sinusitis, the inflammation of the sinuses located near the nose, is often caused by bacterial infection. During a 2012 study published in the European Respiratory Journal, sinusitis complaints were found to be common among people with COPD.

Here’s how chronic obstructive pulmonary disease can lead to sinusitis:

• Inflammation of the respiratory tract: COPD involves chronic inflammation, which can extend to the nasal passages and sinuses. "The chronic inflammation can come in the way of sinus drainage pathways, leading to sinusitis," says the expert.
• Mucus overproduction: People with COPD produce excess mucus, which can block the sinuses and become a breeding ground for bacteria, resulting in sinus infection.
• Reduced immune function: COPD patients often have weakened immune systems, making them more prone to infections, including sinusitis.

"In essence, the respiratory changes seen in COPD can create an environment where sinusitis is more likely to occur," says Dr Sood.

Chronic obstructive pulmonary disease and sinusitis: Know how to diagnose sinus problem

Diagnosing sinusitis in a COPD patient can be challenging because both conditions share overlapping symptoms like coughing, congestion, and mucus production. However, there are specific diagnostic approaches that can help distinguish sinusitis in a person with COPD:

• Medical history and symptom analysis: A detailed history, including the presence of facial pain, pressure, or headaches, may indicate sinusitis rather than purely COPD-related symptoms.
• Physical examination: The doctor may look for signs of sinus tenderness or pressure in the facial area.
• Nasal endoscopy: This procedure allows direct visualisation of the nasal passages and sinuses, helping identify inflammation, polyps, or blockages.

Chronic obstructive pulmonary disease and sinusitis: Here's how COPD problems can get triggered

Sinusitis can exacerbate chronic obstructive pulmonary disease symptoms and trigger flare-ups. During a 2007 study published in COPD: Journal of Chronic Obstructive Pulmonary Disease, one-third of people with sinusitis were also found to have symptoms of COPD or asthma.

• Increased inflammation: Sinus infections can cause inflammation that spreads to the lower respiratory tract, worsening COPD symptoms like coughing and breathlessness.
• Mucus accumulation: Sinusitis leads to an increase in mucus production, which can drip down into the lungs (postnasal drip), leading to airway irritation and triggering COPD symptoms.
• Infection spread: Bacterial infections in the sinuses can easily spread to the lower respiratory tract, causing bronchitis or pneumonia, which are severe complications for COPD patients.

COPD and sinusitis are connected. Image courtesy: Adobe Stock

How to treat chronic obstructive pulmonary disease and sinusitis?

Treatment of both chronic obstructive pulmonary disease and sinusitis requires an approach that addresses both the conditions simultaneously.

1. COPD

• Smoking cessation is the most effective way to slow COPD progression.
• Medications such as Bronchodilators can help relax the muscles around the airways, making breathing easier. "Inhaled corticosteroids can reduce inflammation in the lungs," says the expert.
• Pulmonary rehabilitation programme includes exercise training, and support to improve lung function.
• For advanced COPD, oxygen therapy may be necessary to ensure adequate oxygen levels in the blood.

2. Sinusitis

• Nasal irrigation can help reduce nasal congestion and clear mucus from the sinuses.
• Boil water and pour it into a container. Place a towel over your head, and inhale steam to treat sinusitis, according to Harvard Health Publishing.
• Nasal steroids can reduce inflammation in the nasal passages.
• "In chronic cases where medications fail, sinus surgery may be needed to clear blockages," says the expert.

Chronic obstructive pulmonary disease and sinusitis can be exacerbated by pollutants, allergens, and smoke. "It is best to avoid these triggers if you have both conditions," says the expert.

Chronic obstructive pulmonary disease and sinusitis are distinct, but interconnected conditions. Understanding the relationship between these conditions and implementing a comprehensive treatment plan can help manage the symptoms effectively.

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