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Care During Chemotherapy and Beyond

Cold Symptoms

COMMON COLD SYMPTOMS:
Includes: Pharyngitis, Post-Nasal drip, Rhinitis, Runny nose, Sinusitis

COMMON COLD SYMPTOMS

Pharyngitis

  • Pharyngitis is the inflammation of the back of your throat, which is called your pharynx. This may include the surrounding lymph tissue, called your tonsils. Lymph tissue helps to fight infections.
  • A virus, bacteria, or a fungus may cause pharyngitis. Antibiotics may be used to treat bacteria, or a fungal infection. However, antibiotics won't work if a virus has caused your pharyngitis.
  • Viruses are the most likely cause of the common cold symptoms of pharyngitis. Other causes of pharyngitis include:
    • Bacteria - such as Group A ß (beta)-hemolytic strep (STREP), or neisseria gonorrhea
    • Allergies with post-nasal drip, causing your throat to be sore and irritated
    • Trauma from heat, alcohol, or irritating agents (such as smog or smoke) can cause symptoms of the common cold
    • Fungus, such as candida (yeast infection)
  • You may be more at risk for developing pharyngitis if:
    • You have recently received chemotherapy, or your immune system is weakened from your disease. 
    • You have another illness that has lessened your ability to fight a viral or bacterial infection.
    • You use alcohol, and smoke cigarettes. These may cause your throat to be irritated. 
    • You have diabetes 
    • If you are under a lot of stress, and lead a very active lifestyle
    • You live or work in a place with lots of people (such as day care centers, schools, or prison systems)

Symptoms:

  • You may have a sore throat
  • You may have fever or chills, or feel "achy".
  • You may have trouble swallowing food or liquids, as it may be painful. Your glands or lymph nodes may be swollen. 
  • It might feel as if there is a "lump" or something caught in your throat. 
  • There may be white or grayish patch in the back of your throat. 
  • You may be overly tired, or very weak (fatigued).

How to Alleviate Pharyngitis Symptoms:

  • Avoid crowds or people with colds, especially if chemotherapy or your disease has weakened your immune system. Report fever, chills, or any other signs of infection or symptoms of a cold immediately to your healthcare provider. 
  • Wash your hands often. Do not share food, drinks, or towels with anyone. 
  •  Dispose of your toothbrush, and get a new one. Your old toothbrush may have bacteria and germs.
  • Your doctor or healthcare provider may swab the back of your throat, to send for culture. This is to see if your common cold symptoms of pharyngitis are caused by a bacterial infection. Follow the instructions given to you by your healthcare provider until the throat culture results are available. 
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, as often as you like. Most people gargle with this solution 4 times a day.
  • Drink 2 to 3 liters of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. 
  • If you have pain in your throat, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or prolong bleeding.  
  •  If you have swollen glands, you may place a warm washcloth or compress to the area, 4 times a day, for 20 minutes at a time. This may help relieve some discomfort.
  • Use hard candy, or lozenges to soothe your throat. 
  • If you have a strep pharyngitis, you should not return to school or work unless you have been on antibiotics for at least 24 hours.
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin unless your healthcare provider permits this when common cold symptoms are present. 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
  • In general, eating a well -balanced meal, limiting salt intake, high fat and high cholesterol foods is recommended. However, if you have a sore throat, avoid foods with a high acid content (spaghetti sauces, tomatoes), and deep fried foods (fried chicken or pork).  If you have pain swallowing solid food, try thinner soups, or foods until your throat pain improves. 
  •  Try to exercise or move around, as tolerated, to maintain your optimal level of functioning.
  • After you recover from your common cold symptoms, discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help promote the flow of oxygen in your lungs and blood. Exercise may also help your immune system.
  • You should avoid alcohol. Alcohol may irritate an already sore throat.
  • If you are still smoking, STOP. Smoking will further irritate your throat and nose. Discuss ways to quit smoking with your healthcare provider.
  • If you are ordered a medication to treat this disorder, do not stop taking any medication due to symptoms of a cold unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone. If you miss a dose of your medication, discuss with your healthcare provider what you should do. 
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor for Pharyngitis:

  • Treatment of all types of pharyngitis includes rinsing with salt and soda solution, and Tylenol for comfort. 
    • If your pharyngitis is a result of postnasal drip and rhinitis, treatment of rhinitis due to allergies may include removing what has caused the allergic reaction (allergen), and controlling the common cold symptoms.
    • If the rhinitis was due to an allergy, or an infection, your healthcare provider may prescribe decongestants, antibiotics, and humidified air. Nasal antihistamines, steroids and decongestants may help to control your common cold symptoms.
    • If you have bacterial pharyngitis, your doctor or healthcare provider may prescribe antibiotic therapy.
  • Antibiotics: The strep bacteria are important to get rid of, if you, or someone in your close household contact (such as children, and those with a weakened immune system) is at risk for rheumatic fever.  The most common antibiotics prescribed for a strep infection, are Penicillin V, or Amoxacillin. You will most likely be ordered one of these antibiotics for at least 10 days. Even though you may feel relatively well in 2 to 3 days, make sure you take all the prescribed medication for the symptoms of the common cold, to get rid of the infection.
    • Persons with a fungal infection may receive an anti-fungal antibiotic, such as Nystatin, to treat your throat infection. If you are ordered Nystatin, you will be told to swish the oral solution for 30 seconds, and then swallow it. 
    • These are the most commonly suggested antibiotics, which will treat the bacteria that are often present in strep infections. However, depending on your overall health status, and your healthcare provider, he or she may suggest that another antibiotic be used for the common cold symptoms.
    • Remember: The main reason to treat a possible strep infection is to prevent rheumatic fever. Not everyone with pharyngitis has a strep infection, so not everyone with pharyngitis will receive antibiotics.
  • Tylenol - If you have throat pain, in addition to sucking on lozenges and salt water gargles, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
    • If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and prolong bleeding. 
  • Do not stop any of your medications abruptly, without discussing with your healthcare provider. 

When to Contact Your Doctor or Health Care Provider:

  • Persistent fever of 100.5° F (38° C), chills, or a worsening sore throat (possible signs of infection, especially if you are undergoing chemotherapy).
  • Shortness of breath, or increased trouble swallowing, may suggest an abscess has formed (an infected area) in your throat or tonsil area. 
  • If you notice a green, brown, black or bloody discharge or mucous from your nose, or from a cough
  • Dark colored urine, or painful urination
  • Bleeding that does not stop after a few minutes, or new, unexplained bruises.
  • Any new rashes on your skin, especially if you have been taking a new antibiotic or medication
  • If your throat pain worsens, or does not improve in 3-4 days, return to your healthcare provider for an evaluation of your common cold symptoms.

