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crs-patient-journey

Back Patient journey We know that understanding your health journey can feel overwhelming, especially when dealing with a condition like CRS. This module is here to help you make sense of the process, step by step. By breaking it down into four clear stages, we aim to guide you through what to expect and empower you to take an active role in managing your health. The journey is laid out like a waterfall: most people stay at the first step if their symptoms are managed well. You only move to the next step if your symptoms are severe or do not improve with initial treatment. We recommend going through earlier modules first to better understand the terms and concepts used in these charts and using our Glossary. Step 1: Self-care and seeing your pharmacist: This step explains what to do when you first notice symptoms are not going away, like a stuffy nose or trouble smelling. In case you haven’t seen a healthcare professional for your symptoms and don’t experience any red-flag symptom, you can start with self-care. Ask your pharmacist for advice about saline douching and corticosteroid sprays, even before going to see your GP. In case you started a decongestant, discontinue after 7 days to avoid dependence. Step 2: Visit your general/family doctor (GP): While CRS is usually diagnosed when symptoms last for at least 3 months, it is important not to wait too long to see your doctor. Getting help early can make managing your symptoms easier and may prevent them from getting worse. This is the step where you start with a clear treatment plan. Step 3: Referral to a specialist, when symptoms do not improve within 3 months after treatment, or if you have red-flag symptoms. Your specialist will confirm the diagnosis of CRS with additional tests and rule out other diseases. Step 4: Referral to a specialised centre: This step covers follow-up care, adjustments to treatment, and how ongoing symptoms are managed. At this stage, specialised tests are often needed to understand why certain treatments have not worked and to find the best way 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

