Allergy symptoms can easily be mistaken for the common cold in much the same way as the other signs and symptoms of chronic airway-digestive inflammatory disease (CAID). In fact, the allergic response is actually one of the main causes leading to CAID: Allergies left untreated will cause inflammation to the sinus membranes, spawning the cascade of swelling and obstruction. Once this occurs, you may experience the same congestion, headaches, postnasal drip, hoarseness, and so on that you would feel during a bout of sinusitis. On top of these symptoms, you may also experience certain symptoms that pertain to the allergic reaction, including:
■ Asthma ■ Itchy, watery eyes
■ Eczema ■ Runny nose
■ Food allergy ■ Sneezing
Allergies can seriously affect your quality of life. Allergies will persist for as long as you are exposed to the allergen. If you have environmental allergies, such as pollen or ragweed, your symptoms can last as long as a few weeks to more than a few months. Severe allergies require more than a standard cold medication. Untreated allergy symptoms can also develop into more chronic conditions, such as ear infections and sinusitis.
Doctors are still unclear as to why some patients with allergies develop sinus disease, nasal polyps, and asthma, while other’s allergic reactivity manifests itself in rashes and/or itching. I believe that each individual’s genetic map must code for the areas to be affected (known as target areas) by the inflammatory process that erupts with an allergic reaction.
Because the allergic response and the symptoms of sinus disease and CAID are so similar, it is often difficult for anyone, including a doctor, to differentiate between the two.
My patient Steven came to the office complaining of continuous nasal congestion, postnasal drip, and headaches. He told me that he felt as if he were always suffering from some kind of sinus-related symptom. His problems start in the beginning of the spring each year and last through the fall. He sneezes at times and has itchy eyes in the fall when it is windy. Steven complained that his mucus usually turns yellow in the fall when the weather gets colder, although he claimed that it is clear and white throughout the spring and summer. Once the winter starts, his symptoms improve dramatically, except for an occasional 2- to 3-day cold. He started self-medicating with over-the-counter (OTC) remedies, including decongestant nasal sprays. He was also being treated by a health-food store with various vitamins and holistic products. These supplements do make him feel better but not good enough: He said that he used his nasal spray every 2-3 hours. Worse, Steven couldn’t sleep because he couldn’t breathe through his nose at night, and his wife said he had begun to snore.
Steven went to an allergist who said that he did not have allergies and treated him with an antibiotic for 7 days and a nasal spray for 2
weeks. However, Steven was never tested for allergies, and his symptoms didn’t improve. Another ear, nose, and throat (ENT) specialist did a computed tomography (CT) scan and recommended surgery. Steven’s internist recommended various antihistamines and decongestants and kept putting him on a 5-day course of antibiotics, which offered some improvement but never seemed to do the trick.
Steven came to my office, and I took a history and performed a physical examination. I sat down and spoke with Steven and let him know that 1 thought he suffered from allergic rhinitis, which turned into a chronic sinusitis in the fall. During the examination I listened to his chest and heard a slight wheezing. He told me that this often happened in the spring or fall, but it never bothered him enough to treat. His biggest pressing problem was the rhinitis medicamentosa that he developed from the topical decongestant. He was addicted to his nasal spray, was rebounding from the medicine, and was worse than ever. 1 recommended that he see another allergist for allergy testing. I sent him to an osteopath for control of his supplements and his holistic medicines. I placed him on a course of nasal steroid sprays and oral steroids and decongestants for 2 weeks and told him in no uncertain terms to quit taking the topical decongestant spray immediately.
Steven came back to my office 2 weeks later. He told me that he went cold turkey on the decongestant spray, even though the first 2 nights were extremely tough. By the end of the 1st week, he no longer thought about using the decongestant spray. His snoring stopped as his breathing retuned to near normal. I then put him on an antibiotic for 30 days, which cleared up his yellow discharge. He reported that his allergy testing was positive, and the allergist instituted an allergy-shot protocol. We placed him on a nasal steroid spray and an antihistamine over the next year.
By the next spring Steven told me that he was barely feeling his old allergy symptoms. He breezed through to the next spring without an infection. He stated he wheezed maybe once a year when the pollen got really bad but even then it was barely noticeable. On his own, Steven learned how to use a nasal irrigator when the allergy season is in full swing. Overall, Steven feels like a new man.