Postnasal Drip

  • "Postnasal drip" is a term used to describe drainage from your nose that runs down the back of your throat.  You might notice this more if you are lying down. Viruses causing a rhinitis, or inflammation in your nasal passages, are the most common cause of a post-nasal drip. You may also notice postnasal drip if you have sinus congestion, or a sinus infection (sinusitis). 
  • Antibiotics may be used to treat a bacteria or fungal infection. However, antibiotics won't work to treat your symptoms if a virus has caused your postnasal drip. 
  • You may be more at risk for developing symptoms of the common cold, postnasal drip if:
    • You have recently received chemotherapy, or your immune system is weakened from your disease. You may be prone to developing a cold virus, rhinitis, or sinus infection.
    • You have another illness that has lessened your ability to fight a viral or bacterial infection.
    • You use alcohol, and smoke cigarettes. These may cause your throat to be irritated. 
    • You have diabetes 
    • If you are under a lot of stress, and lead a very active lifestyle
    • You live or work in a place with lots of people (such as day care centers, schools, or prison systems)
  • Postnasal drip occurs because as a cold virus attacks and infects your nose passages, and sinus cavity. Your immune system reacts to this attack by creating mucus.
  • The mucus is usually thin and clear, and works by trapping bacteria and small particles. The mucus will then flush or clean the virus out of your body, through your nose, or down the back of the throat. 
  • The bacteria start to change the color of the mucus after about 2 or 3 days, as the mucus continues to clear out germs. The color of mucus can suggest that there may be bleeding or infection present. It may also be yellowed, due to age. 
  • Post-nasal drip is usually associated with rhinitis, which is a swelling and irritation of your nasal passages. Rhinitis leads to common cold symptoms or runny nose, itching of the nose, throat or eyes, sneezing, and congestion. Many people associate postnasal drip and rhinitis with the common cold, or allergy symptoms. If you have post-nasal drip, you will often have rhinitis as well.

Symptoms:

  • You may have a sore throat, fever or chills. You may feel "achy". The sore throat is usually a result of your postnasal drip. 
  • You may feel as if you need to clear your throat often.
  • The postnasal drip may make you cough. 
  • You may have a runny nose, with sneezing and an "itchy" nose, that feels "congested", or "blocked". 
  • You may have pain or tenderness over your forehead, cheekbones, or behind your eyes (your sinus passages).
  • You may be tired, or very weak (fatigued), if you have a viral or a bacterial illness.

How to Alleviate Postnasal Drip Symptoms:

  • Postnasal drip is usually a symptom of a sinus infection, or rhinitis. It is usually caused by a virus. Treatment for postnasal drip involves treating your common cold symptoms, and the underlying cause of your illness.
  • If you have an allergic rhinitis that is causing your postnasal drip, using decongestants (such as antihistamines) and topical nose sprays may help.
  • If you have inflammation in the back of your throat, or a sore throat (pharyngitis), it is most likely a result of your postnasal drip. Depending on your overall health status, and other symptoms of the common cold, your doctor or healthcare provider may swab the back of your throat, to send for culture. This is to see if there is pharyngitis is caused by a bacterial infection. Follow all the instructions given to you by your healthcare provider until the throat culture results are available. 
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, as often as you like. Most people gargle with this solution 4 times a day.
  • Use a vaporizer or a humidifier to moisten the air. Avoid dry air when common cold symptoms are present. Even though you it may seem as if your secretions are draining appropriately, they may still form a "blockage", causing a subsequent sinus infection. Humidified air will help liquefy your mucus secretions to drain when you are congested. 
  • Drink 2 to 3 liters of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. Keeping well hydrated will prevent congestion, and also liquefy your secretions.
  • If you have pain in your joints, muscles, or throat due to the symptoms of a cold, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or prolong bleeding.   
  • If your healthcare provider thinks that you have a strep pharyngitis in addition to your post-nasal drip symptoms, you should not return to school or work unless you have been on antibiotics for at least 24 hours. 
  • If you have swollen glands as a result of a viral illness, you may place a warm washcloth or compress to the area, 4 times a day, for 20 minutes at a time. This may help relieve some discomfort, symptoms of the common cold.
  • Use hard candy, or lozenges to soothe your throat, if it has become sore.
  • Oftentimes, postnasal drip is caused by allergies in the environment (allergic rhinitis). Avoiding what has caused the allergy symptoms is the best way to treat an allergic rhinitis. This includes:
    • Ridding your house of common, allergy-causing substances, or decrease the amount, by keeping it clean. Dust mites, pet dander, cockroaches and mold spores all cause allergy symptoms, and may be found in the home.
    • Outside ragweed, tree pollen, grasses and mold spores often cause allergies. Ragweed causes an allergic rhinitis in about 75% of allergy sufferers. If you have severe allergies, avoid spending unnecessary time outside during the months of mid-August, until the first frost (known as, the "peak months"), without first taking an antihistamine.  
    • Also, wear a particulate respirator, or a high-efficiency mask, when working outside or gardening during the peak months.
    • Dusting furniture and floors with damp mop routinely. Vacuum at least weekly. Many electric vacuums actually spread dust mites - so make sure to clean your vacuum periodically. 
    • Eliminate exposure to household pets when symptoms of a cold or an allergy are present. Washing them won't necessarily help, as with cats, the allergen is found in their saliva, not their hair. 
    • Prevent dampness in your home. Keep the air humidity at less than 50%.
    • Remove carpets that may trap dust. If your carpets are on concrete, they may build up mold spores. Remove them, too. 
    • Discuss with your healthcare provider the symptoms of a cold or an allergy you are experiencing. Keep a diary to help determine what it is that you are allergic to. You may live your whole life without allergies, and they may develop as you age. Nasal antihistamines, steroids and decongestants may help to control your symptoms. 
  • Your doctor or healthcare provider may suggest that you see an allergy specialist for skin testing, if your allergies are severe, or if they do not respond to treatment.
    • A skin test is a relatively painless procedure, where an allergy specialist will place a small amount of an allergy-causing substance either on top of, or under your skin.
    • After about 20 minutes, the allergist will see if there is a reaction at the site that the test was placed.
  • Avoid crowds or people with colds, especially if chemotherapy or your disease has weakened your immune system. Report fever, chills, or any other signs of infection of common cold symptoms immediately to your healthcare provider. 
  • Wash your hands often. Do not share food, drinks, or towels with anyone. 
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin unless your healthcare provider permits this. 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
  • In general, eating a well -balanced meal, limiting salt intake, high fat and high cholesterol foods is recommended. However, if you have a sore throat, avoid foods with a high acid content (spaghetti sauces, tomatoes), and deep fried foods (fried chicken or pork).  If you have trouble swallowing solid food, or if you feel nauseated due to the postnasal drip, try bland, thinner soups or foods until your throat pain improves. 
  • Try to exercise or move around, as tolerated, to maintain your optimal level of functioning.
  • After you recover from your illness, discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help promote the flow of oxygen in your lungs and blood. Exercise may also help your immune system.
  • You should avoid alcohol. If you are still smoking, STOP. Smoking will further irritate your throat, and the mucus membranes in your nose. This will contribute to your common cold symptoms. Discuss ways to quit smoking with your healthcare provider.
  • If you are ordered a medication to treat this disorder, do not stop taking it unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone. If you miss a dose of your medication for symptoms of a cold, discuss with your healthcare provider what you should do. 
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor for Postnasal Drip:

