How to treat chronic sinusitis and polyps?

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

It sounds like you have chronic sinusitis with nasal polyps, which can cause a persistent bad smell from the nose due to bacterial buildup, inflammation, or mucus trapping. Since you have had this for over five years, and medications have not helped, you may need a different treatment approach.

Possible causes of nasal odor and chronic sinusitis:

1. Nasal polyps and blocked sinuses → Traps mucus & bacteria, leading to bad odor.

2. Chronic bacterial or fungal sinus infection → If antibiotics like Ciprofloxacin and Flagyl do not work, you may have a resistant infection or a fungal sinus infection.

3. Post-nasal drip → Mucus buildup in the back of the throat can cause a foul smell.

4. Deviated septum or structural issues → Prevents sinuses from draining properly.

Next steps for treatment:

1. Stronger or different antibiotics (if bacterial): Since Ciprofloxacin and Flagyl did not help, you might need a broader-spectrum antibiotic (like Augmentin or Clindamycin). A nasal swab culture can confirm if you have a resistant infection.

2. Nasal steroids (for polyps and inflammation): Fluticasone (Flonase) or Mometasone (Nasonex) nasal sprays can shrink polyps & reduce inflammation. Prednisone (oral steroid) might help temporarily but is not a long-term fix.

3. Saline nasal irrigation (to flush bacteria and mucus): Daily use of a Neti Pot or saline rinse (like NeilMed sinus rinse) can help clear mucus and bacteria. Add Xylitol nasal spray (like Xlear) to prevent bacterial growth.

4. Fungal sinus Infection? (If antibiotics did not work). If the bad smell is musty or moldy, you might have a fungal sinus infection (antibiotics would not work for this). Itraconazole (antifungal medicines) or antifungal nasal rinses may be needed.

5. Surgery (If severe polyps or blockage): If medications do not work, Endoscopic Sinus Surgery may be needed to remove polyps, infected tissue, or fix a deviated septum.

6. If you have never had a CT (computed tomography) scan, ask your doctor to check if surgery is needed.

What you should do now:

1. See an ENT Specialist (Otolaryngologist) for a nasal swab and CT scan.

2. Try a daily saline rinse + steroid nasal spray (Flonase or Nasonex).

3. If antibiotics do not work, ask about a fungal infection or chronic bacterial resistance.

Since you have suffered for five years, a specialist should do a deeper evaluation to find the real cause. Would you like help with home remedies to manage the symptoms while you wait for an appointment?

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.