BHealthy Blog

Is it Sinusitis, Allergies or the Flu?

David Gerson, MD

Often it can be difficult to tell the difference but there are clues that can help you and your doctor tell which one is causing your symptoms. It’s important to figure out which one it is because while many of the treatments are the same there are several that are different.

Allergies are associated with sneezing, runny nose, nasal obstruction, and itching of the eyes, nose, and throat. It is also frequently associated with postnasal drip, cough, irritability, and fatigue. Allergies recur, you don’t get a fever and antibiotics will do absolutely nothing to help and in fact could make things worse.

There are seasonal and year-round (perennial) allergies. These are usually easy to tell apart by their frequency of symptoms. Examples of seasonal would be ragweed in the fall, trees in late winter early spring. Year-round allergies are often caused by animals such as cats and irritants in the home like house dust and molds. A good history taken by your doctor can often narrow the list of culprits but if you are having symptoms frequently and want to really narrow them down you can get allergy tested using a skin scratch test or lab testing on your blood. These are very helpful if you are considering allergy treatments to build a resistance to the allergens causing your symptoms.

Sinusitis is a condition that can cause a stuffy nose, pain in the face, and yellow or green mucus from the nose. The sinuses are hollow areas in the bones of the face. They have a thin lining that normally makes a small amount of mucus. When this lining gets infected, it swells and makes extra mucus. This causes symptoms.

Sinusitis can occur when a person gets sick with a cold. The germs causing the cold can also infect the sinuses. Many times, a person feels like his or her cold is getting better. But then he or she gets sinusitis and begins to feel sick again. You can also be at higher risk of developing a sinus infection if you get allergic rhinitis.

Common symptoms of sinusitis include:

  • Stuffy or blocked nose
  • Thick yellow or green discharge from the nose
  • Pain in the teeth
  • Pain or pressure in the face – This often feels worse when a person bends forward.

People with sinusitis may also have other symptoms including:

  • Fever
  • Cough
  • Trouble smelling
  • Ear pressure or fullness
  • Headache
  • Bad breath
  • Feeling tired

Most of the time, symptoms start to improve in 7 to 10 days. See your doctor or nurse if your symptoms last more than 7 days, or if your symptoms get better at first but then get worse.

Most of the time, sinusitis does not need to be treated with antibiotic medicines. Only about 2% of sinus infections are caused by bacteria yet about 85% of patients presenting for sinusitis get prescribed antibiotics. Antibiotics do not kill viruses. Many people get over sinus infections without antibiotics.

However, some people with sinusitis do need treatment with antibiotics. If your symptoms have not improved after 7 to 10 days, ask your doctor if you should take antibiotics.

Some signs you might need antibiotics are:

  • Purulent nasal discharge
  • Upper tooth or facial pain, especially if one sided
  • Sinus tenderness on one side only
  • Worsening symptoms after initial improvement
  • Fever greater than 100.5

To reduce your symptoms in either case you can:

  • Take an over the counter pain reliever to reduce the pain
  • Rinse your nose and sinuses with salt water a few times a day – Ask your doctor or nurse about the best way to do this.
  • Start an antihistamine with a decongestant
  • Consider nasal antihistamine

Your doctor might also prescribe a steroid nose spray to reduce the swelling in your nose.

What about the flu? Flu symptoms are usually more severe than cold symptoms and come on quickly. Symptoms of flu include sore throat, fever, headache, muscle aches and soreness, congestion, and cough. Swine flu in particular is also associated with vomiting and diarrhea.

Watch Dr. Gerson talk “the crud” on KATV: