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Maybe It’s Not a Cold

Knowing the Difference Between Allergies, Sinusitis, and Cold Symptoms

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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, post-nasal 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 for another week. If it lasts longer, consider another problem, such as a sinus infection or allergies.

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.

The entire cold is usually over all by itself in about seven days. If it lasts longer, consider another problem.

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 sinusitis; however, untreated chronic sinusitis can cause damage to the sinuses and cheekbones that sometimes requires surgery to repair.

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, and even respiratory problems. For some people with allergies, symptoms may be seasonal, but for others it is a year-round discomfort.

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. 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.
  • Decongestants can help relieve sinus pressure and a stuffy nose, making it easier for you to breathe. These will also dehydrate you, so drink plenty fluids.
  • Pain relievers help relieve the pain associated with a sore throat and headache, and can reduce a fever. These include acetaminophen, aspirin, ibuprofen, and naproxen.

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

Sinus Health
Maintaining sinus health during the cold and flu season can help prevent a case of sinusitis. To keep your sinuses clear, drink plenty of fluids to keep nasal discharge thin and 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.

Avoid drinking alcohol and smoking, as both can irritate your nasal passages. If you have allergies, try to avoid contact with things that trigger attacks. If you cannot, use OTC or prescription antihistamines or a prescription nasal spray to control allergy attacks. 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.


Source: American Academy of Otolaryngology – Head and Neck Surgery,

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2010-2011.