  • Postnasal drip is usually a symptom of a sinus infection, or rhinitis. A virus usually causes this symptom of a cold. Treatment for postnasal drip involves treating your common cold symptoms, and the underlying cause.
    • Treatment of postnasal drip caused by a sinus infection may include antibiotic therapy, decongestants, humidified air (such as a vaporizer or a steamy shower), and drinking lots of fluids.
    • Treatment of rhinitis due to allergies (which may be causing your postnasal drip) includes removing what has caused an allergic reaction (allergen), and controlling the symptoms through the use of antihistamines, decongestants, and nasal sprays.  
    • If the rhinitis was due to an infection, your healthcare provider may prescribe decongestants, antibiotics, and humidified air. Nasal steroids, antihistamines, decongestants and saline sprays may also help to control your symptoms of the common cold.
  • Antibiotics: Infectious rhinitis or sinusitis has most likely caused your postnasal drip. If you have been diagnosed with allergic rhinits, you will most likely not be prescribed an antibiotic, unless your illness has been prolonged, and an infection has occurred.
    • If you have developed pharyngitis, and are at risk for rheumatic fever, your doctor or healthcare provider may want to protect you against developing strep.  The most common antibiotics prescribed for a strep infection, are Penicillin V, or Amoxacillin. You will most likely be ordered one of these antibiotics for at least 10 days.
    • If you have had a prolonged illness and postnasal drip, you may develop a sinus infection (sinusitis). The first-line treatment of a sinus infection includes Amoxacillin 500mg by mouth, 3 times a day, for 10-14 days. 
      • These are the most commonly suggested antibiotics, which will treat the bacteria that are often present in strep and sinus infections. However, depending on your overall health status, and your healthcare provider, he or she may suggest that another antibiotic be used to treat the common cold symptoms.
    • Even though you may feel relatively well in 2 to 3 days, make sure you take all the prescribed medication, to get rid of the infection. 
    •  Persons with a fungal infection may receive an anti-fungal antibiotic, such as Nystatin, to treat your throat infection. If you are ordered Nystatin, you will be told to swish the oral solution for 30 seconds, and then swallow it. 
    • The main reason to treat a possible strep infection is to prevent rheumatic fever. Not everyone with pharyngitis has a strep infection, so not everyone with pharyngitis will receive antibiotics.
  • Antihistamines: If you have sneezing, watery eyes and itching, antihistamines may prevent nasal congestion due to allergies, and decrease common cold symptoms of postnasal drip.
    • Non-prescription antihistamines include most commonly Diphenhydramine (Benadryl ®), and Chlorpheniramine (Chlor-Trimeton®).  However, these drugs may leave you drowsy, and with a dry mouth. 
    • Newer prescription antihistamines without side effects of dry mouth, drowsiness or sedation, include Loratadine (Claritin®), and Fexofenadine (Allegra®). You can take one of these pills daily, every other day, or whenever you have symptoms. These medications may be prescribed alone, or in combination with a decongestant (such as Loratadine/Pseudoephedrine Claritin-D®).
  • Corticosteroids: Corticosteroids (steroids) work locally to decrease nasal irritation and inflammation, if given in the form of a nasal spray (topical). This is good for symptoms of a cold, because you don't have to worry about any unfavorable, long-term side effects of steroids from a short-term, local use. Only a small amount is distributed through your body. Common topical nasal steroids include Budesonide (Rhinocort®), and Fluticasone propionate (Flonase®). 
  • Decongestants: May be helpful in a pill form or as a nasal spray (topical), to relieve a feeling of "blockage"; or common cold symptoms of a runny nose. The most commonly prescribed pill to treat congestion is Pseudoephedrine (Sudafed®). A commonly used nasal spray decongestant is Azelastine (Astelin®).  Antihistamines, in combination with a decongestant, work well in some people, as the decongestant will enhance the effectiveness of the antihistamine. Be careful using decongestants, though, if you have a history of high blood pressure. Discuss this with your healthcare provider. 
  • Tylenol:  If you have muscle, joint or throat pain from your illness, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
    • If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and prolong bleeding. 
  • Do not stop any of your medications abruptly, without discussing with your healthcare provider. 

When to Contact Your Doctor or Health Care Provider:

  • Fever of 100.5° F (38° C), chills, or a worsening sore throat (possible signs of infection, especially if you are undergoing chemotherapy).
  • Shortness of breath, or increased trouble swallowing, may suggest an abscess (an infected area) has formed in your throat.
  • If you notice a green, brown, black or bloody discharge or mucous from your nose, or from a cough
  • Dark colored urine, or painful urination
  • Bleeding that does not stop after a few minutes, or new, unexplained bruises.
  • Any new rashes on your skin, especially if you have been taking a new antibiotic or medication
  • If your common cold symptoms worsen, or do not improve in 3-4 days of seeing your healthcare provider, you must call them for an evaluation.

Rhinitis

  • Rhinitis is a swelling and irritation of your nasal passages, leading to symptoms of cold such as runny nose, itching of the nose, throat or eyes; sneezing, and congestion. Many people associate rhinitis with the common cold, or allergy symptoms.
  • How does rhinitis develop? 
    • Your nose is made up of two nasal passages, and is covered by a mucus membrane. Mucus is a thin, clear, watery substance that works to "clean out" your nose, by trapping small particles and bacteria, before washing them away. 
    • If you become congested, or there is a "blockage" of one of your nasal passages, the other will compensate to help you breathe.
    • If there is constant irritation of mucous in your nasal passages, you may develop rhinitis.
  • There are many types of rhinitis. These include:
    • Allergic rhinitis - this is irritation of your nasal passages, caused by allergies. This includes seasonal allergies (such as pollen, or hay fever), or animal allergies from a pet (such as a cat or a dog). This is a very common form of rhinitis.
    • Non-Allergic rhinitis - Many things may cause you to develop a non-allergic rhinitis. This includes: 
      • Overuse of certain types of nasal sprays to clear your nasal passages, such as Afrin, can cause a "rebound" effect, with worsening common cold symptoms of congestion, and runny nose. This is called rhinitis medicamentosa. Therefore, if you are ordered a nasal spray, discuss with your healthcare provider whether or not you may use it for longer than 3 to 5 days in a row.
      • Certain medications and diseases have rhinitis as a side effect. 
      • Congestion and irritation may occur due to irritants, such as smoke and pollution
      • As you age, your nasal passages may dry out over time. This usually happens in the elderly population.
      • Blockage due to polyps or foreign objects in the nasal passages may lead to rhinitis. Treatment includes removing the cause.
    • Infectious rhinitis - is caused by a virus, bacteria
      • If you have symptoms of a cold for less than 6 weeks (including runny nose, itching, sneezing and congestion), you are considered to have an acute rhinitis.
      • If your common cold symptoms last longer than 6 weeks, you may have a chronic rhinitis, caused by allergies, or structural problems in your nose.

Symptoms:

What are some common cold symptoms to look for?

  • You may have a sore throat, fever or chills. You may feel "achy". The sore throat is usually a result of postnasal drip. (Postnasal drip is a term used to describe drainage from your nose that runs down the back of your throat).
  • You have a runny nose, with sneezing and an "itchy" nose. Your nose may feel "congested", or "blocked."
  • You may be tired, or very weak (fatigued).

