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CRS Patient Journey

Back Patient journey Understanding your health journey with chronic rhinosinusitis (CRS) can feel overwhelming. This module simplifies the process into four clear stages, guiding you step by step. Most patients remain at the first stage if their symptoms are well-managed, progressing only if symptoms persist or worsen. For the best experience, review the earlier modules to familiarise yourself with key terms and concepts, and refer to our Glossary for additional support. Take control of your CRS journey with confidence! Step 1: Self-Care and Pharmacist Guidance If your symptoms, like a persistent stuffy nose or reduced sense of smell, aren’t improving, this step helps you take action. If you haven’t seen a healthcare professional and don’t have any red-flag symptoms, start with self-care. Your pharmacist can offer guidance on saline douching and corticosteroid sprays, which are both effective options before visiting your GP. If you’re using a decongestant, be sure to stop after seven days to prevent dependence. Step 2: Visit Your General/Family Doctor (GP) Chronic rhinosinusitis (or CRS) is typically diagnosed after symptoms persist for at least three months, however, don’t wait too long to see your doctor. Early intervention can make your symptom management easier and help prevent worsening. At this stage, your GP will assess your condition and create a clear treatment plan tailored to your needs. Step 3: Referral to a Specialist If your symptoms don’t improve after three months of treatment or you have red-flag symptoms, it is time to see a specialist. A specialist will confirm your CRS diagnosis with additional tests and rule out other possible conditions to ensure you get the right treatment. Step 4: Referral to a Specialized Center If symptoms persist despite treatment, a specialised centre can provide advanced care. This stage involves follow-up evaluations, treatment adjustments, and specialised tests to determine why previous treatments haven’t worked. The goal is to find the most effective approach to help you feel better. Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Patient journey Step 1: Pharmacist / Self-Care Step 2: Visit GP Step 3: Visit Specialist Step 4: Specialised or referral centre

Lifestyle and Prevention in CRS

Back Lifestyle and environment Managing Triggers for Better Sinus Health Your environment and daily habits can play a big role in worsening sinus symptoms. Identifying and adjusting these factors may help improve symptom control, especially if your condition is difficult to manage. The first step is to understand how certain triggers can make your symptoms worse—awareness is key to finding relief. Factors That Can Worsen Sinus Symptoms Several environmental factors and habits can irritate your nose and sinuses, making chronic rhinosinusitis (CRS) symptoms harder to manage. Here are some common triggers and ways to minimize their impact: Active or Passive Smoking/Vaping: Smoke irritates your sinuses and airways, worsening symptoms. Speak with your doctor about resources to help you quit. Workplace or Environmental Irritants: If your job involves dust, strong odours, or chemicals, wear a mask to protect your sinuses and follow safety guidelines. Similarly, avoid irritants during hobbies or at home, like gardening, painting, or woodworking. If breathing problems or wheezing occur due to work-related irritants, consult a pulmonologist. Polluted Air: Airborne particles can trigger symptoms, particularly indoors. Ensure proper ventilation in your home to help reduce their buildup. Allergens: If you’re allergic to specific triggers, limit exposure as much as possible. Consider allergy-proofing your home for better symptom control. Be sure to check out this excellent guide on how to do this properly. Alcohol: Some CRS patients find alcohol exacerbates symptoms, leading to blocked or stuffy sinuses. While not an allergy, alcohol intolerance can mimic similar effects. Recreational Drug Use: Snorting drugs can damage your nose and sinuses. If you’re struggling with this, talk to your doctor for support and guidance. Common Cold: Viral infections can mimic CRS symptoms but typically resolve within a week. However, they can worsen CRS symptoms (an exacerbation). Reduce the risk of viral infections by wearing a mask in crowded places like buses, shops, and airplanes. Recognising and avoiding these triggers can help manage CRS symptoms more effectively. Prevention Checklist for Sinus Health Now that you have a better understanding of what can worsen your symptoms, here are some practical prevention tips to help protect your sinuses and improve your health. Avoid Things That Worsen Symptoms Quit smoking and avoid exposure to smoke, whether it’s from cigarettes or vaping. Wear a mask when around dust, chemicals, strong odours, or in crowded environments. Ventilate your home regularly by opening windows or using fans to bring in fresh air. Consider using an air purifier and clean it often. If you live on a busy street, ventilate from the opposite side of your home. Avoid strong-smelling sprays or cleaners that may irritate your sinuses. Take Care of Your Sinuses Rinse your nose daily (ideally twice a day) with a saline solution to keep your sinuses clear. Maintain an Active and Healthy Lifestyle Eat a balanced diet rich in fruits and vegetables to support your immune system. Exercise regularly to boost overall health and immune function. Avoid excessive alcohol and do not use recreational drugs. Reduce stress and ensure you get enough sleep to maintain a strong immune system. Manage Allergies Avoid allergens such as pollen, pet dander, dust mites, and mould. Consider following a guide to make your home allergy-free. Clean your home regularly by washing bedding often and vacuuming with a HEPA filter. Use allergy medication as prescribed by your doctor or pharmacist to keep symptoms in check. Prevent Viral Respiratory Infections Wear a mask in crowded spaces or areas where you might be exposed to viruses. Wash your hands frequently to reduce the risk of catching cold or flu viruses. Avoid close contact with people who are sick to reduce your chances of getting a viral infection. Talk to Your Doctor If your symptoms don’t improve or worsen, contact your doctor to discuss further treatment options. By following these prevention tips, you can better manage your sinus health and reduce the risk of CRS flare-ups. Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Lifestyle, environment, and prevention Lifestyle and environment Prevention checklist

