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Respiratory Disorders (Expert Forum)
I cannot figure what is wrong ?? Sinus or Throat?
Answered by
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I cannot figure what is wrong ?? Sinus or Throat?
by Leaf2, Nov 08, 2004 12:00AM
About a 6 weeks ago I experienced a cold. From the time of that cold until now, I have experienced a chronic cough. The cough produces small amounts of thick yellow mucus or phlegm. The phlegm does not begin until about 45 minutes after I wake up in the morning and lasts, usually, for about 3 hours.
At night, my throat tends to be dry and itchy. I also have experienced some sinus congestion in the morning. I have not experienced any other symptoms (e.g., fatigue, fever, chills, etc.). Not even a sore throat. And I do not smoke.
A physician prescribed flonase, amoxicillin, and promethazine. I have been taking all three for the past 4 days with little or no improvement.
I cannot figure out if the source of my problem is my sinuses or my throat, or something else.
Any help would be appreciated.
At night, my throat tends to be dry and itchy. I also have experienced some sinus congestion in the morning. I have not experienced any other symptoms (e.g., fatigue, fever, chills, etc.). Not even a sore throat. And I do not smoke.
A physician prescribed flonase, amoxicillin, and promethazine. I have been taking all three for the past 4 days with little or no improvement.
I cannot figure out if the source of my problem is my sinuses or my throat, or something else.
Any help would be appreciated.
Doctor's Answer
by National Jewish, Nov 11, 2004 12:00AM
, Nov 11, 2004 12:00AM
In a person who has a normal chest x-ray and who doesn’t smoke the most common causes of cough are postnasal drip, chronic sinus problem, heartburn, and asthma. Viral infections like a cold can cause inflammation of the airways of the lungs with or without inflammation of the mucous membranes that line the sinus cavities.
If a virus were the cause the amoxicillin you were prescribed would not be effective in getting rid of the infection. If bacteria were the cause by now you should be having less cough, mucus, and throat problems if the amoxicillin is helping to get rid of the infection.
The inflammation in the airways of the lungs can cause coughing, especially when you are active or laugh. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the coughing will stop. This is called reactive airways disease (RAD) and behaves a lot like asthma. On a simple breathing test, called spirometry, this may not show up. This inflammation often clears more quickly when it is treated with an inhaled steroid medicine, which is given to treat asthma. Usually this medicine needs to be used every day for several weeks to months for it to help. Your doctor is the best judge of this.
Sinusitis is inflammation of the mucous membranes that line the sinus cavities. In addition to an infection this could be due to an allergy, or ongoing exposure to an irritant, such as pollution or smoke. Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, an odor coming from the nose, postnasal drip, cough, sore throat, laryngitis, lightheadedness, constant low fever, and thick, yellow to green nasal drainage.
The best way to identify a sinus infection is with a sinus CT scan, although sinus x-rays are a decent alternative. A sinus CT scan will also identify if any of the openings that drain your sinuses are blocked. If your symptoms are due to sinusitis, they will last as long as the inflammation continues. Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sin.html for more information about ways to clear up the inflammation. Please check with your doctor to see which of these would work best for you.
This inflammation can block sinus drainage and cause increased mucus production. The mucus may not move easily with coughing, especially when it is thick. As the sinus infection clears, this mucus drains from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip that can be irritating to the throat. This may explain your itchy throat. Typically this is worse at night when you lay down to sleep. Generally this irritation feels the worst when you wake up and gets better as the day goes on. This mucus can fester sinusitis.
The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and relieve your blocked sinuses by decreasing the swelling so they drain better. A combination antihistamine-decongestant will do both. Often a prescription antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis. Check with your doctor to see which of these would help you more.
A nasal wash helps remove mucus and germs from the nose and sinuses. This can temporarily decrease the postnasal drip and help your sinuses to drain better. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
If your symptoms continue, your doctor may recommend a prescription nasal steroid spray, like Flonase® (fluticasone). This can decrease mucus production and improve sinus drainage by decreasing the inflammation in the nose and openings that drain the sinuses. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. To get the most help from a nasal steroid spray use it after doing a nasal wash. A nasal steroid spray does not provide immediate relief of symptoms. It may take several weeks of routine use to become effective. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.
If a virus were the cause the amoxicillin you were prescribed would not be effective in getting rid of the infection. If bacteria were the cause by now you should be having less cough, mucus, and throat problems if the amoxicillin is helping to get rid of the infection.
The inflammation in the airways of the lungs can cause coughing, especially when you are active or laugh. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the coughing will stop. This is called reactive airways disease (RAD) and behaves a lot like asthma. On a simple breathing test, called spirometry, this may not show up. This inflammation often clears more quickly when it is treated with an inhaled steroid medicine, which is given to treat asthma. Usually this medicine needs to be used every day for several weeks to months for it to help. Your doctor is the best judge of this.
Sinusitis is inflammation of the mucous membranes that line the sinus cavities. In addition to an infection this could be due to an allergy, or ongoing exposure to an irritant, such as pollution or smoke. Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, an odor coming from the nose, postnasal drip, cough, sore throat, laryngitis, lightheadedness, constant low fever, and thick, yellow to green nasal drainage.
The best way to identify a sinus infection is with a sinus CT scan, although sinus x-rays are a decent alternative. A sinus CT scan will also identify if any of the openings that drain your sinuses are blocked. If your symptoms are due to sinusitis, they will last as long as the inflammation continues. Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sin.html for more information about ways to clear up the inflammation. Please check with your doctor to see which of these would work best for you.
This inflammation can block sinus drainage and cause increased mucus production. The mucus may not move easily with coughing, especially when it is thick. As the sinus infection clears, this mucus drains from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip that can be irritating to the throat. This may explain your itchy throat. Typically this is worse at night when you lay down to sleep. Generally this irritation feels the worst when you wake up and gets better as the day goes on. This mucus can fester sinusitis.
The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and relieve your blocked sinuses by decreasing the swelling so they drain better. A combination antihistamine-decongestant will do both. Often a prescription antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis. Check with your doctor to see which of these would help you more.
A nasal wash helps remove mucus and germs from the nose and sinuses. This can temporarily decrease the postnasal drip and help your sinuses to drain better. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
If your symptoms continue, your doctor may recommend a prescription nasal steroid spray, like Flonase® (fluticasone). This can decrease mucus production and improve sinus drainage by decreasing the inflammation in the nose and openings that drain the sinuses. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. To get the most help from a nasal steroid spray use it after doing a nasal wash. A nasal steroid spray does not provide immediate relief of symptoms. It may take several weeks of routine use to become effective. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.
Flonase should take care of that and nasal congestion. Be sure to use it according to the prescribing instructions [pdf] at
www.flonase.com
shake gently before using
initial pump priming is 6
It can also be more effective after doing a warm saline nasal wash. See;
http://nationaljewish.org/medfacts/nasal.html
Nasal Wash Treatment
Excerpt
"Method 3 - Use your hands for this technique. Pour some saltwater into your palm, then sniff the liquid up your nose, one nostril at a time. Blow your nose lightly. This technique may not be as effective but may be used in some situations. "