Allergies or Chronic Sinusitis? Most Get It Wrong and Don't Get Treated

May 23, 2011— -- The pollen count is through the roof and once again, you have a stuffy nose, sinus pain, fatigue and reduced sense of smell and taste. Oh great, another bad allergy season, you think.

And you'd be wrong. These are the hallmarks of a sinus infection, not allergies, though most allergy patients can't tell the difference, according to a recent survey by the Asthma and Allergy Foundation of America.

In an online survey of more than 600 asthma and allergy patients, researchers found that about half self-diagnosed their symptoms as allergies when really they had a sinus infection, or sinusitis.

Despite the fact that 70 percent of those surveyed most trust a primary care physician to correctly diagnose allergies or sinusitis, only 36 percent reported consulting a physician when they had symptoms of these conditions.

"This study highlights how often people diagnose themselves. We're human. It's a natural response to go online and come up with our own diagnosis, but 10 to 15 times a day I get patients coming in convinced they have X, when really they have Y," says Dr. Stacey Silvers, an ear, nose, and throat doctor at Beth Israel Hospital in New York City.

For years, New Yorker Dawn Burley, 27, figured her headaches, facial pain and fatigue were just the signs of seasonal allergies and migraines. But allergy medication didn't lessen her symptoms, and she hated treating the pain of her migraines without knowing their cause. She had such severe pressure and pain around her eyes that she would become sensitive to light and had difficulty sleeping.

"It was really ruining my life. I'd have so many days where I could barely function," she says. It wasn't until she saw Silvers that anyone put her symptoms together and realized she had sinus problems. Though she had been diagnosed with acute sinus infections in the past, no doctor had recognized that Burley had chronic sinusitis because of the way her sinuses were formed.

After undergoing a minimally-invasive, in-office procedure in which a balloon is inflated to open her sinus passageways -- a more extensive treatment than most require -- Burley says she could breathe easier, sleep sounder and had more stamina. "I didn't even realize that these things could get better," Burley says.

This is not uncommon of those with untreated sinus or allergy problems, Silvers says. "I've had patients tell me they didn't know it wasn't normal that their nose was always clogged at night. They didn't realize that most people can breathe out of both sides of their nose. People get used to these things, and they don't think it's abnormal or treatable," she says.

Sinus Infection vs. Allergies -- How Do You Know?

Thirty-five million Americans suffer from nasal allergies and 7 million suffer from chronic sinus infections, yet most people can't tell the difference between these two conditions.

"There is abundant confusion between cold, sinus and allergy symptoms," says Dr. Clifford Bassett, medical director of the Allergy and Asthma Care of New York. This means that often these conditions get mistreated or go untreated, which can lead to "chronic nasal congestion and associated symptoms" that can affect quality of life as well as daytime performance, he says.

Symptom Breakdown

Here's a breakdown of which symptoms belong to which ailments.

The Common Cold -- "Cold and allergy can present similarly," says Silvers, so the defining difference is the length: If your congested nose and breathing difficulty last longer than seven to 10 days, it's probably not a cold. Most likely, it's allergies, and needs to be treated with an antihistamine, not a decongestant.

Seasonal Allergies -- If your sinus congestion is accompanied by watery or itchy eyes and it tends to last several weeks, it's may be allergies, says Silvers. The problem is, many often treat their allergies like a cold, with over-the-counter decongestants, which will work in the short run but are not advisable. "When someone is taking a daytime decongestant every day and a nighttime one to sleep, for weeks and weeks, this is not good," she says. Especially when their allergy might be due to an environmental trigger, such as a feather pillow, that could be easily eliminated.

Sinusitis or Chronic Sinusitis -- With sinusitis, the nasal passageways become inflamed and the liter or more of mucus created every day by your body gets backed up in the sinuses. "This is when you get patients complaining of headache, pressure or pain in their face and chronic fatigue," Silvers says.

A headful of mucus is an exhausted head, one that's hard to lift off the pillow and patients can be irritable and fatigued on most days," says Silvers. If you suffer from facial tenderness, pressure or pain, headache behind the eyes and forehead, or loss of taste or smell and fatigue, you may have sinusitis.

If you experience this three or more times a year, you may have chronic sinusitis, like Burley, and should consult with your physician or an ear, nose and throat specialist. What most people don't know, Silvers says, is that you can have sinusitis without having a runny or stuffy nose or difficulty breathing, because the mucus is congested further back in the sinuses.

If you suffer from any of the above symptoms and they do not resolve within a week or so (and hence are unlikely to be a cold or flu), you should consider seeing your physician, who may refer you to an allergist or an ear, nose and throat specialist.