• Posted February 28, 2024

Is It Allergies or Sinusitis? Many Folks Are Misdiagnosed

What if you'd been treated for years for a condition, only to find out that you'd long ago been misdiagnosed?

That's what's happening to a sizable number of Americans who are taking allergy meds (to little effect) when in fact they have chronic rhinosinusitis (CRS), a new study contends.

"We have seen so many patients suffer for so long due to the confusion between allergies and CRS,"said study lead author Dr. Ahmad Sedaghat. "I've had patients who tell me that they have been treated with allergy shots for 10, 20 or more years without relief of their symptoms but who after we discovered they had CRS and we started them on appropriate treatment, achieved relief within a few months."

Sedaghat is director of rhinology and allergy and professor of otolaryngology, head & neck surgery at the University of Cincinnati College of Medicine. His team published its findings recently in the journal Otolaryngology Head & Neck Surgery.

According to background information in a university news release, CRS affects almost 15% of Americans. The condition is typically treated with antibiotics.

The trouble is, the outward signs of sinusitis can mimic those of a nasal allergy.

"As someone who grew up in [the Midwest], I can attest to how commonly we tend to attribute sinus and nasal symptoms to 'allergies,'" Sedaghat said. "But the reason for this is that nasal allergies [allergic rhinitis] and CRS have overlapping symptomatology, often characterized by nasal blockage and nasal drainage. Both can also cause sinus pressure."

The treatment for CRS and nasal allergies is very different, however, which means that misdiagnosis can lead to months or years of needless misery.

The new study involved 219 people who'd been thought to have nasal allergies. Each underwent nasal endoscopy and testing to gauge the severity and type of their sinus/nasal symptoms.

"We specifically used this questionnaire to study our patients' symptoms because we could simultaneously measure symptoms of CRS and allergic rhinitis without having to use different questionnaires,"Sedaghat explained.

A majority (91.5%) did have some form of environmental allergy, testing revealed.

However, almost half (45.2%) also tested positive for CRS, the team found.

Knowing that you have chronic sinusitis might result in treatments that resolve symptoms, even if you've taken allergy meds for years, Sedaghat said.

He said he was "excited to bring light to this very important problem that so many patients in our region are dealing with. Almost 50% of patients who came to see us for what they thought were nasal allergies had CRS."

"Imagine how many patients may be under-treated and how many patients can be positively impacted by seeking out care for the possibility of CRS," Sedaghat added.

The solution to misdiagnosis and under-diagnosis of sinusitis isn't that complicated, he said.

"These tools -- for example, easy-to-use questions for patients to ask themselves -- will help the large fraction of patients who are suffering from nasal and sinus symptoms despite allergy treatments to seek out additional care for CRS," Sedaghat said.

More information

Find out more about chronic sinusitis at the Cleveland Clinic.

SOURCE: University of Cincinnati, news release, Feb. 26, 2024