Is It a Cold or Sinusitis?

It's important that you know the difference, doctors say

FRIDAY, Nov. 21, 2003 (HealthDayNews) -- As the days grow shorter and the night air colder, that means one thing -- the start of the common cold season with all its attendant symptoms.

Like stuffy nose. Headaches. Post-nasal drip.

But it's also prime time for one of the most common chronic health conditions in the country -- sinusitis, whose symptoms include stuffy nose, headaches and post-nasal drip.

So how do you tell what ails you?

With difficulty.

"It's very hard for patients to distinguish between a cold and sinusitis because very often the symptoms are the same," says Dr. Stanley Blaugrund, chairman of the department of otolaryngology, Head and Neck Surgery at Lenox Hill Hospital in New York City.

Nasal congestion, a runny nose, bad breath, facial pain, headache and night cough are all signs of both maladies. The symptoms are caused by swelling of the sinus passages so they can't drain the fluid that builds up there, Blaugrund says.

With a cold, the swelling typically goes down in three days to a week, allowing the mucus to pass through and out of the nose and giving people relief from their symptoms.

Sinusitis occurs, however, when the swelling persists, blocking the nasal passages so the mucus has no way of escaping, leaving the sinuses vulnerable to infection.

"The majority of these illnesses are just colds," says Dr. George Zalzal, professor of otolaryngology and pediatrics at George Washington University in Washington, D.C.

"But if the symptoms last for 10 days or more, you could be dealing with sinusitis," Zalzal says.

Sinusitis is one of the most common chronic health problems in the United States, affecting about 37 million people a year, according to the National Institute of Allergies and Infectious Diseases. If not treated properly, the condition can become acute, lasting anywhere from three to eight weeks, or chronic, lasting for months or even years, doctors say.

So health experts recommend going to the doctor sooner rather than later if you suspect sinusitis. This is particularly true for children, says Zalzal.

"For children, especially if a child is very young, any symptom that lasts beyond two or three days, particularly a cough or a fever, could be a sign of something else as well," such as sinusitis or bronchitis, he says.

Your family doctor will usually be able to diagnose whether you have a cold or sinusitis and prescribe the proper medicine. For sinusitis, treatments include decongestants, pain relievers, steroid nasal sprays to reduce inflammation in the nose, and oral or intranasal nebulized antibiotics to control bacterial infection.

Blaugrund says it's important that the doctor take a culture of the discharge from your nose so he can identify any bacteria present and then know the right antibiotic to treat it.

"Many antibiotics are used indiscriminately, and a culture is the only definitive way to see if there is an infection, see which bacteria is causing it and determine the right antibiotics," he says.

If you're still not feeling well after visiting your family physician, it might be time to see an otolaryngologist, who specializes in ear, nose and throat problems.

These specialists can do a CT scan of the sinuses and perform an endoscopy to see if there are any physiological reasons for clogged nasal passages. Problems can include polyps, which, though rarely cancerous, block the nasal passages; or anatomical abnormalities that make the nasal passages too narrow for the natural flow of mucus. Both conditions can be remedied by surgery, doctors say.

But simple preventive measures taken as the cold season kicks into gear can go a long way toward helping you ward off sinusitis, a condition Blaugrund calls "the most common cause of absenteeism in the work place."

He recommends washing hands frequently; sleeping with a window open at night to let fresh air into often-overheated, stuffy rooms; and heat vaporizers to keep the air as clean as possible.

More information

To learn more about sinusitis, visit the National Institute of Allergy and Infectious Diseases or the American Academy of Otolaryngology - Head and Neck Surgery.

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