You're sneezing, coughing, and all stuffed up. It sounds and feels like a cold, alright. But as time goes on, you start to wonder. Is it turning into a sinus infection? They've got some things in common, but there are ways to tell them apart. The right diagnosis lets your doctor get you the best treatment. It's an illness caused by many different kinds of viruses, which are tiny infectious particles. You can't miss the symptoms: You may also get a cough and a mild fever. The symptoms usually build, peak, and slowly disappear. Some medications can ease symptoms. For example, decongestants may decrease drainage and open the nasal passages. Pain relievers may help with fever and headache. Cough medicine may help, as well. Colds typically last from a few days to about a week or longer. Sometimes, a cold may cause swelling in the sinuses, hollow spaces in your skull that are connected to each other. The swelling can prevent the flow of mucus. This can lead to a sinus infection. If you have pain around your face and eyes -- and thick yellow or green mucus for more than a week -- see your doctor. It's inflammation or swelling of your sinuses. Normally they're filled with air. When they become blocked and filled with fluid, bacteria can grow there and cause infection. The result: a sinus infection. You may hear your doctor refer to it as sinusitis. They may include things like: These symptoms can also happen with a cold. But if they continue for more than 10 days, you may have a sinus infection. Any condition that blocks off the drainage channels of your sinuses can cause a sinus infection, such as: A sinus infection may start after a cold. It can also happen because of something called a deviated septum, which refers to a shift in your nasal cavity. Your doctor will give you a physical exam and take your medical history. You might get a CT scan of your sinuses. Your doctor may prescribe medication. They may recommend antibiotics if your symptoms go on for more than 10 days. Decongestants, antihistamines, and other drugs help lessen the swelling in your sinuses and nasal passages. Steam and hot showers can help you loosen mucus. Your doctor may also suggest nasal saline to wash mucus from your nose. In rare cases, when a sinus infection doesn't go away, long-term antibiotics or surgery may be needed. Most colds go away without medical treatment. If you have pain around your face or eyes, along with thick yellow or green nasal discharge for more than a week, check with your doctor. Also call them if you have fever or symptoms that are severe or don't get better with over-the-counter treatments.
SOURCES: National Jewish Medical and Research Center: "It a Cold or the Flu?" American Academy of Allergy, Asthma & Immunology: "Sinusitis." Asthma and Allergy Foundation of America: "Rhinitis and Sinusitis." National Institute of Allergy and Infectious Diseases: "Sinusitis." UpToDate: "Acute Sinusitis and Rhinosinusitis in Adults."
You’ve got a cough, your throat’s sore, and your nose is stuffed up. Sounds like a cold, right? It might be something more than that if you’ve been sniffly for over a week, or if your symptoms seem to be getting worse. Here’s how to get a sense of what might be making you feel under the weather. These typically last 3 to 10 days. You could have symptoms like: Try to rest up while the cold runs its course. There's probably no need to call your doctor unless your symptoms are severe or you have other medical problems. Pick up the phone if you have any of these symptoms. It could mean you have something more than a cold:
Call 911 for any of these problems: Sometimes a cold causes swelling in the sinuses or lungs. That can lead to other problems, like these: Sinus infection (sinusitis): This happens when a cold virus infects your sinuses -- the hollow areas in the bones of your cheeks, forehead, and under your eyes. These areas swell, and your body makes more mucus. It’s a perfect place for bacteria to grow and thrive. You may get a headache, fever, and some or all of these symptoms:
See your doctor if these symptoms are severe, you still feel bad after 7 days, or if you get better and then get worse. Get emergency medical help right away if you have one or more of these problems. They could be warning signs of something more serious, like meningitis: Bronchitis (a chest cold): You get it when the large tubes that carry air into your lungs become swollen and irritated. Telltale symptoms of this illness can include: Most of the time, you don’t need to see a doctor for bronchitis. But call yours ASAP if you have any of these symptoms -- you could have pneumonia: Get emergency care or call 911 for any of these symptoms: If you’re over age 75 and have a cough that won’t stop, see your doctor. You could have bronchitis, even if you don’t have any other symptoms. Ear infection : Colds and sinus infections can keep fluid trapped in your ear behind your eardrum. When this happens, bacteria or viruses can grow and cause an infection. Warning signs of an ear infection can include: See your doctor right away if you have a high fever or severe pain in your ear. Hacking and sneezing are normal when you have a cold. Other problems, like a high fever, aren’t. If any of your symptoms concern you, put your mind at ease -- call the doctor.