How to Alleviate Rhinitis Symptoms:

  • If you have an allergic rhinitis, using nasal or oral (by mouth) decongestants and antihistamines, may help.
  • Avoiding what has caused the allergy symptoms is the best way to treat an allergic rhinits. This includes:
    • Ridding your house of common, allergy-causing substances, or decrease the amount, by keeping it clean. Dust mites, pet dander, cockroaches and mold spores all cause allergy symptoms, and may be found in the home.
    • Outside ragweed, tree pollen, grasses and mold spores often cause allergies. Ragweed causes an allergic rhinitis in about 75% of allergy sufferers. If you have severe allergies, avoid spending unnecessary time outside during the months of mid-August, until the first frost (known as, the "peak months"), without first taking an antihistamine. 
    • Also, wear a particulate respirator, or a high-efficiency mask, when working outside or gardening during the peak months.
    • Dusting furniture and floors with damp mop routinely. Vacuum at least weekly. Many electric vacuums actually spread dust mites - so make sure to clean your vacuum periodically. 
    • Eliminate exposure to household pets. Washing them won't necessarily help, as with cats, the allergen is found in their saliva, not their hair. 
    • Prevent dampness in your home. Keep the air humidity at less than 50%.
    • Remove carpets that may trap dust. If your carpets are on concrete, they may build up mold spores. Remove them, too. 
    • Discuss with your healthcare provider the symptoms of a cold or allergy you are experiencing. Keep a diary to help determine what it is that you are allergic to. You may live your whole life without allergies, and they may develop as you age. Nasal antihistamines, steroids and decongestants may help to control your symptoms. 
  • Your doctor or healthcare provider may suggest that you see an allergy specialist for skin testing, if your allergic rhinitis is severe, or if it does not respond to treatment.
    • A skin test is a relatively painless procedure, where an allergy specialist will place a small amount of an allergy-causing substance either on top of, or under your skin.
    • After about 20 minutes, the allergist will see if there is a reaction at the site that the test was placed.
  • Avoid crowds or people with common cold symptoms, especially if chemotherapy or your disease has weakened your immune system. Report fever, chills, or any other signs of infection or symptoms of a cold immediately to your healthcare provider.
  • Wash your hands often. Do not share food, drinks, or towels with anyone. 
  • If you have inflammation in the back of your throat, or a sore throat (called pharyngitis), it is most likely a result of postnasal drip. However, depending on your overall health status, and other common cold symptoms, your doctor or healthcare provider may swab the back of your throat, to send for culture. This is to see if your pharyngitis is caused by a bacterial infection. Follow the instructions given to you by your healthcare provider until the throat culture results are available. 
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, as often as you like. Most people gargle with this solution 4 times a day.
  • Use a vaporizer or a humidifier to moisten the air. This will help liquefy your mucus secretions when you are congested. 
  • Drink 2 to 3 liters of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. Keeping well hydrated will prevent congestion, and also liquefy your secretions. It may seem that your have a constant runny nose, but there may be some "hidden" congestion, that could lead to a sinus infection. 
  • If you have pain in your joints, muscles, or throat due to common cold symptoms, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or prolong bleeding.  
  • If you have swollen glands from a viral infection, you may place a warm washcloth or compress to the area, 4 times a day, for 20 minutes at a time. This may help relieve some discomfort.
  • Use hard candy, or lozenges to soothe your throat. 
  • If your healthcare provider thinks that you have a strep pharyngitis in addition to your rhinitis, you should not return to school or work unless you have been on antibiotics for at least 24 hours. 
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin unless your healthcare provider permits this. 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
  • In general, eating a well -balanced meal, limiting salt intake, high fat and high cholesterol foods is recommended to help alleviate common cold symptoms. However, if you have a sore throat, or feel ill, avoid foods with a high acid content (spaghetti sauces, tomatoes), and deep fried foods (fried chicken or pork).  These can cause you to feel nauseated. If you have throat pain while swallowing solid food, try thinner soups, or foods until your throat pain improves.
  • Try to exercise or move around, as tolerated, to maintain your optimal level of functioning.
  • After you recover from your illness, discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help promote the flow of oxygen in your lungs and blood. Exercise may also help your immune system.
  • You should avoid alcohol when symptoms of the common cold are present. If you are still smoking, STOP. Smoking will further irritate your throat, and the mucus membranes in your nose. Discuss ways to quit smoking with your healthcare provider.
  • If you are ordered a medication to treat this disorder, do not stop taking the medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills or nose sprays with anyone. If you miss a dose of your medication, discuss with your healthcare provider what you should do. 
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor to Treat Rhinitis:

  • Treatment of rhinitis due to allergies may include removing what has caused the allergic reaction (allergen), and controlling the symptoms. 
  • If your rhinitis is due to an infection, your healthcare provider may prescribe oral decongestants, antibiotics, and humidified air. Nasal antihistamines, steroids and decongestants may help to control your symptoms as well.
  • Your healthcare provider may suggest allergy shots if you have severe, seasonal allergies.
  • Antibiotics. Infectious rhinitis is less common than allergic rhinitis. Therefore, you will most likely not be prescribed an antibiotic for your rhinitis. 
    • However, if you have developed pharyngitis, are at risk for rheumatic fever, your doctor or healthcare provider may want to protect you against developing a strep infection. The most common antibiotics prescribed for a strep infection, are Penicillin V, or Amoxacillin. You will most likely be ordered one of these antibiotics for at least 10 days. 
    • If you have a prolonged rhinitis, it may lead to a sinus infection. If you have been diagnosed with a sinus infection, you will most likely receive antibiotics. The first-line treatment of a sinus infection includes amoxacillin 500mg by mouth, 3 times a day, for 10-14 days.
    • These are the most commonly suggested antibiotics, which will treat the bacteria that are often present in strep and sinus infections. However, depending on your overall health status, and your healthcare provider, he or she may suggest that another antibiotic be used to treat common cold symptoms.
    • Even though symptoms of the common cold may be gone in 2 to 3 days, make sure you take all the prescribed medication, to get rid of the suspected infection. 
    • Remember: The main reason to treat a possible strep infection is to prevent rheumatic fever. Not everyone with pharyngitis has a strep infection, so not everyone with pharyngitis will receive antibiotics. Rhinitis will often be treated with antihistamines and decongestants to prevent a sinus infection.
  • Antihistamines: If you have sneezing, watery eyes and itching, antihistamines may prevent nasal congestion due to allergies.
    • Non-prescription antihistamines include most commonly Diphenhydramine (Benadryl ®), and Chlorpheniramine (Chlor-Trimeton®).  Side effects of these drugs may leave you drowsy, and with a dry mouth.
    • Newer prescription antihistamines without side effects of dry mouth, drowsiness or sedation, include Loratadine (Claritin®), and Fexofenadine (Allegra®). You can take one of these pills daily, every other day, or whenever you have common cold symptoms. These medications may be prescribed alone, or in combination with a decongestant (such as Loratadine/Pseudoephedrine (Claritin-D®).
  • Corticosteroids: Corticosteroids (steroids) work locally to decrease nasal irritation and inflammation, if given in the form of a nasal spray (topical). This is good for common cold symptoms, because you don't have to worry about unfavorable long-term side effects of steroids, from a short-term, local use. Only a small amount is distributed through your body. Common topical nasal steroids include Budesonide (Rhinocort®), and Fluticasone propionate (Flonase®). 
  • Decongestants: May be helpful in a pill form or as a nasal spray (topical), to relieve a "blockage"; or symptoms of a runny nose.
    • The most commonly prescribed pill to treat congestion is Pseudoephedrine (Sudafed®). 
    • A commonly used nasal spray decongestant is Azelastine (Astelin®).  
    • Antihistamines, in combination with a decongestant, work well in some people, as the decongestant will enhance the effectiveness of the antihistamine. Be careful using decongestants, though, if you have a history of high blood pressure. Discuss this with your healthcare provider.
  • Tylenol: If you have muscle, joint or throat pain among your common cold symptoms, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
    • If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and prolong bleeding.  
  • Do not stop any of your medications abruptly, without discussing with your healthcare provider. 

