Understanding Chronic Rhinosinusitis: Symptoms & Treatment

Chronic rhinosinusitis (CRS) is a persistent and often frustrating condition that affects about 12.3% of the general population in the US. Unlike a common sinus infection that clears up with a round of antibiotics, CRS sticks around, often for months or even years. The thing about CRS is it can seriously disrupt your quality of […]
April 21, 2024
Dr. Ves Gitchev
Dr. Ves Gitchev MD is the Director of Global Healthcare Partnerships at Science 37. A pioneer and innovator with nearly 2 decades of experience in the research industry, Dr. Gitchev's focus is on delivering the highest quality results to drive scientific advancement.

Chronic rhinosinusitis (CRS) is a persistent and often frustrating condition that affects about 12.3% of the general population in the US. Unlike a common sinus infection that clears up with a round of antibiotics, CRS sticks around, often for months or even years.

The thing about CRS is it can seriously disrupt your quality of life. You might constantly feel like your head is in a fog, struggling to breathe through your nose and dealing with annoying facial pain or pressure. Even your sense of smell might take a hit, making everything from your morning coffee to your favorite meal less enjoyable.

What is Chronic Rhinosinusitis?

CRS is a chronic condition where the nose or sinuses, which are hollow spaces in the skull around the nose, become inflamed and swollen.

  • Rhinitis: Inflammation or swelling of the lining of the nose
  • Sinusitis: Inflammation of the lining of the sinus

This inflammation or swelling makes it difficult for mucus to drain properly, leading to symptoms like nasal congestion, facial pain or pressure, postnasal drip, reduced sense of smell and taste, chronic cough, fatigue, and even bad breath.

What are the Symptoms of CRS?

CRS is one of the most common chronic conditions worldwide. It causes a range of symptoms that include:

  • Sneezing
  • Headache
  • Nasal discharge and stuffiness
  • Pressure or pain in the nose, forehead, and between the eyes
  • Stuffy or runny nose
  • Cough that tends to get worse at night
  • Reduced sense of taste and smell
  • A tickle in your throat due to postnasal drip (where your saliva mixes with mucus from the nose and drips to the back of the throat)

What Causes Chronic Rhinosinusitis

CRS isn't caused by a single factor but rather a combination of factors that affect your nasal passages and sinuses. These factors include:


Common allergens like pollen, dust mites, wood dust, mold, or pet dander can set off a chain reaction in your body. When they come into contact with your nasal passages, your immune system may interpret them as threats. This triggers a cascade of reactions, including releasing histamines and other chemicals that cause inflammation in your nasal cavity and sinuses. Over time, repeated exposure to these allergens can lead to CRS as your body continues to build an immune response to perceived threats.


Microscopic organisms like bacteria or fungi thrive in warm, moist environments, making your sinuses an ideal breeding ground. When an infection takes hold (usually because sinuses are blocked and filled with fluid), your immune system springs into action, sending out white blood cells to fight off the invaders.

However, sometimes, the infection persists despite your body's best efforts, leading to chronic inflammation and discomfort. Factors like recurring colds or respiratory infections, cystic fibrosis, acute sinusitis, allergic rhinitis, allergy asthma, untreated dental issues, or even swimming in contaminated water can increase your risk of developing chronic rhinosinusitis due to infections.

Structural Issues

Structural abnormalities in your nasal passages, like a deviated septum or nasal polyps, can obstruct proper sinus drainage. This obstruction creates a breeding ground for bacteria and inflammation and paves the way for chronic rhinosinusitis to take hold.

Diagnosis of Chronic Rhinosinusitis

Diagnosing CRS typically involves a thorough evaluation by an ear, nose, and throat (ENT) doctor, which may include the following:

Medical History

Your doctor will ask about your symptoms. They'll want to know how long you've been experiencing them, their severity, and any factors that seem to worsen or alleviate them. They'll also want to know about any previous treatments you've tried and whether they provided relief.

Physical Examination

The doctor will then conduct a physical exam. This might involve looking inside your nose using a small, handheld instrument called a nasal speculum. They'll check for inflammation, swelling, or other abnormalities in your nasal passages and sinuses.

Nasal Endoscopy

n some cases, your doctor may recommend a nasal endoscopy to assess the inside of your nasal passages and sinuses in more detail. This allows them to look closely at any inflammation, polyps, or other issues contributing to your symptoms.

Imaging Studies

Your doctor may order imaging studies like a computed tomography scan (CT scan) or magnetic resonance imaging (MRI). They'll use this to identify structural abnormalities like a deviated septum or sinus blockages that may be contributing to your symptoms.

Allergy Testing

If an allergy is suspected to trigger your CRS, your healthcare provider may recommend allergy testing to identify specific allergens causing inflammation in your nasal passages and sinuses. This can help guide treatment decisions, such as avoidance measures or allergy medications.

Treatment Options for Chronic Rhinosinusitis

CRS treatment aims to alleviate symptoms, reduce inflammation, and improve overall quality of life. Standard treatment options include:

  • Nasal saline irrigation: Regularly rinsing the nasal passages with saline solution can help reduce congestion and flush out mucus, relieving symptoms.
  • Nasal corticosteroids: Topical nasal corticosteroid sprays can help reduce inflammation in the nasal passages, improve breathing, and decrease nasal congestion.
  • Antibiotics: In cases where bacterial infections are suspected or confirmed, antibiotics may be prescribed to target the underlying cause of sinus inflammation.
  • Allergy management: Avoiding allergens and using allergy medications like antihistamines or nasal decongestants can help alleviate symptoms for individuals with allergic rhinosinusitis.
  • Surgery: For severe cases of CRS that do not respond to conservative treatment measures, sinus surgery may be recommended to correct anatomical abnormalities or remove nasal polyps.

Enroll to Science 37 Clinical Trial

If you've been diagnosed with chronic rhinosinusitis and have struggled to relieve your symptoms, you may be interested in participating in the groundbreaking Science 37 clinical trials. This study aims to evaluate the safety and efficacy of a new potential treatment option for people like you who are living with the challenges of CRS.If you've been diagnosed with chronic rhinosinusitis without nasal polyps and are seeking alternative solutions, consider participating in this study to contribute to medical science and potentially benefit from cutting-edge therapies. Together, we can work towards better outcomes for CRS patients everywhere.

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