CRS FAQs

Back FAQs Our FAQs address detailed questions, especially for those with long-standing conditions. If you still have unanswered questions after reviewing this portal, feel free to contact our team at contact@euforea.eu. Please note, that we cannot answer personal inquiries. About CRS What is chronic rhinosinusitis (CRS)? Inflammation is the body’s natural response to germs, irritants, and foreign substances like chemicals. When this inflammation affects the lining inside the nose and spreads to the sinuses, it’s known as rhinosinusitis. Sinuses are air-filled spaces surrounding the nose. Common symptoms of rhinosinusitis include nasal congestion, reduced or lost sense of smell, facial pain or pressure, and mucus that either drips from the nose or drains down the back of the throat. When these symptoms persist for more than 12 weeks, it is classified as Chronic Rhinosinusitis (CRS). CRS can occur with or without nasal polyps—soft, non-cancerous growths in the nose or sinuses that may cause discomfort and disrupt daily activities. The exact reason why some individuals with CRS develop nasal polyps while others do not is still unknown. CRS with nasal polyps is often referred to as Nasal Polyp Syndrome. Is CRS inherited? Chronic rhinosinusitis (CRS) with nasal polyps often runs in families, suggesting a genetic component to the condition. However, CRS without nasal polyps has also been observed in family members, indicating that hereditary factors play a role in both forms of the disease. Studies involving identical twins have shown that both siblings may not necessarily develop nasal polyps, highlighting the significant role of environmental factors alongside genetic predisposition. This emphasizes that both inherited traits and external influences contribute to the development of CRS. Why do I have sinuses? Sinuses are air-filled cavities located within the bones of your face and skull, lined with a thin, moist layer of mucus. Together with the nose, the sinuses play a crucial role in filtering, warming, and humidifying the air we breathe. This process helps protect the lungs from harmful particles and irritants. In addition to respiratory functions, the sinuses also contribute to the resonance of your voice, influencing how you sound when speaking. Furthermore, the sinuses act as a cushion, absorbing energy to protect the brain in the event of an accident. How many people have CRS? Around 10% of people are affected by chronic rhinosinusitis (CRS), which is roughly equivalent to the entire population of Spain. In certain regions of Europe, the prevalence of CRS is even higher, highlighting the widespread impact of this condition across the continent. What is the difference between chronic sinusitis and chronic rhinosinusitis? When the inner lining of the nose becomes inflamed and the inflammation spreads to the nearby sinuses, the condition is called rhinosinusitis. While the terms sinusitis and rhinosinusitis are often used interchangeably, rhinosinusitis more accurately reflects the condition affecting both the nose and the sinuses. Despite this distinction, both terms are commonly used to describe the same underlying condition. Does CRS progress when I get older? Chronic rhinosinusitis (CRS) can evolve as you age. In children, CRS is typically milder, and nasal polyps (soft, painless growths in the nose or sinuses) are rare unless the child has a condition like cystic fibrosis. In adults, CRS with nasal polyps can worsen if left untreated. Over time, polyps can grow larger, pressing against the bones in the face and sometimes altering their appearance. Another sign that CRS may be worsening is the development of asthma-like symptoms, such as shortness of breath, wheezing (a whistling sound while breathing), coughing, or coughing up mucus from the chest. If you experience any of these symptoms, it’s important to consult your doctor for further guidance. Can CRS be cured? Chronic rhinosinusitis (CRS) is typically not curable, but its symptoms can often be managed and controlled with appropriate treatment. The condition involves long-term inflammation of the sinuses, which can be challenging to treat. The causes of this inflammation can vary, including infections, allergies, structural abnormalities in the nose, or immune system issues. Fortunately, many people experience less severe symptoms as they reach the age of 60. With proper care and management, CRS can be effectively controlled to improve quality of life. Causes of CRS What causes CRS? While the exact cause of chronic rhinosinusitis (CRS) is not