When to Call Your Doctor or Health Care Provider:

  • Fever of 100.5° F (38° C), chills, or a worsening sore throat (possible signs of infection, especially if you are undergoing chemotherapy).
  • Shortness of breath, or increased trouble swallowing, may suggest an abscess (an infected area) has formed 
  • If you notice a green, brown, black or bloody discharge or mucous from your nose, or from a cough
  • Dark colored urine, painful urination
  • Bleeding that does not stop after a few minutes, or new, unexplained bruises.
  • Any new rashes on your skin, especially if you have been taking a new antibiotic or medication
  • If your common cold symptoms worsen, or do not improve in 3-4 days of seeing your healthcare provider, you must call them for an evaluation.

Runny Nose

  • A "runny nose" is a defense mechanism of your nose and immune system that occurs when your nasal passages are attempting to clear away viruses, bacteria or particles.  A runny nose can lead to rhinitis. Rhinitis is a swelling and irritation of your nasal passages, resulting from symptoms of a runny nose, itching of the nose, throat or eyes; sneezing, and congestion. Many people associate rhinitis and a runny nose with the common cold, or allergy symptoms.
  • How does a runny nose develop? 
    • Your nose is made up of two nasal passages, and is covered by a mucus membrane. Mucus is a thin, clear, watery substance that works to "clean out" your nose, by trapping small particles and bacteria, before washing them away. 
    • If you become congested, or there is a "blockage" of one of your nasal passages, the other will compensate to help you breathe. 
    • If there is constant irritation of mucous in your nasal passages, your nose will start to "run", or drain mucus down the back of your throat (called postnasal drip), or out your nose. This will lead you to develop the common cold symptoms of rhinitis.
  • There are many types of rhinitis, all of which have the common cold symptom of a runny nose. These include:
    • Allergic rhinitis - this is an irritation of your nasal passages, caused by allergies. This includes season allergies (such as pollen, hay fever), or animal allergies (from a cat or a dog). This is a very common form of rhinitis, with a runny nose being the foremost common cold symptom.
    • Non-Allergic rhinitis - Many things may cause you to develop a non-allergic rhinitis with nasal discharge. This includes:
      • Overuse of nasal sprays to clear your nasal passages, such as Afrin, can cause a "rebound" effect, with worsening symptoms of congestion, and runny nose. This is called rhinitis medicamentosa. Therefore, if you are ordered a nasal spray, you must use it no longer than 3 to 5 days in a row.
      • Certain medications and diseases have rhinitis and a runny nose as a side effect. 
      • Congestion and irritation may occur due to irritants, such as smoke and pollution can cause your nose to run
      • As you age, your nasal passages may dry out over time. This usually happens in the elderly population. Your nose may secrete small amounts of mucus, but a runny nose is less common, as dry nasal passages are common.
      • Blockage due to polyps or foreign objects in the nasal passages may lead to rhinitis, with common cold symptoms of a runny nose. Treatment includes removing the cause. 
    • Infectious rhinitis - is caused by a virus, bacteria or a fungus
      • If you have symptoms of a cold for less than 6 weeks (including runny nose, itching, sneezing and congestion), you are considered to have an acute rhinitis. 
      • If your common cold symptoms last longer than 6 weeks, you may have a chronic rhinitis, caused by allergies, or structural problems in your nose.

Symptoms:

  •  You may have a sore throat, fever or chills. You may feel "achy". The sore throat is usually a result of postnasal drip. (Postnasal drip is a term used to describe drainage from your nose that runs down the back of your throat).
  • You have a runny nose, with sneezing and an "itchy" nose. Your nose may feel "congested", or "blocked."
  • You may be tired, or very weak (fatigued), if you have an illness, such as the cold or influenza (the flu).

How to Alleviate Runny Nose Symptoms:

