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http://my.webmd.com/content/Article/72/81689.htm

Chronic Fatigue Linked to Sinus Problems

Sinusitis May Also Be a Cause of Unexplained Bodily Pains

By Salynn Boyles

WebMD Medical News  Reviewed By Brunilda  Nazario, MD

on Monday, August 11, 2003

Aug. 11, 2003 -- The causes of chronic fatigue and the bodily pain condition known as fibromyalgia remain a mystery, but intriguing early research suggests that for many sufferers the answer may be right under -- or more accurately inside -- their noses.

The new study shows a possible link between unexplained fatigue or body pain and sinus problems. If confirmed, they may lead to better treatments for chronic fatigue syndrome and fibromyalgia, a condition characterized by widespread pain for which no cause can be found, study author C. Chester, MD, tells WebMD. The town University professor of medicine and general internist says he began his research after realizing that many of his patients with sinus problems also complained of fatigue and many patients with unexplained fatigue and aches also had sinus problems.

"Often when I treated sinus symptoms, the fatigue and body aches would disappear," Chester says. "Fatigue is a known symptom of sinusitis, but sinus problems are not generally considered in patients with unexplained fatigue and body pain."

Chester surveyed 297 consecutive patients, age 40 or younger, undergoing general medical exams. During routine questioning, the patients were asked about fatigue, body pain, and symptoms typical of a sinus infection.

Roughly 22% of the patients complained of unexplained chronic fatigue, 11% complained of unexplained chronic pain, and 9% said they had both. These patients, Chester found, were 10 times more likely than other patients to have symptoms associated with sinusitis.

Sinus symptoms were more common among patients with unexplained fatigue than among those with fatigue that could be explained by mental or physical illness, suggesting that unexplained fatigue is more closely linked to sinus problems than other types of fatigue.

Fifteen of the 65 patients with symptoms of fatigue met the diagnostic criteria for chronic fatigue syndrome, and most of these patients had sinus problems. The findings are published in the Aug. 11 issue of the Archives of Internal Medicine.

"We clearly need to do more research to see if sinus treatments alleviate fatigue and pain," Chester said in a news release. "This study does, however, offer hope for possible help in the future."

Harvard Medical School otolaryngologist Neil Bhattacharyya, MD, is also researching the link between sinus problems and chronic fatigue syndrome. In a study reported early this year, he found that approximately four out of five patients with chronic sinusitis also reported suffering from severe fatigue.

Bhattacharyya says fatigue among patients with chronic sinus problems may stem from their inability to get a good night's sleep or from medications used to treat the condition. Even those that claim to be nonsedating cause drowsiness in about half of the people who take them, he says.

"We know that fatigue is a symptom of sinusitis, but it is wrongly considered to be a minor symptom," Bhattacharyya tells WebMD. "I believe sinus problems and fatigue are linked much more often than most people realize."

SOURCES: Archives of Internal Medicine, Aug. 11, 2003. , C. Chester, MD, general internist, clinical professor of medicine, town University Medical Center, Washington, D.C. Neil Bhattacharyya, MD, assistant professor of otolaryngology, Brigham and Women's Hospital and Harvard Medical School, Boston.

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