ENT Tips for Cold and Flu Season

Written by on January 31, 2013 in Features - No comments
Maybe it’s not a cold: Knowing the difference between sinusitis and cold symptoms
The common cold

More than 200 different types of viruses can cause a cold. The three most frequent symptoms of a cold are nasal stuffiness, sneezing, and runny nose. Throat irritation is also often involved. Adults and older children with colds generally have minimal or no fever. Infants and toddlers often run a fever in the 100 to 102 degree range.

Depending on which virus is the culprit, the virus might also produce a headache, cough, postnasal drip, burning eyes, muscle aches, or a decreased appetite, but in a cold, the most prominent symptoms are in the nose.

Once you have “caught” a cold, the symptoms begin in one to five days. Usually irritation in the nose or a scratchy feeling in the throat is the first sign, followed within hours by sneezing and a watery nasal discharge.

The entire cold is usually over all by itself in about seven days, with perhaps a few lingering symptoms (cough) for another week. If it lasts longer, consider another problem, such as a sinus infection or allergies.

Sinusitis

Acute bacterial sinusitis is an infection of the sinus cavities caused by bacteria. It usually is preceded by a cold, allergy attack, or irritation by environmental pollutants. Unlike a cold or allergy, bacterial sinusitis requires a physician’s diagnosis and may require treatment with an antibiotic to cure the infection and prevent future complications.

Normally, mucus collecting in the sinuses drains into the nasal passages. When you have a cold or allergy attack, your sinuses become inflamed and are unable to drain. This can lead to congestion and infection. Diagnosis of acute sinusitis usually is based on a physical examination and a discussion of your symptoms.

When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute, however, untreated chronic sinusitis can cause damage to the sinuses and cheekbones that sometimes requires surgery to repair.

Ask your otolaryngologist if you believe you have a sinus infection (see sidebar at right). For more information on ear, nose, and throat winter health, visit www.entnet.org.

Allergies

Allergy symptoms appear when the immune system reacts to an allergic substance that has entered the body as though it was an unwelcome invader. Many common substances can be allergens—pollens, food, mold, dust, feathers, animal dander, and chemicals

When an allergen reenters the body, the immune system rapidly recognizes it, causing a series of reactions. It also causes the production of many inflammatory substances including histamine. Histamine produces common allergy symptoms such as itchy, watery eyes, nasal and sinus congestion, headaches, sneezing, scratchy throat, hives, or shortness of breath. Other less common symptoms are balance disturbances, skin irritations such as eczema, and even respiratory problems like asthma. For some allergy sufferers, symptoms may be seasonal, but for others it is a year-round discomfort.

Over-the-counter medications and sinus pain: Know the facts!

Drugs for stuffy nose, sinus trouble, congestion and drainage, and the common cold constitute a large segment of the over-the-counter market for America’s pharmaceutical industry. Even though they do not cure allergies, sinusitis, colds, or the flu, they provide welcome relief for at least some of the discomforts of seasonal allergies and upper respiratory infections. However, it’s essential for consumers to read the ingredient labels, evaluate their symptoms, and choose the most appropriate remedy.

Antihistamines - help dry up a runny nose and relieve sneezing. Avoid them during the congested phase of your cold because they can make mucus thicker and more difficult to drain. They are most helpful when symptoms are caused by an allergy. Some older brands may cause you to be sleepy.

Decongestants - can help relieve sinus pressure and a stuffy nose, making it easier for you to breathe. These will also dehydrate you! Take lots of fluids. Avoid at bedtime, since they are stimulants.

Pain Relievers - help relieve the pain associated with a sore throat, and headache, and can reduce a fever. These include acetaminophen (Tylenol), aspirin, ibuprofen (Advil, Motrin) and Naproxen (Aleve).

Always make sure to consult with your doctor about your prescription medications before you start taking an O-T-C product, as some can cause drug interactions.

*note – Information is for adults only.

Is it a sinus infection?

1. Facial pressure/pain/fullness?   ❏ yes ❏ no
2. Nasal congestion or stuffiness?   ❏ yes ❏ no
3. Cloudy or colored nasal discharge?   ❏ yes ❏ no
4. Postnasal drip?   ❏ yes ❏ no
5. Illness lasting 10 days or longer?   ❏ yes ❏ no
6. Improvement followed by worsening?   ❏ yes ❏ no

If you answered “Yes” to three or more of the symptoms listed above, you may have an acute bacterial sinus infection. An examination by an ear, nose, and throat specialist may be warranted.

Symptoms of sinusitis:

• symptoms of upper respiratory infection lasting 10 days or more
• improvement followed by worsening within 10 days
• facial pain, pressure, or fullness
• nasal discharge that is cloudy or colored
• nasal congestion or stuffiness
• post-nasal drip
• cough

At-home treatments for sinusitis:

• nasal sprays that moisturize the nasal cavity, reduce dryness, and help clear thick or crusty mucus
• humidification (moisturizing the air) of living spaces in dry climates will aid the movement of mucus through the sinuses

An otolaryngologist can:

• determine if you have an infection requiring an appropriate antibiotic
• discover if you require intensive medical treatment for a condition such as nasal obstructions, necessitating sinus surgery
• Make treatment recommendations and discuss long-term outcomes

Maintaining sinus health

Maintaining sinus health during the cold and flu season can help prevent a case of sinusitis. The American Academy of Otolaryngology— Head and Neck Surgery suggests the following ways to keep your sinuses clear:

• Drink plenty of fluids to keep nasal discharge thin and keep your body hydrated.
• You may get some relief from your symptoms with a humidifier, particularly if air in your home is heated by a forced-air system.
• If you are going to fly during the holiday seasons, use a nasal spray decongestant before take-off to prevent blockage of the sinuses, allowing mucus to drain.
• Avoid smoking and drinking alcohol, as both can irritate your nasal passages.
• If you have allergies, try to avoid contact with things that trigger attacks. If you cannot, use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks.

By The American Academy of Otolaryngology – Head and Neck Surgery

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