Allergy, Cold or a Sinus Infection?

You wake up one morning with a stuffy nose and it just doesn’t seem to getting better. Allergy, viral respiratory infection or a bacterial sinus infection? Here are some helpful hints to identify what you may have and some clues you can provide your busy doctor to prescribe or recommend the correct treatment.

There are so many overlapping signs and symptoms that not only are patients confused, but doctors often are as well!

An allergy occurs when your body sees an ordinary substance as foreign, and the immune system tries to combat the substance using a particular arm of the immune system (IgE)that is primarily reserved for fighting parasitic infections. These antibodies (IgE) induce the release of certain chemicals (or mediators) which cause symptoms like itchy eyes, runny nose, post-nasal drip, itchy ears and in some cases, even asthma. The foreign substance could be tree pollen, grass, ragweed, cat, dust, a certain food, or any number of other ordinary substances that the body somehow identifies as foreign.

The signs that are common to the two are runny nose and nasal congestion. More particular to allergies are the itchy, watery eyes, the clear, runny nose, and the itchy throat. With colds you are more likely to have a fever, and you may have some sinus pain, and the mucus discharge may be a different color, like green or yellow. A sinus infection may end up lasting longer than a cold and cause headache, cough and fever. Often times to confirm the diagnosis if there is a question, your doctor may want to order a conebeam CT scan of the sinus @ Midtown Sinus Imaging in order to confirm or rule out the diagnosis of a sinus infection and prescribe the appropriate therapy. Especially if it appears you are having multiple sinus infections and you want to confirm that you truly are getting infections and to see if there are any anatomical abnormalities that are predisposing you to get these infections by blocking the drainage of mucus from your sinuses. This mucus then just sits in your sinus cavities and serves as a fertile breeding ground (like the petri dish we use to grow bacteria) that gets colonized with bacteria and then gets infected. This infection persists until:

  • The correct antibiotic is used to eradicate the infection
  • The mucus is cleared from the sinus cavity

The most common reasons for poor drainage are:

  • Swelling from allergies
  • Deviated Septum
  • Swelling from inadequate treatment of chronic sinus infections
  • Other reasons for anatomical blockage

It's difficult often for doctors and patients to often tell the difference between the three. But if you're getting a cold at the same time every year, or after you visit your sister who has a cat, you might suspect it's an allergy. There are also some other telltale signs of having an allergy, like if the person also has eczema, itchy skin, asthma, or a history of allergies in their family. A cold usually follows a time course of about seven to ten days, usually with a predictable series of symptoms. A bacterial sinus infection will persist until it has been treated appropriately. But it is possible that they have identical symptoms and further diagnostic tests may have to be done or through trial and error in seeing what helps and doesn’t under the supervision of a physician.

We don't have a cure for the cold, so the treatment options are limited to treating the symptoms. For the congestion and runny nose there are decongestants. Cough suppressants and expectorants can help with a cough. Sometimes the coughs can be more serious, arising from the lungs and should be evaluated closely to rule out asthma, bronchitis or pneumonia! If you are not getting better after a few days or are getting worse, make an appointment with your physician or with one of the doctors at the New York Allergy and Sinus Center and get tested and treated because faster diagnosis means faster relief!