fully understood, it is believed to result from a combination of factors that contribute to the development of the disease. This includes an interaction between personal traits, such as genetics, and environmental factors like air pollution, cigarette smoke, and allergens. These factors together trigger long-lasting inflammation in the sinuses and nasal cavity, leading to the symptoms associated with CRS. Understanding this interaction is key to better managing and treating the condition. Is CRS caused by bacteria or viruses? Inflammation is the primary cause of chronic rhinosinusitis (CRS) and can be triggered or worsened by various factors such as infections (bacterial and viral), smoking, air pollution, and allergens. This inflammation leads to thickening of the inner lining of the nose and sinuses, increased mucus production, and sometimes the formation of polyps, which contribute to CRS symptoms. It’s important to note that CRS is not simply an “infection that won’t go away.” Many bacteria and fungi naturally reside in our sinuses, even in people who do not have sinus disease. While bacteria and viruses may contribute to inflammation, killing them with antibiotics does not cure CRS. Instead, the condition is likely caused by a combination of factors, including environmental influences and genetic predisposition, resulting in the persistent inflammation characteristic of CRS. Is CRS caused by my allergy? The exact role of allergies in contributing to chronic rhinosinusitis (CRS) is not fully understood, but it is clear that allergies are more common among people with CRS than in the general population. This is particularly true for year-round allergies, such as those to moulds or house dust mites. Poorly controlled allergies can worsen CRS symptoms, and individuals with allergies often experience more severe and recurrent CRS. Furthermore, allergies frequently co-exist with asthma, adding another layer of

Patient Initiatives

Back Patient initiatives Welcome to the Patient Initiatives! In this section we highlight the various ways you can connect, engage, and take action as part of the CRS community. Whether you’re looking for support, want to stay informed, or are inspired to get involved, these initiatives are here for you. If you’d like to receive further information or register for any of the activities, please contact Xander Bertels, our Patient Advisory Board & Advocacy Manager, at xander.bertels@euforea.eu. Patient Testimonials Find out more patient stories on our dedicated page here. Global CRSwNP Awareness Day Join us in raising awareness for CRS at our Global Awareness Day on Nasal Polyp Syndrome. Each year, we celebrate this important event on April 24th, and 2025 will mark our 4th edition under the theme “New Ambitions of Care.” To advance the field, we hold panel discussions with patients and stakeholders from around the globe. In this year’s edition, you, as a patient, can contribute to defining the ambitions for the future of CRS care. These ambitions will then be discussed by a multidisciplinary panel of healthcare providers to find a consensus on how to best address the unmet needs. Check below the 2025 patient panel discussion: Patient Advisory Board At EUFOREA, one of our key goals is to bring stakeholders together, and our Patient Advisory Board is a great example of this mission in action. With quarterly meetings, the Advisory Board brings patients together to discuss the latest trends in CRS and other airway diseases. It’s not just about connecting with others who understand what you’re going through—it’s also about making a real difference in care. In fact, this very Patient Portal you’re using is one of the outcomes of these discussions! The Advisory Board focuses on unmet needs and how CRS affects daily life, ensuring patient voices are at the center of improving care and support. By working together, we’re driving meaningful change for the entire CRS community. Patient Advisory Board 20km run for airway diseases If you are living near Brussels (Belgium), you might consider joining our EUFOREA Delegation to run for CRS and other airway diseases on May 25, 2025! As part of the team, EUFOREA will sponsor your entry fee and you’ll receive a colourful EUFOREA top. For more practical details, visit the organiser’s website for the 20km Run of Brussels. Polyp Gossip Podcast Patient organisations Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Patient initiatives Patient Testimonials EUFOREA Global Awareness Days Patient Advisory Board 20km run for airway diseases Patient organisations