  • If you have a runny nose, or allergic rhinitis, using decongestants (such as antihistamines) and topical nose sprays may help.
  • Avoiding what has caused the runny nose and allergy symptoms is the best way to treat your symptoms. This includes:
    • Ridding your house of common, allergy-causing substances, or decrease the amount, by keeping it clean. Dust mites, pet dander, cockroaches and mold spores all cause allergy symptoms, and may be found in the home.
    • Outside ragweed, tree pollen, grasses and mold spores often cause allergies. Ragweed causes an allergic rhinitis in about 75% of allergy sufferers. If you have severe allergies, avoid spending unnecessary time outside during the months of mid-August, until the first frost (known as, the "peak months"), without first taking an antihistamine.  
    • Also, wear a particulate respirator, or a high-efficiency mask, when working outside or gardening during the peak months.
    • Dusting furniture and floors with damp mop routinely. Vacuum at least weekly. Many electric vacuums actually spread dust mites - so make sure to clean your vacuum periodically. 
    • Eliminate exposure to household pets. Washing them won't necessarily help, as with cats, the allergen is found in their saliva, not their hair. 
    • Prevent dampness in your home. Keep the air humidity at less than 50%.
    • Remove carpets that may trap dust. If your carpets are on concrete, they may build up mold spores. Remove them, too. 
    • Discuss with your healthcare provider the common cold symptoms you are experiencing. Keep a diary to help determine what it is that you are allergic to. You may live your whole life without allergies, and they may develop as you age. Nasal antihistamines, steroids and decongestants may help to control your common cold symptoms.
  • Your doctor or healthcare provider may suggest that you see an allergy specialist for skin testing, if your runny nose or allergic rhinitis is severe, or if it does not respond to treatment.
    • A skin test is a relatively painless procedure, where an allergy specialist will place a small amount of an allergy-causing substance either on top of, or under your skin.
    • After about 20 minutes, the allergist will see if there is a reaction at the site that the test was placed.
  • Avoid crowds or people with common cold symptoms, especially if chemotherapy or your disease has weakened your immune system. Report fever, chills, or any other signs of infection immediately to your healthcare provider. 
  • If you are still smoking, STOP. Smoking will further irritate your throat, and the mucus membranes in your nose. Discuss ways to quit smoking with your healthcare provider.
  • Wash your hands often when you have symptoms of a cold. Do not share food, drinks, or towels with anyone. 
  • If you have inflammation in the back of your throat, or a sore throat (pharyngitis), it is most likely a result of your postnasal drip. However, depending on your overall health status, and other common cold symptoms, your doctor or healthcare provider may swab the back of your throat, and send it for culture. This is to see if your pharyngitis is caused by a bacterial infection. Follow the instructions given to you by your healthcare provider until the throat culture results are available. 
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, as often as you like. Most people gargle with this solution 4 times a day.
  • Use a vaporizer or a humidifier to moisten the air. Avoid dry air. This will help liquefy your mucus secretions when you are congested. Although you may have a runny nose, it is important that these secretions continue to drain, to prevent overgrowth of bacteria in your sinuses from congestion. 
  • Drink 2 to 3 liters of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. Keeping well hydrated will prevent congestion, and also liquefy your secretions.
  • If you have pain in your joints, muscles, or throat caused by common cold symptoms, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or prolong bleeding.  
  • If you have swollen glands, you may place a warm washcloth or compress to the area, 4 times a day, for 20 minutes at a time. This may help relieve some discomfort.
  • Use hard candy, or lozenges to soothe your throat. 
  • If your healthcare provider thinks that you have a strep pharyngitis in addition to your runny nose or rhinitis, you should not return to school or work unless you have been on antibiotics for at least 24 hours. 
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin for symptoms of the common cold unless your healthcare provider permits this. 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
  • In general, eating a well -balanced meal, limiting salt intake, high fat and high cholesterol foods is recommended. However, if you have a sore throat and loss of appetite due to your symptoms, avoid foods with a high acid content (spaghetti sauces, tomatoes), and deep fried foods (fried chicken or pork).  If you have pain swallowing solid food, try thinner soups, or foods until your throat pain improves. 
  • Try to exercise or move around, as tolerated, to maintain your optimal level of functioning.
  • After you recover from your common cold symptoms, discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help promote the flow of oxygen in your lungs and blood. Exercise may also help your immune system.
  • You should avoid alcohol. If you are still smoking, STOP. Smoking will further irritate the mucus membranes in your sinuses, and nose, accentuating yoru common cold symptoms. Discuss ways to quit smoking with your healthcare provider. 
  • If you are ordered a medication to treat this disorder, do not stop taking the medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills or inhalers with anyone. If you miss a dose of your medication, discuss with your healthcare provider what you should do. 
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor for Runny Nose:

  • Treatment of rhinitis and a runny nose due to allergies may include removing what has caused an allergic reaction (allergen), and controlling the common cold symptoms. If the rhinitis was due to an infection, your healthcare provider may prescribe decongestants, antibiotics, and humidified air. Nasal antihistamines, steroids and decongestants may help to control your symptoms of a cold.
  • Your healthcare provider may suggest allergy shots if you have severe, seasonal allergies. 
  • Nasal antihistamines, steroids and decongestants may help to control your symptoms.
    • Treatment of a runny nose may include antibiotic therapy if an infection is present, decongestants, humidified air (such as a vaporizer or a steamy shower), and drinking lots of fluids.
    • Treatment of a runny nose or rhinitis due to allergies may include removing what has caused an allergic reaction (allergen), and controlling the common cold symptoms through the use of antihistamines, decongestants, and nasal sprays. .
  • Antibiotics. Runny noses due to infection are less common than a runny nose due to allergies. Therefore, you will most likely not be prescribed an antibiotic for your runny nose.
    • However, if you have developed pharyngitis, or are at risk for rheumatic fever, your doctor or healthcare provider may want to protect you against developing a strep infection. The most common antibiotics prescribed for a strep infection, are Penicillin V, or Amoxacillin. You will most likely be ordered one of these antibiotics for at least 10 days.
    • If you have a prolonged runny nose, or the common cold symptoms of rhinitis, it may lead to a sinus infection. If you have been diagnosed with a sinus infection, you will most likely receive antibiotics. The first-line treatment of a sinus infection includes amoxacillin 500mg by mouth, 3 times a day, for 10-14 days.
    • Even though you may feel relatively well in 2 to 3 days, make sure you take all the prescribed medication, to get rid of the infection. 
    • These are the most commonly suggested antibiotics, which will treat the bacteria that are often present in strep and sinus infections. However, depending on your overall health status, and your healthcare provider, he or she may suggest that another antibiotic be used.
    • Remember: The main reason to treat a possible strep infection is to prevent rheumatic fever. Not everyone with pharyngitis has a strep infection, so not everyone with pharyngitis will receive antibiotics. 
    • It is important, when you have a runny nose, to maintain a clear nose. This will prevent a future sinus infection.
  • Antihistamines: If you have a runny nose, sneezing, watery eyes and itching, antihistamines may help to decrease your common cold symptoms.
    • Non-prescription antihistamines include most commonly Diphenhydramine (Benadryl ®), and Chlorpheniramine (Chlor-Trimeton®).  However, these drugs may leave you drowsy, and with a dry mouth.
    • Newer prescription antihistamines without side effects of dry mouth, drowsiness or sedation, include Loratadine (Claritin®), and Fexofenadine (Allegra®). You can take one of these pills daily, every other day, or whenever you have common cold symptoms. These medications may be prescribed alone, or in combination with a decongestant (such as Loratadine/Pseudoephedrine Claritin-D®).
  • Corticosteroids: Corticosteroids (steroids) work locally to decrease nasal irritation and inflammation, if given in the form of a nasal spray (topical). This is good, because you don't have to worry about bad long-term side effects of steroids from a short-term, local use. Only a small amount is distributed through your body. Common topical nasal steroids include Budesonide (Rhinocort®), and Fluticasone propionate (Flonase®).
  • Decongestants: May be helpful in a pill form, or as a nasal spray (topical), to relieve a "blockage", or common cold symptoms of a runny nose.
    • The most commonly prescribed pill to treat congestion is Pseudoephedrine (Sudafed®). 
    • A commonly used nasal spray decongestant is Azelastine (Astelin®). 
    • Antihistamines, in combination with a decongestant, work well in some people, as the decongestant will enhance the effectiveness of the antihistamine. Be careful using decongestants, though, if you have a history of high blood pressure. Discuss this with your healthcare provider.
  • Tylenol: If you have muscle, joint or throat pain from your common cold symptoms, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
    • If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and prolong bleeding.  
  • Do not stop any of your medications abruptly, without discussing with your healthcare provider. 

When to Contact Your Doctor or Health Care Provider:

  • Fever of 100.5° F (38° C), chills, or a worsening sore throat (possible signs of infection, especially if you are undergoing chemotherapy).
  • Shortness of breath, or increased trouble swallowing, may suggest an abscess has formed (an infected area). 
  • If you notice a green, brown, black or bloody discharge or mucous from your nose, or from a cough
  • Dark colored urine, or painful urination
  • Bleeding that does not stop after a few minutes, or new, unexplained bruises.
  • Any new rashes on your skin, especially if you have been taking a new antibiotic or medication
  • If your common cold symptoms worsen, or do not improve in 3-4 days of seeing your healthcare provider, you must call them for an evaluation.

