Health Care

Suspicious sneeze

You're stuffed up, you're sniffling -- but is it an allergy or is it a cold?

It's not always easy to tell, even for someone like Dr. Kevin Lunde, an otolaryngologist (ears, nose and throat specialist) at Baylor Plano hospital in Texas.

"At times, I have performed allergy testing on patients with recurrent nasal and upper respiratory symptoms to help determine if allergies or colds are the cause," Lunde said.

It's important to figure it out because the treatments are different. After all, the antihistamines that can do so much for easing your allergy distress are not going to help your cold and might even make it worse. Up to 5 percent of allergies and colds will leave you vulnerable to sinus-tract infections, which are bacterial and call for antibiotics.

Sometimes it takes a little detective work to figure out what ails you.

"If you get sick with sneezing, sore throat and muscle aches, and it happens every September, it's probably allergies," said Dr. J. Robert Wyatt, an otolaryngologist and president of the Dallas Academy of Otolaryngology.

If you don't usually get sick in September, but you spent time at your toddler's school hanging around with his little playmates and find yourself sniffling three days later, it's probably a cold, he adds.

Kids can pass colds back and forth to each other and bring them home throughout the school year. And allergy season can last most of the year, adds Dr. Sandeep Gupta, an allergist at Texas Health Presbyterian Hospital Dallas and Baylor Plano.

Which is why the duration and speed of the symptoms might provide even better clues:

Colds, which are viruses that damage and kill cells by entering them and multiplying, hit suddenly and usually leave in about three to five days, although symptoms can linger for a few days after the virus itself has passed.

Allergies, which occur when your immune system overreacts to something such as pollen that is not really a threat, come on slowly and linger through the three or four weeks, or as long as the allergen is around.

Additional signs for colds include mild fevers, lymph node enlargement, muscle aches and coughing.

Allergies are more characterized by sneezing, itching and rashes, and swelling under the eyes caused by inflammation.

What to do?

There are some common treatments for both. Experts recommend eight hours of sleep, daily exercise for an optimum 60 minutes and eight glasses of water daily. Many doctors recommend daily sinus rinses, humidifiers and warm chicken soup as well. All of these measures can help prevent or lessen the symptoms as well as help you bounce back sooner.

With colds, you also might want to take acetaminophen (Tylenol) for mild fever and muscle pain. You want to make sure to keep resting for at least a week to 10 days, even if you feel better on the third or fourth day: Your immune system be low, and you be more vulnerable to infection.

For allergies, the best offense is a good defense -- avoid what you are allergic to. If you can't do that, take over-the-counter allergy medications such as loratadine (Claritin) and cetirizine (Zyrtec) as needed, noting that cetirizine can cause drowsiness. Consult with your doctor before taking allergy medications with decongestants, such as Claritin D and Zyrtec D, because they can affect blood pressure.

If these don't help, your doctor might want to prescribe more intense allergy medications or discuss allergy shots, which can decrease sensitivity to allergens over time for some people.

If you are a frequent allergy sufferer, Wyatt recommends having your doctor examine your nose for nasal polyps (noncancerous lumps of swollen tissues that can get bigger over time), enlarged turbinates (ridges inside your nose that can get bumpier over time) and deviated septum (when the cartilage inside your nose is bent), all of which can result in symptoms that can be mistaken for allergic reactions. These problems can be fixed surgically.

Young children also should be watched carefully for signs of colds or allergies, as their immune systems might not be as strong as those of older children or adults, said Dr. J. Andrew Bird, an allergy and immunology specialist at Children's Medical Center Dallas, and assistant professor of pediatrics at the University of Texas Southwestern Medical Center.

"As we age, our immune system develops a memory response that is protective against future infections of the same type," he notes.

Because colds and allergies can lead to sinus infections, it is important to watch for those symptoms as well -- a thick, yellowish discharge and fever. See your doctor immediately, as antibiotics usually are recommended when there is a bacterial infection

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