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Medical information to help you take your health to the next level!

From Bonita Coe, MD, MBA and Best Health For Your Life Consulting LLC

• Runny nose

• Stuffy nose

• Sore throat

• Swollen glands in the neck

• Scratchy throat

• Hoarseness/loss of voice

• Cough

• Nose itching

• Watery, itchy eyes

• Post nasal drainage/mucous going down the back of your throat

• Headache

• Malaise/feeling unwell

• Lethargy/fatigue

• Fever (meaning that you actually took your temperature with a thermometer and it is 100 degrees Fahrenheit (38 degrees Celsius) or above

• Chills

• Chest pain

• Chest tightness

• Wheezing

• Sneezing

• Body aches/muscle aches

• Pain or pressure in the ears

• Pain in the face (pain behind nose, cheeks, eyes, forehead or pain in teeth)

• Trouble breathing/shortness of breath

So, if you have any of these symptoms, what could be the cause?

• A cold (caused by respiratory viruses) ?

• A bacterial respiratory infection (caused by bacteria)?

• Allergies (Seasonal Allergies, Environmental Allergies)?

• Asthma

• Reactive airways?

• Something else?

What is a cold?

Colds are caused by many types of respiratory viruses and can occur year-round.

Common respiratory viruses that cause the common cold:

• Rhinoviruses

• Coronaviruses (COVID 19 is in this category)

• Influenza viruses (The flu is in this category)

• Parainfluenza viruses

• Respiratory Syncytial Virus (RSV)

• Adenoviruses

• Enteroviruses

• Metapneumovirus

• Other viruses

The common cold, caused by viruses, can have many of the symptoms listed above. A cold usually lasts about 7 days, often with lingering symptoms for another 7-14 days. Viral respiratory illnesses can, however, last up to 4-6 weeks, slowly getting better over time. Typically, people start to feel better by 7-14 days and over the counter medications can be used to help manage symptoms. Often the inflammatory process of the infection can block the tiny sinus passages and cause a complication of a bacterial sinus infection (see below).

There is no cure for viral respiratory illnesses.

ANTIBIOTICS DO NOT KILL VIRUSES.

Viral respiratory illnesses have to run their course, so taking an antibiotic does NOT have an effect on a viral infection.  When antibiotics are not needed, they will not help you and the side effects of taking antibiotics can hurt you. You should see your doctor if you are having prolonged symptoms and/or if you are having trouble managing your symptoms, especially if you have trouble breathing or eating or having severe nausea, vomiting or diarrhea.

Anti-viral medications (you may have heard of Tamiflu brand name, which is only for Influenza/”The Flu” treatment and Paxlovid brand name for COVID 19 infection treatment), do not cure you of the virus infection. An anti-viral medication only decreases the duration of the symptoms and helps to lessen the severity of symptoms if it is taken within a designated time after symptoms start.

So when are antibiotics useful?

But first, what is an acute sinus infection?

A sinus infection is caused by inflammation in the nose and sinus cavities. The most common causes of sinus infections are VIRUSES associated with the common cold. Bacteria can take over and infect the sinus cavity that is already inflamed by the viral infection.

Any condition that blocks the narrow passage ways in the sinus cavities can lead to a bacterial sinus infection (allergies, abnormalities in the nose like a deviated septum and many other conditions that block sinus drainage or cause a decrease in immunity).

Current clinical guidelines recommend NOT starting antibiotics for sinus infections unless persistent for at least 7-10 days after diagnosis, but instead recommends strategies to get the sinuses draining without antibiotics first.  Many people with sinus infections get better WITHOUT antibiotics.

Your doctor may consider that you have a sinus infection (which may be caused by a bacteria) and antibiotics can help with this. When the decision is made to treat the sinus infection with antibiotics, a 10 day course of antibiotics along with the other treatments reviewed below may be recommended.

https://www.entnet.org/wp-content/uploads/files/uploads/PracticeManagement/Resources/_files/adult-sinusitis-patient-info-diagnosis-of-sinusitis.pdf

Your doctor may also prescribe an antibiotic if you have had a chest x-ray that is abnormal, when the chest x-ray has been ordered to evaluate your symptoms. It may be determined by you history, symptoms and any lab tests done that you may have a bacterial pneumonia (pneumonia=infection in the lungs) that may be helped by taking an antibiotic.

https://www.entnet.org/wp-content/uploads/files/uploads/PracticeManagement/Resources/_files/adult-sinusitis-patient-info-treating-acute-bacterial-rhinosinusitis.pdf

If it’s not a cold, then what could it be?

