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Diagnosing Chronic Fatigue? Check for Sinusitis

Georgetown University Medical Center News Release

31 July 2004

Patients suffering with unexplained chronic fatigue or unexplained body pain should ask their doctors to check for sinusitis, according to a Georgetown University Medical Center researcher. A study published in the August 11, 2003 issue of the Archives of Internal Medicine demonstrates a possible link between these ailments, offering possible new hope to patients.

The observational study found that patients with unexplained chronic fatigue were nine times more likely to also suffer sinus symptoms than members of a control group, and patients with unexplained chronic pain were six times more likely to have sinus symptoms. An earlier ear, nose, and throat study cited by this Georgetown research found that symptoms such as chronic fatigue and body pain were alleviated following treatment of sinusitis.

Taken together, these studies give sufferers reason for optimism.

"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 diagnosis 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 patientís medical evaluation."

Through his private internal medicine practice, Chester questioned 297 patients, noting unexplained chronic fatigue in 22 percent, unexplained chronic pain in 11 percent, and both symptoms in 9 percent of the patients. While these numbers are consistent with previous studies, Chester observed an unusual connection between patients with chronic pain or fatigue: prevalent sinus symptoms.

The CDC approximates that sinusitis affects 32 million Americans. Rates are highest among women and people living in the South. Women comprised 46 percent of the participants in this study, but represented 60 percent of the group with fatigue, predominance also noted in most prior studies.

Fifteen out of the 65 patients in Chesterís 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 comprehensive research to see if sinus treatments alleviate fatigue and pain. This study does, however, offer hope for possible help in the future," said Chester.