Glossary

Back A Acoustic rhinometry: A test that uses harmless sound waves inside your nose to measure how open (or blocked) your nasal passages are.Acute: A term describing a health condition or set of symptoms that starts suddenly and typically lasts for a short time. In the context of rhinosinusitis, “acute” means symptoms have been present for less than 12 weeks.Allergen: A substance (like pollen, dust mites, or pet dander) that can cause an allergic reaction in certain people.Allergic rhinitis (hay fever): An allergic reaction in the nose that can make you sneeze, have a runny or stuffy nose, and itchy/watery eyes. Often triggered by pollen, dust mites, or pets.Anterior: Means “toward the front.” For example, the front part of the nose or sinus passages is referred to as the anterior region.Anterior rhinoscopy: A quick exam where a doctor looks into the front part of your nose using a special tool (nasal speculum) to check for swelling, irritation, or nasal polyps.Anterior rhinomanometry: A test measuring how easily air moves through your nose to see if the nasal passages are blocked.Anti-inflammatory: A term for medicines (like corticosteroids) or actions (like rinsing with salt water) that reduce swelling, redness, or irritation in the body.Antibiotics: Medicines used to kill or slow down the growth of bacteria. Sometimes prescribed for sinus infections but not always useful in chronic sinus inflammation.Asthma: A lung condition where the airways become inflamed and narrow, making it hard to breathe. People with CRS often have asthma too.Autoimmune disorders: Conditions where the body’s immune system mistakenly attacks healthy cells, thinking they are harmful. B Biologics: Special medicines given by injection that target specific parts of the immune system to reduce inflammation. Used when other options haven’t worked and after a specialist has made a detailed assessment of your condition. C Cellulitis: A skin infection that causes redness, swelling, warmth, and pain in the affected area. Although rare, a severe sinus infection in CRS can sometimes spread into the tissues around the sinuses or eyes, leading to cellulitis.Chest symptoms: Issues such as coughing, shortness of breath, wheezing, or tightness in the chest—often linked with lung conditions like asthma or COPD.Chronic: Means something that lasts a long time (often three months or more) or keeps coming back.Chronic cough: A cough that does not go away and lasts for at least three weeks.Chronic obstructive pulmonary disease (COPD): A long-term lung disease (often linked to smoking or polluted air) where airways and tiny air sacs in the lungs are damaged, causing breathing difficulties.Chronic rhinosinusitis (CRS): A condition defined by long-lasting inflammation inside the nose and sinuses, causing symptoms like a stuffy nose, runny nose, loss of smell, and facial pain.Comorbidities: Other conditions or diseases that occur at the same time as the main condition. For example, many people with CRS also have asthma or allergies.Complication: An unexpected, sometimes serious, problem that arises because of an existing condition or its progression. For example, a severe sinus infection spreading to the eye area could be considered a complication.CT scan: An imaging test that takes detailed pictures of the inside of your body (in this case, your sinuses) to see how swollen they are or if there are any blockages.Cystic fibrosis: A genetic disorder that affects the lungs, pancreas, and other organs. It can sometimes lead to more severe forms of sinus disease in children. D Decongestant nasal sprays/drops: Medicines sprayed or dropped into the nose for quick relief of stuffiness. Safe only for short-term use (a few days) due to the risk of “rebound congestion” if overused.Decongestant pills: Tablets (often containing pseudo-ephedrine) that help shrink swollen tissues in the nose. Used short-term only because the risks generally outweigh the benefits. For some people, it can be unsafe to take these pills.Diagnosis: The process where a doctor determines what health condition a person has.Differential diagnosis: A list of possible conditions that could explain a patient’s symptoms. Before confirming CRS, your doctor will consider other conditions that could cause your symptoms. E Endotyping / Phenotyping: Specialist terms for classifying a disease by looking at the exact type of inflammation or cells involved. This helps doctors tailor treatments, like deciding what type of biologics to use.ENT doctor (Ear-Nose-Throat specialist): A doctor who specialises in conditions affecting the ear, nose, and throat. Also called an otolaryngologist.Exacerbation: A sudden worsening or flare-up of symptoms. If you understand when you’re having an exacerbation, you can see your doctor sooner and adjust medications if needed. F Facial pain/pressure: An uncomfortable feeling in the face, forehead, or cheeks that can happen when sinuses are inflamed or blocked or due to nasal polyps.FESS (Functional Endoscopic Sinus Surgery): A type of sinus surgery where a specialist uses a thin camera (an endoscope) to open and clear the sinuses. It is called “functional” because it aims to restore normal sinus function rather than just remove tissue.First-line treatments: The initial or standard treatments recommended by medical guidelines. For CRS, these include saline rinses and nasal corticosteroid sprays.Fungal infection: An infection caused by fungi (like mould). Generally, normal sinuses can handle fungi without trouble, but in certain cases, fungus can worsen sinus issues. G Genetics (Hereditary): Refers to the information passed down from parents to children through genes that can make some people more likely to develop certain conditions. H Hormone changes: Body chemicals (like oestrogen) that can shift during pregnancy or menopause, sometimes affecting conditions like CRS.House dust mite: Tiny insect-like pests found in household dust that can trigger allergies and make CRS symptoms worse if you are allergic. I Immune system: Your body’s defence against infections and foreign substances. In CRS, this system may overreact, causing ongoing inflammation.Immune deficiencies: Conditions where the immune system is weaker or does not work properly, leading to more frequent infections.Immunotherapy: A treatment that may help the body get used to allergens so it reacts less over time. Often given as injections or drops/pills under the tongue.Inflammation: Swelling or irritation in the body’s tissues,

