Chronic Sinusitis: Yellow Mucus and Nasal Bleeding Concerns - Otolaryngology

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Yellow nasal discharge?


Hello, doctor.
Last time I asked about having yellow nasal discharge in the morning and some post-nasal drip.
Does this indicate chronic sinusitis? Should I take medication for it? Today, I still have some yellow nasal discharge with a small amount of blood streaks.
I used a flashlight to examine my nasal cavity and touched the area with a disinfected cotton swab to try to wipe away the bleeding spot on the inferior or middle turbinate (hypertrophic turbinate), which showed slight bleeding.
I have used a nasal spray called Win Way; is that okay? Can I use a cotton swab to wipe away the blood? Why does blowing my nose easily cause bleeding from the turbinate mucosa? Should I seek aggressive treatment?

Chen, 30~39 year old female. Ask Date: 2015/02/27

Dr. Zheng Jueyi reply Otolaryngology


Dear Chen,
Hello, if there is only one instance of yellow nasal discharge, it does not necessarily indicate sinusitis; you can observe it for now.
Regarding the location of the nosebleed, it is advisable not to forcefully blow your nose or repeatedly touch the bleeding area with a cotton swab.
You can apply eye ointment or petroleum jelly to the area, and once the wound from the bleeding heals naturally, it should stop bleeding.
Wishing you safety and health.
Sincerely,
Dr.
Jue-Yi Cheng
Director, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2015/02/27

More Info


Chronic sinusitis is a common condition that can lead to a variety of symptoms, including yellow mucus, nasal congestion, and even nasal bleeding. Your description of experiencing yellow mucus and occasional blood-streaked discharge from your nose suggests that you may indeed be dealing with chronic sinusitis, particularly if these symptoms have persisted for an extended period.

Chronic sinusitis is characterized by inflammation of the sinus cavities that lasts for more than 12 weeks, despite attempts at treatment. The yellow mucus you are experiencing is often a sign of infection or inflammation in the sinuses. The presence of blood in the mucus can be concerning, as it may indicate irritation or damage to the delicate mucosal lining of the nasal passages.

When you mention using a flashlight to inspect your nasal cavity and noticing slight bleeding from the inferior or middle turbinate (nasal conchae), it is important to understand that these structures can become engorged and inflamed in response to chronic sinusitis. The use of cotton swabs to clean the nasal passages is generally not recommended, as this can further irritate the mucosa and lead to more bleeding. Instead, gentle nasal irrigation with saline solutions or the use of a nasal spray can help keep the nasal passages moist and clear of mucus without causing additional trauma.

The use of a nasal spray, such as the "win way" nasal spray you mentioned, can be beneficial in managing symptoms of chronic sinusitis. These sprays often contain saline or medicated solutions that can help reduce inflammation and promote drainage of mucus. However, it is crucial to follow the instructions provided by your healthcare provider regarding the frequency and method of use.

Regarding your question about why blowing your nose can lead to bleeding, this is often due to the increased pressure exerted on the nasal mucosa during the act of blowing. If the mucosa is already inflamed or fragile due to chronic sinusitis, this pressure can cause small blood vessels to rupture, leading to the presence of blood in the mucus.

In terms of treatment, it is advisable to consult with an ear, nose, and throat (ENT) specialist if you have not already done so. They can perform a thorough examination, possibly including imaging studies like a CT scan, to assess the extent of sinus involvement and determine the best course of action. Treatment options may include:
1. Nasal corticosteroids: These can help reduce inflammation in the nasal passages and sinuses.

2. Saline nasal irrigation: Regularly rinsing the nasal passages with saline can help clear mucus and allergens.

3. Antibiotics: If a bacterial infection is suspected, a course of antibiotics may be necessary.

4. Surgery: In cases where chronic sinusitis does not respond to medical treatment, surgical intervention may be considered to improve sinus drainage.

In conclusion, while your symptoms may suggest chronic sinusitis, it is essential to seek professional medical advice for a proper diagnosis and treatment plan. Avoid using cotton swabs to clean your nasal passages, and instead, focus on gentle nasal irrigation and following your healthcare provider's recommendations for managing your symptoms. If bleeding persists or worsens, or if you experience additional symptoms such as severe pain or fever, seek medical attention promptly.

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