COLD .7 ALLERGY? Here~ How You Can Tell the Difference By Robert Dinsmoor

yT u have symptoms of a co ld - -

neezing, coughing, stuffy

nose-- that don't seem to be going

away. Perhaps that's because it's not

really a cold. Allergies or a sinus

infection can produce some of the

same or similar symptoms. And yet,

the treatment for a cold, sinus infec-

tion and allergies are each different.

Furthermore, since any of these con-

ditions can trigger an asthma attack,

proper treatment is important.

"When people have a runny

nose, they have a hard time differenti-

ating between an infectious process

and allergies," says Diane Ponticelli,

RN, of the Asthma Center at the

Lahey Clinic in Burlington,

Massachusetts. "And if it's infectious,

they have a hard time determining

whether it's a cold or sinusitis." So,

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INUS INFECTION? how can you tell the difference? And when should you see the doctor? To be able to make these distinctions, it helps to understand all three condi- tions.

C o l d s

Everyone gets a cold at one time or another. Colds are caused by viral infections that commonly affect the nose and throat, and sometimes the larynx and lungs. Typically, a cold produces such symptoms as a runny nose, fever, sneezing, watery eyes, sore throat and coughing. There is no specific treatment for a cold. Physicians generally recommend get- ting plenty of rest and drinking lots of fluids. Cold symptoms can be treated with over-the-counter cold medications, including deconges- tants; fever-reducing medicines, such as Tylenol; and expectorants, such as Robitussin. These medications do not cure the cold, but rather make the symptoms less troublesome and the person more comfortable. A cold will usually run its course in about a week. When symptoms last for longer than a week, this suggests that it might not be a cold, but some- thing else.

A l l e r g i e s

Allergic rhinitis or "hay fever" may produce symptoms similar to those of a cold, including sneezing, a runny nose, a stuffy nose and watery eyes. Unlike a cold, allergies tend to also cause itching of the eyes and nose. Allergic rhinitis is the body's reaction to airborne allergens, in which the lining of the nasal passages, the sinus- es and the eyes become inflamed. In fact, allergies are very common in people with asthma. Treatment for the symptoms of allergies is different from that of a cold.

One measure to treat allergies is avoidance, trying to limit one's expo-

sure to the allergen that is provoking the reaction. Common airborne aller- gens include pollen, mold, animal dander, dust mites and cockroach debris. People can avoid pollen by staying indoors, preferably in an air- conditioned environment, as much as possible during hay fever season. There are numerous steps that can be taken in the indoor environment to help keep it free of dust mites, dan- der, mold and cockroaches. (See "Indoor Allergens: The Battle on the Homefront," Asthma Magazine, July/August 1998)

There are also a number of med- ications, used alone or in combina- tion, to treat the symptoms of aller- gic rhinitis. Antihistamines help block the action of histamine, a chemical in the body responsible for many allergy symptoms. Decongestants can help relieve nasal cv, ngestion. There are nasal sprays that contain medications that, when squirted into the nose, can help reduce the inflammation in the lining of the nose and sinuses and, there-

fore, reduce symptoms of allergic rhinitis.

S i n u s i t i s

Sinusitis is an infection of the paranasal sinuses, the cavities or spaces in the head that surround the nose. Like a cold, sinusitis can cause fever, a runny nose, stuffy nose and cough. Unlike colds, sinusitis can produce headaches. These tend to occur at the forehead and the maxil- lary sinus area (the part of the face below the eyes and above the teeth), and most commonly occurs upon awakening in the morning. Sinusitis may be caused by a viral, bacterial or fungal infection and is often preced- ed by a cold or allergic rhinitis. This is because the inflammation associat- ed with the cold causes swelling of the mucous membranes of the sinus- es, which, in turn, traps air and mucus in the sinuses. Ordinarily there is drainage, which helps rid the sinuses of the bacteria that is normal- ly present. But the excess mucus asso- ciated with a cold, along with sinus

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blockage that inhibits drainage, may allow bacteria to multiply and cause an infection.

Sinusitis is usually treated with a decongestant to reduce the mucus build-up, along with an appropriate antibiotic to treat the infection. Additionally, sometimes doctors recom- mend sinus lavage to patients with sinusitis, which involves irrigating the nasal passages with warm salt water.

H o w t o T e l l t h e D i f f e r e n c e

According to Ponticelli, there are a number of clues people may use to fig- ure out whether they have a cold, aller- gies, or sinusitis: �9 If the nasal drainage or discharge is

clear, the symptoms are most likely due to a cold or allergies. Thicker, dis- colored sinus drainage suggests that an infection is present.

~ Itching of the eyes or nose suggests allergies rather than a cold or sinusitis.

�9 Headaches, especially in the front of the face, suggest sinusitis.

�9 If the symptoms don't go away within seven days, they are probably not due to a cold, but rather due to allergies or sinusitis.

No one wants to go running to the

doctor for every sniffle or sneeze. When should you seek medical attention? "If the fever, chills or cold symptoms don't go away within seven days, it's most likely a sinus infection," says Ponticelli. "People with asthma need to treat colds, allergies and sinusitis early to prevent triggering an asthma flare-up. Also, patients experienc- ing any associated asthma flare-ups that don't resolve with the usual measures they take should seek medical help."

Since colds, sinus infections and allergies are significant triggers for so many people with asthma, these condi- tions should be treated promptly when they arise. However, since the treatment of each is distinctly different, it is impor- tant to try to discern which condition is causing the problems. Understanding and being able to recognize the subtle differ- ences is helpful. It is also important, when in doubt, to consult with your health care provider. Be sure to seek early and appropriate treatment to reduce the risk of the condition causing your asthma to flare.

Robert Dinsmoor is a freelance writer living in Hamilton, Massachusetts, who specializes in topics related to health and health care.

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