Welcome to Chronic Rhinosinusitis

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References

Back Acknowledgements This portal could not have been developed without the support of several people. We would like to acknowledge the following people for their contributions. EUFOREA Core team Dr Sophie Scheire (project co-lead, coordinator, content development) Dr Xander Bertels (project co-lead, coordinator, content development) Tania Lopes (audiovisual content and portal development) Katie Tassell (proofreading) Lieve Celis (proofreading) Vanessa Stockton (proofreading) Lindsay Cypers (proofreading) Prof Dr Wytske Fokkens (content review) Prof Dr Peter Hellings (project supervisor) We would also like to acknowledge the contributions by EUFOREA’s Board (Prof Dr Glenis Scadding, Prof Dr Vibeke Backer, and Prof Dr Susanne Lau) and CRS Expert Panel Members, with Prof Dr Eugenio De Corso as CRS Panel Co-Chair. Additionally, a special thanks to the following experts for their role in the development of the Expert videos: Prof Dr Philippe Gevaert (Ghent University Hospital, Belgium) Prof Dr Guy Scadding (Royal Brompton Hospital, UK) Prof Dr Sietze Reitsma (Amsterdam Medical Centre, the Netherlands) Prof Dr Joaquim Mullol (Hospital Clinic Barcelona, Spain) Dr Camilo Rodriguez-Van Strahlen (Hospital Clinic Barcelona, Spain) Dr Katherine Yuen-Ato (Hospital Clinic Barcelona, Spain) Dr Manon Blauwblomme (Ghent University Hospital, Belgium) We would like to extend a special thanks to Sofie Lang (UZ Gent) for audiovisual support and Elien Borgers (UZ Leuven) for assistance in the recordings. Lastly, we would like to sincerely thank all members of EUFOREA’s Patient Advisory Board for their direct input and feedback, with a special thanks to Dr Thijs Teeling (Chair) and Dr Catherine Shire (Co-Chair). Funding The EUFOREA Patient Portal is supported by an unrestricted grant by Sanofi-Regeneron. EUFOREA has and maintains full editorial control over the content and publication decisions. References EUFOREA Pocket Guide for CRS EUFOREA CRS Patient Empowerment Guide Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020 Feb 20;58(Suppl S29):1-464. doi: 10.4193/Rhin20.600. PMID: 32077450. Orlandi RR, Kingdom TT, Smith TL, Bleier B, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021 Mar;11(3):213-739. doi: 10.1002/alr.22741. Erratum in: Int Forum Allergy Rhinol. 2022 Jul;12(7):974. doi: 10.1002/alr.22987. PMID: 33236525. Hopkins C, Surda P, Walker A, Wolf A, et al. EPOS 4 Patients. Rhinology. 2021 Oct 29. doi: 10.4193/Rhin20.950. Epub ahead of print. PMID: 34762718. Teeling T, Djouder C, Laurens H, Preyra JH, et al. Nasal polyp syndrome: a patient-centred term for CRSwNP by EUFOREA. Front Allergy. 2024 Mar 20;5:1372919. doi: 10.3389/falgy.2024.1372919. PMID: 38596453; PMCID: PMC11003414. Hellings PW, Alobid I, Anselmo-Lima WT, Bernal-Sprekelsen M, et al. EUFOREA/EPOS2020 statement on the clinical considerations for CRS with nasal polyps care. Allergy. 2024 May;79(5):1123-1133. doi: 10.1111/all.15982. Epub 2023 Dec 18. PMID: 38108602. https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661 (dd 02/01/2025) https://cks.nice.org.uk/topics/sinusitis/ (dd 07/01/2025) Logbook January 31, 2025: launch of portal Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Acknowledgements Acknowledgements Funding References Logbook

Preparation for Consultation

Back Preparing for your first consultation If you have signs of CRS, it is important to see a doctor. They can figure out what is wrong, start a treatment plan, or send you to a specialist if needed. This guide will help you get ready for your first visit so you can make the most of it. It can be helpful to bring someone with you, like a family member or friend. They can ask questions you might forget, write down important information, and help you remember what the doctor says. If you feel nervous or overwhelmed, having someone with you can also help you feel supported. You can also ask permission to record the consultation on your mobile phone, so you don’t forget anything. Here you’ll find a guide to prepare for your first consultation. Preparing for your follow-up consultation We’ve also developed a separate patient guide to help you get ready for your next visit with your doctor (follow-up). It will help you think about your health, decide what important things you want to talk about, and check how your treatment is working – including any good effects or side effects. By preparing, you can feel more confident, use your time with your doctor efficiently, and take charge of your health. SNOT-22 survey Sometimes, your doctor might ask you to fill out a survey to understand your symptoms better. These surveys help your doctor see how your condition is affecting you. For example: How bad your nose symptoms are, like a stuffy or runny nose. Other problems, like trouble sleeping, headaches, losing your sense of smell, or difficult asthma. How these problems make you feel and how they affect your daily life. We have added a validated survey (SNOT-22) that doctors often use. Filling in these questions and sharing this information can help your doctor get a clearer picture of what you are going through. Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Preparing for your consultation Your first consultation Your follow-up consultation SNOT-22 survey

