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Diagnosis: Cold? Allergy? Sinusitis?




You're sick, but what do you have? This month's newsletter Diagnosis: Cold? Allergy? Sinusitis? gives information to help you know. There are also tips on treatment and prevention.

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  1. Do I Have A Cold, An Allergy, Or Sinustitis?
  2. What Can I Do To Treat Myself?
  3. When Should I See A Doctor?
  4. What Will A Doctor Do?
  5. What Can I Do To Keep From Getting Sick Again?
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National Allergy E-Mail Newsletter
Diagnosis:
Cold? Allergy? Sinusitis?

Do I Have A Cold, An Allergy, Or Sinusitis?

This man is sneezing, sniffling, and blowing his nose. Does he have a cold, an allergy, or sinusitis?It can be very difficult to tell if you are suffering from allergies, if you have a common cold, or if you have sinusitis. Sometimes it's hard for a doctor to tell. Although allergies, colds, and sinusitis have many of the same symptoms, there are a few markers that can help you tell them apart.

Although you can experience a stuffy nose, sneezing, a runny nose with any of the three, one way to identify a cold is how long the symptoms last. If you are getting over it within 2 weeks, then it was more than likely a cold. If symptoms last more than 2 weeks or keep coming back, that's an indicator that you have an allergy. And to be even more confusing, there are two types of allergy: seasonal that comes and goes with the seasons (like a sensitivity to pollen) and perennial that occurs all year long when you are exposed to the allergen (like pet dander or dust mite waste).

A cold or allergy can lead to infection and/or inflammation of the sinuses. The most striking difference in regards to sinus symptoms with sinusitis is the pain in your sinuses. You have four pairs of sinuses, but this smiling man obviously does not have sinusitis.You have four pairs of sinuses. With sinusitis you will have pain and tenderness in these areas. Often the pain is worse if you bend over. (Obviously, this smiling man does not have sinusitis.)

A cold is caused by a virus and it may take 2 or 3 days after you are exposed for the sinus symptoms to appear. Allergies are caused by exposure to something your immune system wants to fight. An allergy symptom is often immediate: puffy, watery eyes when you are around cats or sneezing when you are near flowers (chrysanthemums always make me sneeze - that's how I know what they are). In addition, it may help you to decide by knowing that colds are contagious and easily transmitted by touch or by air, but no one can catch a runny nose from you if it is due to allergies.

What Can I Do To Treat Myself?

About all you can do is try to relieve the symptoms. I am a wait-and-see-if-it-goes-away person when it comes to aches and pains. Sometimes that is good, and sometimes it is not. If you have a cold, that is the very thing to do. It will run its course in about two weeks. My dad is a believer in the adage: It takes two weeks to get rid of a cold if you take medicine and 14 days if you don't. That has a lot of truth to it, but treating the symptoms can make you more comfortable. You can use steam or a humidifier to loosen mucous, use nasal sprays to moisten dry nasal passages, irrigate nasal & sinus passages to rinse out mucous and infection, and use OTC medicines (it's a good idea to check with your doctor or pharmacist first, especially if you are taking other medicines). And, of course, get extra rest and drink plenty of fluids. The FDA says to pick the right medicine for your symptom and to make sure the label says that it is for that symptom. The following chart gives the FDA recommendations:

Symptom OTC Medicine
Stuffy Nose Nasal Decongestant
Cough Cough Suppressant
Mucous Expectorant
Runny Nose & Sneezing Antihistamine

If you wait for it to go away and it doesn't, there's a good chance your symptoms are due to an allergy. If you think you know what you are allergic to, stay away from it. However, if symptoms persist, you are probably going to need to see your primary care doctor or an allergist for an exact diagnosis and treatment suggestions.