crs-lifestyle-environment-prevention

Back Lifestyle and environment Certain things in your environment or daily habits can make ongoing sinus problems worse. Changing some of these could help you feel better, especially if your symptoms are hard to control. First of all, it is important to understand how certain triggers can worsen your symptoms. Active or passive smoking/vaping: Smoke irritates your nose, sinuses, and airways making your symptoms worse. Talk to your doctor to discuss (help with) quitting. Irritants at work or within your life environment: If your job involves working around dust, strong smells, or chemicals, try wearing a mask to keep these from bothering your nose and sinuses. Strictly follow safety instructions at your workplace. You might also encounter irritants during your hobby or in your living place (for example, gardening, painting, woodworking). If workplace irritants are causing you to have breathing problems and/or wheezing, you need to see a pulmonologist quickly. Polluted air: Small particles in the air can trigger symptoms. Especially in-door, these particles can accumulate. Proper in-door ventilation is the best way to keep this in check. Allergens: When you are allergic to certain triggers, try to avoid them as much as possible. Making your home allergy-free can be a big job. Be sure to check out this excellent guide on how to do this properly. Alcohol: Some people with CRS may notice that they cannot tolerate alcohol. Drinking alcohol might make their nose and sinuses feel blocked or stuffy. Although this might look like an allergy, it is not the same as allergies for pet dander, mould, or pollen. Recreational drug use: Snorting drugs can seriously harm your nose and sinuses. If you need help quitting, talk to your doctor. Common cold: Typical viral infections can cause many of the typical symptoms of CRS but should normally resolve within a week. However, viral infections can also make your CRS worse (which is called an exacerbation). You can reduce the risk of viral infections by wearing a mask in environments where people are close together, like elevators, shops, concerts, buses, trains, and planes. Prevention checklist Now that you better understand what might be worsening your symptoms, let us have a look at some more practical prevention tips to take care of your sinuses. Avoid things that make symptoms worse Quit smoking and stay away from smoke if others around you smoke. Wear a mask if you are around dust, chemicals, or strong smells, or closed environments with people. Open windows or use fans to ventilate and bring fresh air into your home regularly. Use an air purifier if possible and make sure to clean it often. If your home is situated at a busy street, ventilate at the opposite side. Avoid using strong-smelling sprays or cleaners. Take care of your sinuses Rinse your nose every day (ideally twice a day) with a salt water solution. Try to have an active and healthy lifestyle Eat a varied and balanced diet, including foods like fruit and vegetables, to help your body fight off sickness. Exercise regularly to boost your immune system and health. Avoid excessive alcohol consumption and do not use recreational drugs. Reduce stress and prioritize sleep to keep your immune system strong and healthy. Take care of any allergies Avoid triggers by staying away and making your home allergy-free from pollen, pet dander, dust mites, or mould. (Mayo Clinic guide) Keep your home clean by washing bedding often and vacuum regularly using a vacuum with a HEPA filter. Use allergy medication as directed by your doctor or pharmacist to keep symptoms under control. Try to avoid getting viral respiratory infections Wear masks. Wash your hands often so you do not catch viruses that cause the common cold or the flu. Try to stay away from people who have the cold or the flu. Talk to your doctor Tell your doctor if your symptoms do not get better or if they get worse. 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 The FAQs are designed to cover more in-depth questions, particularly interesting if your condition is long-standing. If you have any questions that remain unanswered after going through this portal and FAQs,  don’t hesitate to contact our Team at contact@euforea.eu. Please note that we can’t take any personal questions.   About CRS What is chronic rhinosinusitis (CRS)? Inflammation is the body’s reaction to things like germs and irritants such as foreign objects or chemicals. When inflammation affects the inside lining of the nose and spreads to the sinuses, it is called rhinosinusitis. Sinuses are the air-filled spaces around the nose. Common symptoms of rhinosinusitis include nasal blockage or stuffiness, reduced/loss of smell,  nasal pressure or pain in the face, and mucus that drips out of the front part of the nose or into the back of the throat. When the symptoms of rhinosinusitis are present for more than 12 weeks, it is considered CRS. CRS can present with or without nasal polyps. Nasal polyps are soft, non-cancerous growths in the nose and/or sinuses that can cause symptoms and interfere with your daily life. To date, it remains unclear why some patients with CRS develop nasal polyps and others do not. The form of CRS with nasal polyps is also referred to as Nasal Polyp Syndrome. Is CRS inherited? CRS with nasal polyps runs in families but also CRS without nasal polyps has been observed in family members, strongly suggesting that a hereditary (=genetic) factor contributes to the disease. However, studies in identical twins showed that both siblings will not necessarily develop nasal polyps, which emphasises the additional and important role of non-hereditary, environmental factors. Why do I have sinuses? Sinuses are air-filled cavities in the bones of your face and skull that are covered with a thin moist layer of mucus. The nose and sinuses fulfil an important role in filtering, heating and moistening the air that we breathe through the nose. This is important to protect your lungs. The sinuses also contribute to the resonance of your voice, affecting how we sound when we speak. Moreover, the sinuses also absorb energy (“act as a cushion”) to protect our brain when we have an accident. How many people have CRS? Around 10% of people have CRS. For Europe, this is roughly equivalent to the entire population of Spain. In some areas of Europe, the percentage of people affected by the disease is even higher. What is the difference between chronic sinusitis and chronic rhinosinusitis? When the inner lining of the nose becomes inflamed and the inflammation also extends to the nearby sinuses, it is called “rhinosinusitis“. Although the terms “sinusitis” and “rhinosinusitis” are often used interchangeably, rhinosinusitis more accurately describes the condition affecting both the nose and the sinuses. However, both terms are used to describe the same condition. Does CRS progress when I get older? CRS can change as you grow up. In kids, it is usually milder, and nasal polyps (soft, painless growths in the nose or sinuses) do not happen often unless the child has a condition like cystic fibrosis. For adults, CRS with nasal polyps can get worse if it is not treated. Over time, the polyps can grow bigger and press on the bones in the face, sometimes even changing how the face looks. Another sign that the condition is getting worse is when asthma symptoms start to show up. These include feeling out of breath, wheezing (a whistling sound when you breathe), coughing, or bringing up mucus from your chest. If these things happen, it is a good idea to tell your doctor. Can CRS be cured? CRS typically cannot be completely cured, but its symptoms can often be managed and controlled with treatment. The condition involves long-term inflammation of the sinuses which can be challenging to treat. The underlying causes of the inflammation vary and may include infections, allergies, structural abnormalities in the nose, or issues with the immune system. Usually, the disease becomes less severe after 60 years of age.   Causes of CRS What causes CRS? Although still not fully understood, CRS is probably caused by a combination of different factors that together contribute to the development of the disease. It is believed to be an interaction between personal traits (including your genetic code) and factors in the environment, such as air pollution, exposure to cigarette smoke or allergens. This interaction leads to a long-lasting inflammation in the sinuses and nasal cavity. Is CRS caused by bacteria or viruses? Inflammation is the major cause of CRS. Inflammation can be caused/increased by many factors like infections with bacteria and viruses, smoking, air-pollution and allergens. The inflammation causes thickening of the inner lining of the nose and sinuses, production of mucus and sometimes polyps, which causes the symptoms of CRS. It is important to understand that CRS is not just an “infection that won’t clear”. Many bacteria and fungi normally live in our sinuses, whether a person suffers from sinus disease or not. While the presence of bacteria and viruses can contribute to inflammation, simply killing the bacteria with antibiotics does not cure the condition. Instead, the disease likely results from a combination of different factors, including the impact from the environment and your genetics. This together produces the long-lasting inflammation that is typical in CRS. Is CRS caused by my allergy? The importance of allergy as a contributing factor to CRS is not fully understood. Allergies are more common among people with CRS than they are among people in the general population. This is especially true for year-round allergies to for example moulds or house dust mites. Allergies that are poorly controlled can contribute to a worsening of CRS symptoms. Additionally, it appears that allergic patients get severe and recurrent CRS more often. Allergy also frequently co-exists with asthma, which further contributes to the complexity. I think my CRS started when I inhaled some water/chemical/gas/smell via my nose at work. Is that possible? Yes, it is possible. Breathing in certain

crs-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. Want to know more about our previous panel discussions? Be sure to check out the 2024 Edition themed “The Empowered Patient“. 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. 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

crs-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,

crs-welcome

Back https://s3.nl-ams.scw.cloud/euforea-wp-develop/uploads/Updated-CRS-Animated-Video_27.01.25.mp4

crs-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 (proof-reading) Lieve Celis (proof-reading) Vanessa Stockton (proof-reading) Lindsay Cypers (proof-reading) 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 following experts for their additional role in the development of the Expert videos for current and upcoming modules. Prof Dr Philippe Gevaert (Ghent University Hospital, Belgium) Prof Dr Guy Scadding (Royal Brompton Hospital, UK) Prof Dr Sietze Reitsma (Amsterdam Medical Center, the Netherlands) Prof Dr Joaquim Mullol (Hospital Clinic Barcelona, Spain) Prof Dr Vibeke Backer (Copenhagen University Hospital, Denmark) Prof Dr Guy Brusselle (Ghent University Hospital, Belgium) Prof Dr Michael Wechsler (National Jewish Health, USA) Dr Camilo Rodriguez-Van Strahlen (Hospital Clinic Barcelona, Spain) Dr Katherine Yuen-Ato (Hospital Clinic Barcelona, Spain) Dr Manon Blauwblomme (Ghent University Hospital, Belgium) Sven Verschraegen (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

crs-preparing-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

crs-treatment

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

crs-about-the-disease

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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