Treatment of CRS

Back Maintenance treatments Nasal Rinsing There are many ways to manage CRS. Maintenance treatments focus on reducing inflammation and irritation, clearing mucus, and improving breathing through the nose. One of the key therapies for CRS is nasal rinsing with saline (salt water). This simple solution can: Help clear out your nasal passages and sinuses Help prevent secretions from dripping into your throat Wash away allergens and irritants that might be making your symptoms worse Using a rinse before applying other medications to your nose (like corticosteroid sprays) can also help those medicines work better by allowing them to reach the inside of your nose more effectively. Nasal rinsing with saline has few side effects, except that you need to learn how to do it properly to avoid discomfort. Nasal rinsing should be done daily and preferably twice a day. Saline solutions can be easily prepared at home by mixing clean, previously boiled, lukewarm water with unionized salt (9 grams of salt with 1 litre of water, or 3 grams in a nasal rinsing device) and pouring into a nasal rinsing device. These devices are available over-the-counter. Always prepare a fresh saline solution before use. https://youtu.be/BhsC_Pv_om4https://youtu.be/wnpsJfeYJFAhttps://youtu.be/qspu4wb9ZSghttps://youtu.be/qfzrDpdj_90 Nasal corticosteroids An additional effective option is nasal corticosteroid sprays or drops. These sprays: Help reduce inflammation inside your nose and sinuses Reduce stuffiness over time They work by calming down inflammation in your nasal passages and sinuses. Corticosteroid sprays are safe to use in the long term. Some people can experience side effects like irritation, nose bleeding or dryness. However, a correct spraying technique can prevent most of the discomfort. Some of these sprays are available over the counter, but in some countries, you might need a prescription to get them. Your doctor might also advise you to dissolve this drug into your saline solution for nasal rinsing. This is sometimes referred to as corticosteroid irrigation. Keep the spray by your toothbrush so as not to forget. If you suffer from allergies, your physician may also prescribe anti-allergic pills or sprays (also called antihistamines). These medications can typically be bought over the counter at your pharmacy. Short-term relief therapies Sometimes your doctor might recommend a treatment for short term use. These therapies are not recommended for a long period or for frequent use due to adverse effects. Decongestant sprays/drops: These nasal sprays/drops can quickly shrink swollen tissues inside your nose, making it easier to breathe. But if you use them for more than a few days in a row, they can backfire by making your nose feel even more stuffy when you stop using them. This is called rebound congestion, which means your nose becomes dependent on the spray to stay clear. To avoid this problem, you have to use these sprays only as directed and for a short time. If you are already relying on them to breathe, it is important to talk to a doctor, who can guide you on how to stop safely and explore other treatment options. If prescribed by your doctor, it is important to: Use the spray only for the recommended time (no more than 7 days in a row). Schedule a follow-up visit with your doctor to check progress. Understand that it does not treat the inflammation that is causing your symptoms. Decongestant pills: These pills contain pseudo-ephedrine, which is sometimes prescribed for short-term relief for a blocked nose. However, there is no recommendation for long term use due to adverse events (like cardiac risk). Corticosteroid tablets or pills: These are sometimes used for a short time alongside nasal sprays to quickly reduce swelling. They work fast, are strong, and are affordable. However, their benefits do not last long, and long-term or repeated use can lead to several side effects. If it is prescribed for CRS, it should be done under specialist care. Antibiotics: In some cases, the doctor might prescribe antibiotics for a short or longer period. Some antibiotics (like azithromycin) are given by a ENT specialist for a longer period because they can help reduce inflammation. The use of short-term antibiotics is usually not helpful in CRS and frequent short-term courses of antibiotics increase the risk of bacteria to become resistant making the drug less effective. Antibiotics may cause side effects like diarrhoea and fungal infections, along with other side effects, depending on the type of drug you get. Additional options: Surgery What is sinus surgery? If symptoms don’t improve with nasal rinsing or corticosteroid sprays, there are additional options. One of the options your ENT specialist can consider is surgery. The goals of sinus surgery are to: Open up the sinuses to improve drainage of secretions and access to nasal irrigations with salt water and/or delivery of medications like nasal sprays. Remove nasal polyps if they are present and improve nasal passage/breathing May have positive effects on your lower airways Surgery is typically recommended only after trying the combination of nasal rinsing and nasal corticosteroids. What to expect from sinus surgery?: Most nasal symptoms improve after surgery, but it doesn’t cure the condition, because CRS is caused by chronic inflammation of the nose and sinuses. Recovery can take up to several months, though this varies from person to person and depends on the specific procedure done. Sinus surgery is a complex procedure, and complications can happen during surgery. Talk to your doctor to discuss the pros and cons that are relevant to you. If symptoms worsen again, your doctor may need to review your treatment plan and consider more medical or surgical options. Additional options: Biologics What are biologics and when are they used? In cases where symptoms persist after surgery and impact your daily life greatly, biologics can be considered. Biologics are only added to your current treatment after your doctor has made a detailed evaluation of your condition and the type of inflammation you suffer from. This process of figuring out the specifics of your condition is something your specialist may refer to as “endotyping” or “phenotyping”. This is important

