Diagnosing Chronic Fatigue? Check For Sinusitis
WASHINGTON,
DC -- August 13, 2003 -- 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 Alexander C. Chester, M.D., clinical professor of
medicine at Georgetown 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:
Georgetown University
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