Sinusitis

  • What do the sinuses do?
    • Sinuses are important, as they affect the sound of your voice, reduce the weight of the skull, and provide insulation for your skull. The sinuses are located behind your eyes, forehead, and cheekbones. The paranasal sinuses (meaning, "around the nose") connect the nasal passages to the sinus cavity.
    • Sinuses are air filled spaces, found in your skull. They are lined with a membrane that secretes mucus (called, a mucus membrane), which drains into the nose and the back of the throat. The mucus contains bacteria-fighting substances, called antibodies.
    • The sinuses are usually sterile and free from bacteria. It is important that the sinuses remain open and unblocked, to clear out bacteria. When there is an infection present, the membrane in the sinuses will create more mucus, to "flush out" bacteria. If there is a blockage, they are unable to drain. 
  • Sinusitis is the swelling and inflammation of the mucus membranes that line the paranasal sinuses. 
  • Sinusitis is usually caused by a blockage or obstruction in the sinuses. This leads to less clearance of mucus from the sinus cavity. Because the mucus membrane is unable to clear bacteria from the sinus cavity, bacteria can grow. Anything that causes a blockage in the sinus drainage system can cause sinusitis.
  • True cases of sinusitis usually take 10 to 14 days to develop. People may feel sinus pain for a "few days", but these common cold symptoms this can often be relieved by a decongestant. 
  • Other causes of sinus infections are:
    • A recent upper respiratory infection or cold, causing congestion (and sinus blockage)
    • A fungal infection in those with impaired immune systems
    • Allergies - either seasonal or related to something in the air, causing congestion and blockage to the sinuses
    • Deviated septum - this most commonly occurs when the septum of the nose is "off center", usually due to a broken nose, or trauma to the face. 
    • Tumors in the paranasal sinuses, or nose cavity
    • Swimming or diving 
    • A foreign body may be stuck in your nose
    • Polyps (a benign growth) in your nose, causing a blockage.
  • The sinus infection may labeled as: 
    • Acute - when there is a quick onset of symptoms, resolving in a few weeks to a month
    • Subacute - With symptoms lasting less than 3 months
    • Chronic - this is due to a prolonged inflammation of the sinus cavity, with symptoms lasting greater than 3 months.

Symptoms:

  • You may have a headache, facial pain or pressure over the affected sinus cavity. Some people complain of a severe toothache, caused by an infected sinus (usually maxillary), which is located near your cheekbone.
  • Yellow or green nasal discharge.
  • You may have a sore throat, fever or chills. You may feel "achy". The sore throat is usually a result of postnasal drip. (Postnasal drip is a term used to describe drainage from your nose that runs down the back of your throat).
  • You may have a cough caused by postnasal drip, which becomes worse when lying down. 
  • At first, you have a runny nose, with sneezing and an "itchy" nose. Your nose may feel "congested", or "blocked." This may progress into a sinus infection if your nose passages remain blocked. 
  • You may have a prolonged respiratory infection (with cough and fever), for more than 10-14 days.
  • You may be tired, or very weak (fatigued).
  • Your face may be swollen

How to Alleviate Sinusitis Symptoms:

  • If you notice that you are feeling "ill", with common cold symptoms and a blocked nose, which sometimes may be due to allergies, discuss with your healthcare provider whether or not you may take a decongestant or nasal spray. This may promote drainage of the sinus cavity, and prevent a sinus infection.
  • If you have a history of recurrent sinus infections, discuss with your healthcare provider whether or not to take decongestants at the first sign of congestion. 
  • Use a vaporizer or a humidifier to moisten the air. This will help liquefy your mucus secretions when you are congested. Avoid dry heat. 
  • Drink 2 to 3 liters of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. Keeping well hydrated will prevent congestion, and also liquefy your secretions. 
  • Avoid swimming or diving while you have a sinus infection. 
  • If you are still smoking, STOP. Smoking will further irritate the mucus membranes in your sinuses, and nose. Discuss ways to quit smoking with your healthcare provider. 
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, as often as you like. Most people gargle with this solution 4 times a day.
  • Postnasal drip is usually a symptom of a sinus infection, or rhinitis. It is usually caused by a virus. Treatment for postnasal drip involves treating your common cold symptoms, and the underlying cause. 
  • If you have an allergic rhinitis, using decongestants and topical nose sprays may help promote sinus and nasal drainage. 
  • Symptoms of sinusitis, rhinitis and the "common cold" are all similar.  If your sinusitis is caused by a prior allergic rhinitis, it is important to avoid what has caused your allergy symptoms. This includes:
    • Ridding your house of common, allergy-causing substances, or decrease the amount, by keeping it clean. Dust mites, pet dander, cockroaches and mold spores all cause allergy symptoms, and may be found in the home.
    • Outside ragweed, tree pollen, grasses and mold spores often cause allergies. Ragweed causes an allergic rhinitis in about 75% of allergy sufferers. If you have severe allergies, avoid spending unnecessary time outside during the months of mid-August, until the first frost (known as, the "peak months"), without first taking an antihistamine.  
    • Also, wear a particulate respirator, or a high-efficiency mask, when working outside or gardening during the peak months.
    • Dusting furniture and floors with damp mop routinely. Vacuum at least weekly. Many electric vacuums actually spread dust mites - so make sure to clean your vacuum periodically. 
    • Eliminate exposure to household pets. Washing them won't necessarily help, as with cats, the allergen is found in their saliva, not their hair. 
    • Prevent dampness in your home. Keep the air humidity at less than 50%.
    • Remove carpets that may trap dust. If your carpets are on concrete, they may build up mold spores. Remove them, too. 
    • Discuss with your healthcare provider the common cold symptoms you are experiencing. Keep a diary to help determine what it is that you are allergic to. You may live your whole life without allergies, and they may develop as you age. Nasal antihistamines, steroids and decongestants may help to control your symptoms. 
  • Your doctor or healthcare provider may suggest that you see an allergy specialist for skin testing, if your allergic rhinitis is severe, or if it does not respond to treatment.
    • A skin test is a relatively painless procedure, where an allergy specialist will place a small amount of an allergy-causing substance either on top of, or under your skin.
    • After about 20 minutes, the allergist will see if there is a reaction at the site that the test was placed.
  • Avoid crowds or people with common cold symptoms, especially if chemotherapy or your disease has weakened your immune system. Report fever, chills, or any other signs of infection immediately to your healthcare provider. 
  • Wash your hands often. Do not share food, drinks, or towels with anyone. 
  • If you have inflammation in the back of your throat, or a sore throat (pharyngitis), it is most likely a result of post-nasal drip. However, depending on your overall health status, and other symptoms, your doctor or healthcare provider may swab the back of your throat, and send the swab for culture. This is to see if your pharyngitis is caused by a bacterial infection. Follow the instructions given to you by your healthcare provider until the throat culture results are available. 
  • If you have pain in your joints, muscles, or throat due to common cold symptoms, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or prolong bleeding.  
  • If you have swollen glands, you may place a warm washcloth or compress to the area, 4 times a day, for 20 minutes at a time. This may help relieve some discomfort.
  • Use hard candy, or lozenges to soothe your throat. 
  • If your healthcare provider thinks that you have a strep pharyngitis in addition to your rhinitis, you should not return to school or work unless you have been on antibiotics for at least 24 hours. 
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin unless your healthcare provider permits this. 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
  • In general, eating a well -balanced meal, limiting salt intake, high fat and high cholesterol foods is recommended. However, if you have a sore throat, avoid foods with a high acid content (spaghetti sauces, tomatoes), and deep fried foods (fried chicken or pork).  If you have pain swallowing solid food, try thinner soups, or foods until your throat pain improves. 
  • Try to exercise or move around, as tolerated, to maintain your optimal level of functioning.
  • After you recover from your common cold symptoms, discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help promote the flow of oxygen in your lungs and blood. Exercise may also help your immune system.
  • You should avoid alcohol when common cold symptoms are present. 
  • If you are ordered a medication to treat this disorder, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone. If you miss a dose of your medication, discuss with your healthcare provider what you should do. 
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor for Sinusitis:

Drugs that may be prescribed by your doctor to treat common cold symptoms:

  • Viruses and upper respiratory infections may be present before a sinus infection. This is because the mucus that is secreted by your mucus membranes to fight an infection will often cause a blockage of sinuses. With improper drainage of the sinus cavity, bacteria may form over a few days to a few weeks. 
    • If you have had congestion over a few days, your healthcare provider will often prescribe over the counter decongestants, humidified air (such as a vaporizer or a steamy shower), and drinking lots of fluids. If you are better hydrated, this will make your secretions thinner, and easier to drain. The decongestants and humidified air will promote drainage of the sinuses and hopefully, prevent the growth of bacteria in the sinus cavity. 
    • If you have had a prolonged period of congestion, and may have developed a sinus infection with bacteria, your healthcare provider may prescribe antibiotic therapy to treat your infection. You will usually take these in addition to nasal decongestants or sprays, and decongestant pills. 
  • Treatment of rhinitis due to allergies may include removing what has caused an allergic reaction (allergen), and controlling the symptoms of the cold. If the rhinitis was due to an infection, your healthcare provider may prescribe decongestants, antibiotics, and humidified air. Nasal antihistamines, steroids and decongestants may help to control your common cold symptoms.
    • Treatment of postnasal drip caused by a sinus infection may include antibiotic therapy, decongestants, humidified air (such as a vaporizer or a steamy shower), and drinking lots of fluids.
    • Treatment of rhinitis due to allergies may include removing what has caused an allergic reaction (allergen), and controlling the commnon cold symptoms through the use of antihistamines, decongestants, and nasal sprays.
  • Antibiotics. The first-line treatment of a sinus infection includes amoxacillin 500mg by mouth, 3 times a day, for 10-14 days. This depends on your healthcare provider. Other commonly used antibiotics include Amoxacillin/clavulanate (Augmentin®), trimethoprim sulfamethoxazole (Bactrim®), and Clarithromycin (Biaxin®). These are usually used if you are more at risk for infection due to an altered immune system, or if amoxacillin did not work.
    • Even though you may feel relatively well in 2 to 3 days, make sure you take all the prescribed medication, to get rid of the infection. It is important to clear the sinus infection, so that a chronic and prolonged sinus infection will not occur.
    • These are the most commonly suggested antibiotics, which will treat the bacteria that are often present in sinus infections. However, depending on your overall health status, and your healthcare provider, he or she may suggest that another antibiotic be used.
  • Antihistamines: Should only be used with a sinus infection if you have an allergic cause of the infection, as these drugs tend to slow drainage and secretions from the sinuses.  However, if you have sneezing, watery eyes and itching, antihistamines may prevent nasal congestion due to allergies, and decrease common symptoms of postnasal drip.
    • Non-prescription antihistamines include most commonly Diphenhydramine (Benadryl ®), and Chlorpheniramine (Chlor-Trimeton®).  However, these drugs may leave you drowsy, and with a dry mouth. 
    • Newer prescription antihistamines without side effects of dry mouth, drowsiness or sedation, include Loratadine (Claritin®), and Fexofenadine (Allegra®). You can take one of these pills daily, every other day, or whenever you have symptoms. These medications may be prescribed alone, or in combination with a decongestant (such as Loratadine/Pseudoephedrine Claritin-D®).
  • Corticosteroids: Corticosteroids (steroids) work locally to decrease nasal irritation and inflammation, if given in the form of a nasal spray (topical). This is good for symptoms of a cold, because you don't have to worry about bad long-term side effects of steroids from a short-term, local use. Only a small amount is distributed through your body. Common topical nasal steroids for the treatment of sinusitis include beclomethasone dipropionate (Beconase® or Vancenase ®) and Fluticasone propionate (Flonase®).
  • Decongestants: May be helpful in a pill form or as a nasal spray (topical), to relieve a "blockage"; or symptoms of a runny nose.
    • The most commonly prescribed pill to treat congestion is Pseudoephedrine (Sudafed®). 
    • A commonly used nasal spray decongestant is Azelastine (Astelin®).  
    • Antihistamines, in combination with a decongestant, work well in some people, as the decongestant will enhance the effectiveness of the antihistamine. Be careful using decongestants, though, if you have a history of high blood pressure. Discuss this with your healthcare provider.
  • Tylenol: If you have headaches, muscle, and joint or throat pain from your illness, you may take acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours). It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
  • If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and prolong bleeding. 
  • Do not stop any of your medications abruptly, without discussing with your healthcare provider. 

When to Contact Your Doctor or Health Care Provider:

  • Fever of 100.5° F (38° C), chills, or a worsening sore throat (possible signs of infection, especially if you are undergoing chemotherapy).
  • Swelling around the eyes, severe facial pain, or reddened and inflamed areas near your eyes - seek emergency assistance 
  • Shortness of breath, or increased trouble swallowing, may suggest an abscess may have formed (an infected area) in your throat.
  • Trouble breathing should be evaluated immediately 
  • If you notice a green, brown, black or bloody discharge or mucous from your nose, or from a cough
  • Dark colored urine, or painful urination
  • Bleeding that does not stop after a few minutes, or new, unexplained bruises.
  • Any new rashes on your skin, especially if you have been taking a new antibiotic or medication
  • If your symptoms worsen, or do not improve in 3-4 days of seeing your healthcare provider, you must call them for an evaluation.  You should also return to the clinic in 10 to 14 days (after your antibiotic therapy) for an evaluation.


References for Common Cold Symptoms:


MD Consult: A resource for clinicians. (2002).  [On-line]. Available:  http://home.mdconsult.com

Merideth, P. V. & Horan, N. M. (2000).  Adult primary care.  Philadelphia:  WB Saunders Company.

Seller, R.  (2000). Differential diagnosis of common complaints. Philadelphia:  WB Saunders Company.

Tierney, L.M, McPhee, S.J & Papadakis, M. A (2001).  Current medical diagnosis and treatment 2001, Fortieth Edition.  Appleton and Lange:  Stanford, CT

Uphold, C.R and Graham, M. V. (1999).  Clinical guidelines in adult health (5th Edition).  Gainesville: Barmarrae Books.

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