When Should I See A Doctor?
In addition to persistent symptoms, you should consider seeing a doctor if you develop pain in your ear, throat, sinuses or teeth because that may indicate an infection. Sometimes, it is better to be safe than sorry, and if you are having real trouble breathing, that is one of those times. You should call your doctor for advice or consider going to an emergency room if your breathing is affected.
The American Academy of Family Physicians recommends seeing a doctor if you have "swelling or pain around your eyes, cheeks, nose or forehead, a headache, a dry cough, and/or discharge from the nose" because it may be sinusitis. The FDA says you do not need to call your doctor right away if you have cold symptoms, but call if your symptoms get worse or last a long time. Also, the FDA says call your doctor if you have these symptoms: nausea, vomiting, high fever, shaking, chills, chest pain, or coughing with thick, yellow-green mucous.

What Will A Doctor Do?

So you decided to see a doctor. If the doctor determines you have a cold with no secondary infection, he will most likely recommend an OTC medication to match your symptoms because antibiotics will not work on a viral infection. If you have a bacterial infection such as sinusitis, he may prescribe antibiotics. If it appears to be an allergy, according to the AAFA (Allergy & Asthma Foundation of America) the doctor will follow this 3-step evaluation: ask you questions for a personal medical history; conduct a physical exam concentrating attention on your ears, eyes, nose, throat, chest, and skin; perform allergy tests such as a skin test, patch test, or blood test. This will enable the doctor to devise a treatment plan to help you live as normally as possible in spite of your allergy. This plan will include the following components or a combination of them: environmental controls to help you avoid the allergen affecting you, over-the-counter or prescription medication, OTC or prescription nasal sprays, and/or immunotherapy (allergy shots).

What Can I Do To Keep From Getting Sick Again?

There are steps you can take to reduce the likelihood of catching a cold. The FDA states these measures for prevention:
  • Wash your hands often. You can pick up cold germs easily, even when shaking someone's hand or touching doorknobs or handrails.
  • Avoid people with colds when possible.
  • Sneeze or cough into a tissue and then throw the tissue away.
  • Clean surfaces you touch with a germ-killing disinfectant.
  • Don't touch your nose, eyes, or mouth. Germs can enter your body easily by these paths.
Allergies are a different story altogether. If you have an allergy symptom, the number one way to keep from getting sick is to avoid what you are allergic to. There are times when allergens cannot be avoided. For example, cat dander will remain in a home for months after a cat has lived there and pollen and mold spores can be carried for miles by the wind. Environmental controls may be needed to help prevent an allergy symptom. This is where a doctor's diagnosis of what you are allergic to comes in handy. Even though you may not be able to avoid that allergen completely, you can take steps to control your environment and reduce your exposure and this can make a big difference. The following chart shows the environmental controls suggested for different allergens.

Allergen Doctor-Recommended Environmental Controls
Dust Mites
Pollen
Mold
Animal Dander

Preventing sinusitis is mainly achieved by carefully treating cold and allergy symptoms. If you have a cold or allergy, you want to keep mucous out of your sinuses where it can cause infection. A key factor is blowing your nose properly. If you just pick up a tissue and blow, you will likely blow some mucous right into your sinuses. If you must blow your nose, block one side so you only blow from one nostril at a time. And blow gently!

A good prevention tool for allergy and sinusitis is regular
nasal and sinus irrigation. Some people prefer a "gravity" method of letting water flow freely through the nasal and sinus passages; a neti pot is this type. Others prefer a "positive pressure" approach of squirting water in your nose with a special bottle or device. And then there is the "pulsatile" type of irrigation that mimics the natural action of the nasal cilia in removing bacteria and debris. All methods are good - it's really a matter of personal preference. The important thing is to aid the cleansing of nasal and sinus passages in order to remove pollen, dander, mold spores, and other debris and to prevent infection.

Conclusion

Now you can take charge of your health when it comes to colds, allergies, and sinusitis. Do what you can to be comfortable with a cold. If symptoms last more than two weeks, seeing a doctor is advisable. And, of course, preventing a cold, allergy, or sinusitis is preferable than trying to treat any of the three.

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The information in this newsletter is for educational purposes only. Always consult with your doctor first about your specific condition, treatment options and other health concerns you may have.

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