FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

CLOSE ENCOUNTER WITH ALIENS MAY CAUSE READER'S SNEEZING

Question: I've been sneezing and I also have a runny nose. I get hay fever in the fall and have these same symptoms. How can I tell if I have a cold or an allergy, or for that matter, a strep throat?

Answer: Your symptoms of a runny nose and sneezing may be due to any condition that causes irritation to the nasal tissue. Fine dust and cold air are good examples of irritants. However, when they are the source of these symptoms, it's actually a sign of health, not illness. This is because the increased mucus traps more of those fine dust particles or helps warm and moisten that cold winter air.

These and other symptoms can also be caused by allergies and infections. Two different types of "alien invaders" that irritate the tissue of the nose and upper respiratory passages are responsible for these conditions. While each of these invaders produces many of the same symptoms, there are some signs that can help you identify which is the culprit. The victim of a viral infection of the respiratory tract the so-called "common cold" frequently has some generalized body aching, a scratchy sore throat, coughing and sneezing. It is unusual to have a fever higher than 100 degrees. The tonsils and lymph glands in the neck may be slightly enlarged or they may be completely normal.

When the invaders are bacteria such as in a strep throat infection it is common to have a fever of 101 degrees or more. The throat is red, and the tonsils are enlarged and often covered with a white exudate ("ooze," in lay language). The lymph glands in the neck are usually swollen and tender.

A person with an allergy usually experiences nasal congestion, itching or irritated eyes and nose, and some sneezing. The throat is often sore upon arising in the morning, but it is not inflamed. The lymph glands of the neck aren't enlarged, nor is there fever. And yes, you can have allergies that cause symptoms in the winter. Allergies arise when a susceptible individual is exposed to the offending allergen. House dust, mold and animal dander from pets are common culprits during the winter months.

So, it takes some detective work to determine the cause of nasal congestion and sneezing like you are having. If you have a fever higher than 100 degrees, I'd recommend that you see your doctor. If your temperature is lower than this, consult with your first health-care advisor that's mother or grandmother. The non-prescription cold and allergy medications are safe when used in accordance with the package directions, and they may help you feel better. These medications, however, will not help you get over a cold any faster than if you did nothing. Most individuals recover from a cold in a week's time, but it may take longer for those who are under considerable emotional or physical stress.

Allergies, on the other hand, are often dramatically improved with non-prescription medications, but the symptoms quickly return to their previous severity when you stop taking the medicine. I'm suspicious that allergies are the source of your symptoms since they have continued long enough for you to write to me. And individuals with seasonal allergies often develop allergic responses to new things such as that ubiquitous house dust. I'd suggest that you take one of the many non-prescription allergy medications and see if it clears up your sneezing and runny nose. If it does, you will know that you have had a close encounter with an alien invader of the allergy kind.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.