Colds, Flu and Sinusitis
What are colds?
Everyone gets a cold from time to time. Children get more colds than adults.
Colds usually last 1 to 2 weeks. You can catch a cold at any time of year, but they are more common in late winter and early spring.
There is no cure for a cold. Antibiotics will not cure a cold. If you catch a cold, treat the symptoms.
Lots of different viruses cause colds, but the symptoms are usually the same:
You will probably feel a cold come on over the course of a couple of days. As the cold gets worse, your nose may get stuffy with thicker mucus.
A cold is not the same as the flu. Flu symptoms are worse and come on faster. If you have the flu, you may feel very tired. You may also have a fever and shaking chills, lots of aches and pains, a headache, and a cough.
If you feel like you have a cold all the time, or if cold symptoms last more than 2 weeks, you may have allergies or sinusitis. Call your doctor.
Good home treatment of a cold can help you feel better. When you get a cold:
Don't take cold medicine that uses several drugs to treat different symptoms. For example, don't take medicine that contains both a decongestant for a stuffy nose and a cough medicine. Treat each symptom on its own.
A nasal decongestant spray can help your stuffy nose, but make sure you don't use it for more than 3 days in a row. You could get a "rebound" effect, which makes the mucous membranes in your nose swell up even more.
Do not give cough and cold medicines to a child younger than 2 unless you've checked with the doctor first. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do. Using saline drops or a humidifier may help thick or dried mucus to drain. To remove mucus from your baby’s nose, use a suction bulb to gently suction the mucus out. This is a safer way to treat your baby's stuffy nose.
Call your doctor if:
There are several things you can do to help prevent colds:
Influenza (flu) is a viral upper respiratory illness that comes on suddenly, causing a person to feel very sick with symptoms such as fever, body aches, headache, fatigue, loss of appetite, and a dry cough or sore, dry throat. Home treatment to reduce discomfort is usually all that is needed.
In some cases, the flu can lead to complications, such as bacterial pneumonia. People who are at high risk for complications include young children up to 5 years of age, adults age 65 and older, and all those who have certain health conditions, such as chronic heart or lung problems or immune system disorders.
Yearly immunization with the inactivated flu vaccine (flu shot) or the nasal spray vaccine (FluMist) helps reduce the risk of getting the flu and makes symptoms less severe for people who do get the flu.
The flu causes a fever, body aches, a headache, a dry cough, and a sore or dry throat. You will probably feel tired and less hungry than usual. The symptoms usually are the worst for the first 3 or 4 days. But it can take 1 to 2 weeks to get completely better.
It usually takes 1 to 4 days to get symptoms of the flu after you have been around someone who has the virus.
Most people get better without problems. But sometimes the flu can lead to a bacterial infection, such as an ear infection, a sinus infection, or bronchitis. In rare cases, the flu may cause a more serious problem, such as pneumonia.
Certain people are at higher risk of problems from the flu. They include young children, pregnant women, older adults, and people with long-term illnesses or with impaired immune systems that make it hard to fight infection.
Your doctor will ask you about your symptoms and examine you. This usually gives the doctor enough information to find out if you have the flu, especially if many cases of a similar illness have occurred in the area and the local health department reports a flu outbreak.
In some cases, the doctor may do a blood test or take a sample of fluid from your nose or throat to find out what type of flu virus you have.
Most people can treat flu symptoms at home. Home treatment includes resting, drinking plenty of fluids, and taking medicine to lower your fever.
If you think you have the flu, your doctor may be able to give you medicine that can make the symptoms milder. But you need to start taking it within 2 days of your first symptoms.
You can help prevent the flu by getting the flu vaccine every year. The best time to get the vaccine is in October or November, just before the start of flu season. You can get the vaccine as a shot or in a spray that you breathe in through your nose.
Almost anyone over 6 months old can have the flu vaccine. The vaccine is especially important for people who are at higher risk of problems from the flu, including:1
The flu vaccine is also recommended for health care workers and anyone who lives or works with a person who is at higher risk of problems from the flu. Your doctor can help you decide if the flu vaccine is a good choice for you.
The vaccine usually prevents most cases of the flu. But even if you do get the flu after you've had the vaccine, your symptoms will be milder and you'll have less chance of problems from the flu. You cannot get the flu from the flu vaccine.