Chronic Rhinosinusitis

Back Sinuses In this module, we will cover the basics to help you understand chronic rhinosinusitis or CRS. But first, let us begin with an important question: Why do we have sinuses in the first place? Sinuses are small, air-filled spaces inside your head, connected to your nose. Think of them as tiny air pockets behind your nose, cheeks, and forehead. They are covered with soft, moist tissue and help your body in three important ways: Cleaning the air you breathe: They trap dust and germs. Adding moisture and warmth: This makes the air more comfortable before it reaches your lungs. Protecting your brain: They act like airbags to absorb shock if you bump your head. Plus, they even play a role in giving your voice its unique sound! What is CRS? CRS happens when the soft tissue inside your sinuses and nasal passages gets swollen and irritated. This swelling and irritation are called inflammation. It is your body’s immune system working to protect you, similar to what happens when you have a cold. However, with CRS, the immune system does not calm down when it is supposed to, or the soft tissue is continuously irritated by external triggers (like cigarette smoke, air pollution, or workplace irritants like dust, gases, fumes and smoke). This ongoing inflammation or irritation can lead to symptoms that last 12 weeks or longer, including: A stuffy or blocked nose that makes breathing through the nose harder A runny nose or mucus dripping down the back of your throat (postnasal drip) Reduced sense of smell Facial pain or headache CRS is a pretty common condition—about 1 in 10 people in Europe suffer from it. It can be hard to make CRS go away completely, but with the right care and preventive measures, a lot of people feel much better and find it easier to deal with their symptoms in daily life. What causes CRS? The exact reasons behind this long-lasting inflammation are not fully understood. However, we do know that several factors can contribute to CRS, such as: Cigarette smoke Breathing in dirty or polluted air that irritates your nose Allergy to pollen, house dust mite, pet dander, mould, or other inhaled particles Hormone changes, such as during pregnancy or menopause Traits passed down from your family (genetics) Major abnormalities in the internal structure of the nose https://s3.nl-ams.scw.cloud/euforea-wp-develop/uploads/CRS-Patient_classification-of-CRS_30.1.25.mp4 What are nasal polyps? There are two types of CRS: With nasal polyps (CRSwNP) Without nasal polyps (CRSsNP) Nasal polyps are soft, round growths that can form inside your nose or sinuses. They look like tiny grapes and occur because of this long-lasting inflammation. Although these polyps can become larger, the good news is that they are not cancer and will not turn into cancer. If you have (large) nasal polyps, you might: Have trouble smelling Feel facial pain/pressure Feel like your nose is always blocked Be more prone to infections Together with our Patient Advisory Board, we’ve termed this subtype (CRSwNP) as Nasal Polyp Syndrome. We even wrote a full paper around this patient-friendly term, which is free to access here. At a glance CRS Infographic CRS Patient Pocket Guide button-block-bg check checkmark CME badge C M E cmebadge C M E download euforeatv eye facebook faq globe icon_1 icon_2 icon_3 Middel 1 iconmonstr-facebook-1 iconmonstr-info-8 iconmonstr-linkedin-1 iconmonstr-twitter-1 iconmonstr-video-13 iconmonstr-youtube-1 infographic-blue infographic-blue infographic-bulb infographic-darkblue inforgraphic-yellow instagram linkedin pdf pinterest questionmark smartphone spotify tweets twitter youtube Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview About the disease Sinuses What is CRS? What causes CRS? What are nasal polyps? At a glance

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