SOURCES: UpToDate: “Patient information: The common cold in adults (beyond the basics).” Familydoctor.org: “Colds and the Flu.” Cleveland Clinic: “Sinus Infections That Don’t Quit: When You Should Worry.” American Rhinologic Society: “Sinus anatomy.” UpToDate: “Patient information: Acute bronchitis in adults (beyond the basics).” University of Rochester Medical Center: “Otitis Media (Middle-Ear Infection) in Adults.” © 2022 WebMD, LLC. All rights reserved. When to Call a Doctor
The time of year is upon us when blistering heat and monsoon winds give way to peaceful sunny 75 degree days. With the change of seasons come a multitude of challenges for the nose, sinuses and lungs. Allergens, dust, air pollution, particulate matter in the air, changes in barometric pressure and respiratory viruses can all wreak havoc on our respiratory systems leading to nasal congestion, post nasal drainage, cough, wheezing, fatigue and eventually sinusitis and bronchitis. The following 10 tips can help keep your nose, sinuses and lungs healthy this fall and winter.1. Stay hydrated. Drink plenty of water to keep the mucous produced by your nasal, sinus and respiratory passages thin and flowing. This will prevent stagnant mucous from building up in your sinuses and lungs. When thick mucous is retained for long periods of time in the sinuses and lungs bacteria may flourish in that environment leading to sinus infection, bronchitis or pneumonia. Adequate hydration by drinking water helps to prevent thick mucous. 2. Rinse the nasal passages with saline solution. Washing the nasal mucous membranes with saline solution eliminates irritating particles, allergens and thick mucous from the nose and sinus drainage passage ways. Saline solution also stimulates the lining of the nose and sinuses to clean themselves better. Little microscopic hairs called cilia move more frequently when exposed to saline resulting in egress of mucous from the nose and sinuses. Many products are available over-the-counter to rinse the nose with saline including Neil Med® Sinus Rinse, Simply Saline® and Neti Pot™. Remember to use distilled water to mix the saline rather than tap water or bottled drinking water. 1, 2 3. Keep doors and windows closed on poor air quality days. As the temperatures drop in the Valley it is tempting to open our homes to the more temperate desert air. This can allow dust, air pollution and allergens to enter the home and our nose and lungs causing inflammation, swelling and increased mucous production. 4. Change home air filters regularly. Make sure your home HVAC filters are changed as directed to ensure they are actually removing the unwanted particles from the circulated air. 5. Shower in the evenings. Rinse unwanted dust, air pollution and allergens from your body and hair in the evenings. This will prevent inhalation of undesirable particles from soiled pillows and bedsheets. Lingering in a steamy shower will also help loosen mucous in the nasal passages and moisturize dry mucous membranes. 6. Get adequate vitamin D. Vitamin D deficiency has been linked to more frequent viral upper respiratory illnesses, allergic rhinitis, chronic sinusitis, nasal polyps and asthma. 3,4,5,6 Studies have also shown that vitamin D supplementation lead to decreased frequency of winter respiratory tract infections and asthma exacerbations. 7,8,9,10 Thirty to forty percent of Americans are vitamin D deficient. 11 We make vitamin D through the interaction of sunlight on our skin. Our indoor lifestyles and use of sunblock prevent adequate vitamin D production in the skin and many folks, even in southern states, have vitamin D deficiency. 12, 13 Most adults and children take in less than 400 international units (IU) of vitamin D daily. The Institute of Medicine recommends children and adults get no less than 600 IU of vitamin D daily. The Endocrine Society recommends that children receive 1000 IU of vitamin D daily and adults 2000 IU daily.14 Risk factors for vitamin D deficiency include darker pigmented skin, winter season, sun avoidance, obesity, increasing age and use of certain medications including oral steroids and anti-seizure medications. 15 If you believe you are at risk for vitamin D deficiency, see your healthcare provider. You may need over-the-counter supplementation of vitamin D or even prescription vitamin D replacement for very low levels. 7. Get the sleep you need. Lack of sleep increases your risk of getting sick after exposure to a virus. Most adults need 7-9 hours of sleep. Teenagers usually require between 8-10 hours of sleep while children require 9-11 hours. 16 8. Consider an over the counter nasal steroid spray. When your nose has been subjected to allergies or other airborne irritants and nasal congestion is not relieved and prevented with the above measures then consider using an over-the-counter nasal steroid spray as directed for 4-6 weeks. These remedies are effective and relatively safe when used properly. 17,18,19,20 Be sure to aim the spray nozzle towards the internal sidewall of the nose rather than at the internal middle wall (septum). Do not use the steroid spray until consulting with your physician if you have frequent nose bleeds, prior nasal surgery or glaucoma. Discontinue the spray after 6 weeks unless you are under the care of a doctor who has recommended longer use. 9. Consider over-the-counter remedies to relieve sinusitis symptoms. Almost every grocery store or pharmacy has everything you need to find relief from uncomplicated mild acute sinusitis. Symptoms of acute sinusitis include cloudy or colored nasal discharge, nasal congestion, nasal blockage, and pain, pressure or fullness in the face, head or around the eyes which have been present for 4 weeks or less. Over-the-counter decongestant and mucous thinning combination tablets (ie. Mucinex-D ™) and over the counter decongestant spray (ie. Afrin ™-use for maximum of 3 days only) when combined with nasal saline irrigations during early and uncomplicated acute sinusitis can relieve symptoms and help resolve acute sinusitis. Check with your healthcare provider if you have high blood pressure, heart disease, irregular heartbeat, prostate enlargement, urinary retention, frequent bladder infections, anxiety, nervousness or insomnia before taking over-the-counter decongestants as these medications can potentially worsen those conditions. Also, it is very important to avoid using nasal decongestant spray for longer than 3 days. Beyond 3 days of use the decongestant nasal sprays may cause long lasting irritation in the nose and worsen nasal congestion. Most cases of acute sinusitis will resolve without antibiotics. If symptoms last more than 7 days after starting over-the-counter treatment then it is time to see your healthcare provider to determine the appropriate course of action. At that point antibiotics may be prescribed. Keep in mind oral antibiotics have potential harmful side effects including nausea, rash, stomach upset, diarrhea, allergic reaction, causing resistant germs and ridding our body of essential helpful bacteria in the digestive tract. 21 10. Continue to exercise if your symptoms are mild and you have the energy to do so. Avoid exercise if you have shortness of breath, significant cough or any other chest symptoms. However, if you have mild nasal and sinus symptoms (congestion, pressure) aerobic exercise can bring relief. Aerobic exercise results in the release of epinephrine (adrenaline) into your blood stream. This epinephrine release acts as a natural nasal decongestant by constricting blood vessels in the inflamed and swollen tissues in the nose and sinuses. After a few to several minutes of aerobic exercise the nasal passages usually feel clearer. Additionally the repetitive bouncing or vibrations the body experiences from aerobic activity like running and high intensity interval training transmits vibrations to the sinus cavities and lungs which some experts believe helps with clearance of thick mucous from those passages. Natural clearance of mucous from the sinuses by cilia (microscopic hairs which line the mucous membrane and sweep mucous out of the sinus cavity) increases during exercise. 22 Remember to stay well hydrated when you exercise and when you have nasal and sinus symptoms. It is recommended you double your normal water intake to prevent dehydration during exercise in the setting of mild upper respiratory symptoms. Please be respectful of others and avoid group fitness and gyms if you believe you have a contagious viral or bacterial illness. Once symptoms have resolved you may return to the gym. Remember there are plenty of exercise activities you can do on your own without heading to a fitness class or gym. I hope the preceding 10 recommendations keep you feeling clear headed, vibrant and healthy this fall and winter. If your respiratory symptoms persist beyond 7 days despite the measures above, or if you have shortness of breath, consult with a qualified healthcare provider or physician. Ryan M. Rehl, M.D. Founder, Arizona Sinus Center a Division of Valley ENT, P.C. www.arizonasinus.com Immediate Past President Arizona Society of Otolaryngology-Head and Neck Surgery References:
For additional information on sinusitis: |
How to prevent sinus infection from turning into bronchitis
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