Sinusitis is an inflammation of the nasal sinuses. It is usually caused by infection (bacterial or viral), but can also be caused by allergic reactions or other responses to environmental agents.
The sinuses are holes in the skull between the facial bones. There are four large sinuses: two inside the cheekbones (the maxillary sinuses) and two above the eyes (the frontal sinuses).
There are also smaller sinuses (ethmoidal and sphenoidal sinuses) located between the larger ones. The sinuses are lined with membranes that secrete antibody-containing mucus, which protects the respiratory passages from the onslaught of irritants in the air we breathe.
Most sinusitis is caused by infection (such as a cold or an upper respiratory tract infection) spreading to the sinuses from the nose along the narrow passages that drain mucus from the sinuses into the nose.
Allergies to dust, pollen, pet dander; indoor air pollutants, such as cigarette smoke, rug shampoo and formaldehyde (used in the manufacture of carpeting, particleboard and plywood); and outdoor air pollutants all can induce inflammation.
Excessive dryness in homes and offices from dry-air heating and air-conditioning systems can also inflame the sinuses.
Immunologic, as well as structural problems, such as narrow drainage passages, nasal obstruction (tumors, polyps or a deviated septum) problems are other possible causes of sinusitis.
The classic symptoms of chronic (long lasting) sinusitis are:
The classic symptoms of acute (short lasting) sinusitis are:
Maxillary sinusitis (the most common type) manifests as cheek or dental pain. Forehead pain indicates frontal sinusitis. Pain at the bridge of the nose or behind the eye suggests ethmoid sinusitis. Pain is often referred to the top of the head with sphenoidal involvement.
Less common signs of sinusitis include:
The doctor will examine the mouth and throat and look up the nasal passages to determine whether the sinus outlets are blocked. Additionally, the doctor may do a transillumintion or a CAT scan.
Transillumination is done in a dark room with a very bright flashlight that is pressed against the forehead or cheek. If the light shines through the sinuses, the doctor can rule out sinusitis. If little or no light penetrates, the cavity is clogged and sinusitis is evident.
CAT scan is a diagnostic technique in which the combined use of a computer and x-rays are passed through the body at different angles, producing clear, cross-sectional images of the nasal cavities.
The doctor may also perform an endoscopic examination. This is a narrow, flexible fiber-optic scope that is placed into the nasal cavity through the nostrils. It allows the doctor to view where the sinuses and middle ear drain into the nose.
Predisposing factors in the patient's history may help confirm the diagnosis or indicate underlying conditions that require therapy. The two most common predisposing factors are a recent upper respiratory tract viral infection (lasting more that seven to 10 days) and allergic disease.
Additionally, sinusitis is especially likely if cold symptoms are unusually severe or accompanied by a high fever, pus-like nasal discharge or puffy eyes.
If a bacterial infection is present, antibiotics, such as amoxicillin, erythromycin or sulfa drugs, are usually prescribed for about 10 days.
Your doctor also may prescribe one or more of the following remedies (which can be useful in reducing inflammation in the sinuses and nose and speeding recovery):
Decongestants like pseudoephedrine, phenylpherine and phenylpropanolamine constrict the blood vessels and shrink the sinus and nasal membranes, thus, reducing stuffiness in the sinuses and nasal passageways.
After using decongestant sprays for three days, people usually experience a rebound effect - when they stop using the spray, they become even more congested and need more spray for relief. People with chronic allergies or sinus problems should limit the use of decongestant sprays to five treatments a week.
When used as directed by a doctor, prescription inhalers can be taken safely for months.
Recurring sinusitis accompanied by a bacterial infection usually requires one of the new, stronger antibiotics, such as Augmentin, Ceclor or Ceftin. These drugs may be given in larger doses for a longer period of time (up to four weeks) than required for a brief bout of sinusitis. The doctor may also recommend continued use of a prescription nasal inhaler for several months to keep the inflammation down and prevent a recurrence.
Are any tests needed to diagnose the condition or determine the cause?
Is the sinusitis caused from allergies or a bacterial infection?
Will you be prescribing any medications?
What are the side effects?
How effective is the medication?
How long will it take to feel relief of pain and discomfort?
If you are recommending nasal sprays or medication, which ones are most effective?
Are there any home treatments you might recommend?