During fall and winter, I see many patients with a stuffy and runny nose, a cough, chest congestion and frequent throat clearing. These are symptoms of several different conditions. Patients could have simple colds or allergies or other illnesses such as a sinus infection, acute bronchitis, acid reflux, or asthma. Your doctor is trained to sort out your symptoms and examine you to form the right diagnosis and the right treatment plan. If you have any of these symptoms, see your primary care physician.

Here are some of the things I look for when patients have these common cold-weather symptoms:

Colds
Colds are viral upper respiratory tract infections that are well known to all of us. It’s common to have two to three colds per year. We tend to get more colds during the winter months because we are more likely to be exposed to large groups or gatherings such as holiday events or children at school. Colds are characterized by these symptoms:
• cough
• nasal congestion
• a watery clear discharge
• low-grade headaches
• ear aches

treatments

Colds usually last no more than five to seven days and require little treatment other than some over-the-counter cough and cold medications and a large box of tissues.

Allergies

Seasonal allergies can occur year-round or seasonally. These illnesses are related to an allergic response to a variety of airborne (or food-related) proteins. The body responds with these reactions:
• cough
• chest congestion
• wheezing
• hives
• itchy or watery eyes
• fatigue
• headaches
• no fever

Severe exposure to allergens can cause a fever, such as in response to a dirty humidifier, wet basement, or many workplace allergy triggers (foods, dusts, chemicals). Fungal exposure in those settings can cause severe reactions that also affect the lungs and cause long-term lung damage. Allergies tend to be worse in the fall, due to exposure to dust from heating systems (especially forced hot air systems), and in the spring, due to molds from decaying leaves and damp basements. Exposures can be reduced by using a HEPA (high-energy particulate) filter or other type of fan.

treatments

Usually allergies can be easily treated with antihistamines. If symptoms are severe or persistent, you may consider receiving allergy shots from an allergist.

Other conditions

There are a number of other conditions that have similar symptoms to colds and allergies.
•Acute sinusitis, or a sinus infection, is characterized by cough, nasal congestion, low-grade fever, and headaches over the cheeks or forehead. The infection often follows a common cold after three to five days of nasal congestion, a runny nose and sore throat. Usually the cold appears to get better after a few days, but then symptoms worsen including the fever and headaches. Nasal discharge can become discolored (green, yellow, or brown) and need to be frequently cleared with tissues or even a salt water solution with a neti pot. Sinus infections are typically treated with antibiotics for 10 days.
•Acute bronchitis is an illness of the bronchi – the tubes below the windpipe leading to the lungs. Symptoms include a cough, low-grade fever and discolored phlegm (similar to sinusitis). This illness requires similar antibiotic treatment if it persists beyond five to seven days.
•Acid reflux (GERD or gastro-esophageal reflux) can also cause chronic cough and throat clearing, but there are usually no symptoms of nasal congestion, fever, headaches or phlegm. The illness is treated with medications and lifestyle changes.
•Asthma is an illness of the bronchi characterized by cough, wheezing, shortness of breath, phlegm, and in about half of cases, underlying allergies as well. This is a common illness, affecting approximately 5 percent of the population. There are a number of effective medications and treatment options for asthma.

So if you’re experiencing any of these common symptoms, see your doctor. With a few tests, a stethoscope, a chest or sinus X-ray, or allergy tests, he or she can give you an effective treatment plan to help you feel better. Specialists such as allergists, otolaryngologists (ear, nose and throat doctors), and pulmonologists are also available to guide you through symptoms and treatments.

Michael Bader, MD, is on the medical staff of Hallmark Health System. He is board certified in internal medicine and pulmonary medicine.

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