Diagnosing Chronic Fatigue? Check For Sinusitis

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February 03, 2004

Diagnosing Chronic Fatigue? Check For Sinusitis

A new study published in the August 11 issue of the Archives of

Internal Medicine demonstrates a possible link between unexplained

chronic fatigue and sinusitis, two conditions previously not

associated with each other. Also newly noted was a relationship

between sinusitis and unexplained body pain. These findings offer new

hope to patients lacking a diagnosis and treatment for fatigue and

pain. Sinus disease is seldom considered as a cause of unexplained

chronic fatigue or pain, despite recent ear, nose, and throat

(otolaryngology) studies documenting significant fatigue and pain in

patients with sinusitis and dramatic improvement after sinus surgery.

A Harvard study showed that fatigue and pain scores of sinusitis

patients were similar or worse than a group 20 years older with

congestive heart failure, lung disease, or back pain. " Chronic

fatigue is a condition that frustrates both doctors and their

patients since treatments directed at just the symptoms without

knowing the cause are typically ineffective, " said C.

Chester, M.D., clinical professor of medicine at town

University Medical Center and principal investigator of the pilot

study. " While sinusitis will not be the answer for everyone who comes

to an internist with unexplained fatigue or pain, this study does

suggest that it should be considered as part of a patient's medical

evaluation. " Through his private internal medicine practice, Chester

questioned 297 patients, noting unexplained chronic fatigue in 22%,

unexplained chronic pain in 11%, and both in 9%. While these numbers

are consistent with previous studies, Chester observed an unusual

connection between patients with chronic pain or fatigue: prevalent

sinus symptoms. Sinus symptoms were nine times more common on average

in patients with unexplained chronic fatigue than the control group,

and six times more common in patients with unexplained chronic pain.

In addition, sinus symptoms were more common in patients with

unexplained fatigue than in patients with fatigue explained by a

mental or physical illness, suggesting the syndrome of unexplained

fatigue is more closely associated with sinusitis than are other

types of fatigue. The CDC approximates that sinusitis affects 32

million Americans. Rates are highest among women and people living in

the South. Women comprised 46% of the participants in this study, but

represented 60% of the group with fatigue, predominance also noted in

most prior studies. 15 out of the 65 patients in Chester's study met

criteria for chronic fatigue syndrome (CFS), a severe form of

unexplained chronic fatigue associated with body pains and other

symptoms. Most CFS patients had sinus symptoms and many noted a

sudden onset of their illness, similar to people with sinusitis. " We

clearly need to do more research to see if sinus treatments alleviate

fatigue and pain. This study does, however, offer hope for possible

help in the future. " said Chester. SOURCE: town University

Medical Center