Allergies/seasonal allergies/environmental allergies?

You can be allergic to many things (called allergens) in your environment, including pollen from grasses, trees and other plants around where you live. Many people have symptoms that occur in the Spring or Fall/Winter months and some people can have all year long symptoms.  

You can develop allergies at ANY time in life. You can also be allergic to allergens in your home, like dust and dander from your cat or dog.

Any of the symptoms in the above list that last 14 days or longer could be due to allergies, and not a cold.

Asthma and/or reactive airways?

Asthma can occur at any age and symptoms of asthma can be other things other than trouble breathing. You can have asthma as a child and symptoms can recur as an adult. Often, asthma and allergies occur in the same person, but symptoms of each can appear separately at different points in life.

If you have allergies, it is not uncommon to develop asthma at some point in life and if you have asthma, you can develop allergies at some point in life as well.

The condition of reactive airways is on the spectrum of asthma, such that you can have asthma-like symptoms when you are exposed to environmental allergens.

In addition, asthma or reactive airways can be triggered by a cold (viral upper respiratory infection), bacterial sinus infection or allergies.

Make sure that you talk to your doctor about ANY symptoms and do not assume that you have a cold.

IT COULD BE SOMETHING ELSE!

What about this word “bronchitis”?

Many people who are evaluated for upper respiratory symptoms are told that they have “bronchitis”.

But what does that even mean?

The term “bronchitis” just means inflammation of the airways, but it does not tell you why you have “bronchitis”. There are many things that cause “bronchitis”, so if you are told that you have “bronchitis”, you need to ask “from what cause”? You need to have an idea of the cause of the bronchitis” in order to have an idea of how to treat and/or manage symptoms.

Common causes of “bronchitis”:

• Viruses-VIRAL BRONCHITIS

• Allergies-ALLERGIC BRONCHITIS

• Asthma-ASTHMATIC BRONCHITIS

• Bacteria

• Fungi

• Other causes

Got it?

Does it matter what color your runny nose mucous is?

NO! It is incorrect to place too much importance on the color of the mucous coming out of your nose when making decisions about whether to use antibiotics. The color alone cannot distinguish between a cold and a sinus infection!

What can be used without a prescription to help give relief from upper respiratory symptoms?

Of course, you should always let your doctor know about any symptoms that you have and you should always check with your doctor before taking ANY mediation to make sure that it is safe for you.

Nasal/sinus drainage measures like nasal rinses, and warm steam are  recommended for nasal congestion. Expectorants (medications that help loosen up mucous, so you can blow it out and clear the sinus cavities) are also helpful. I recommend caution with using any medications that say “decongestant” or “D” as they can raise blood pressure. Check with your doctor before using a medication that has a decongestant in it.

The treatments recommended here will help you feel better while your body fights off the viral infection, if that is what you have.

Check with your doctor about other treatments and prescription medications than can help control your symptoms.  The treatment recommendation depends on the presumptive cause of your symptoms.

Determining the cause of the symptoms is the key to determining an appropriate treatment recommendation!

Here is what you can do:

• Always pay attention to any new symptoms that you have have and inform your doctor.

• Do not have symptoms for more than 3-5 days before seeking medical attention.

• Rest and try the treatments that are recommended by your doctor.

• Follow up with your doctor for any worsening or persistent symptoms and/or any new symptoms.

• Go to the emergency room (not an urgent care) or call 911  IMMEDIATELY for any shortness of breath or trouble breathing!

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The information, including but not limited to, text, graphics, images and other material presented here is for informational purposes only. No material presented is intended to be a substitute for professional medical advice or medical treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read here. External (outbound) links in the references to other websites or educational material are followed at your own risk. Under no circumstances is the author responsible for the claims of third-party websites or educational providers.