The fall season is here and along with that comes a common comment heard in our office….. “I don’t know if I have a cold or allergies but I feel miserable.” The symptoms of colds and allergies often overlap and have a similar presentation. This article is going to look at some of the differences between these two very common conditions.
TIME OF YEAR: A cold is a viral infection, which is caused by one of many rhinoviruses that affect the nose. Although it is possible to “catch” a cold at any time, cold viruses are more common during the winter months. By contrast, an allergic reaction is an immune response to a harmless substance and is most prominent during the spring and fall months when pollen counts from trees, grasses, and weeds are at their highest.
SYMPTOM ONSET: One of the early differences between colds and allergies is how rapidly symptoms occur. Cold symptoms generally have a gradual onset over a period of several days. A cold may begin with a general sense of fatigue, sore throat, or runny nose and over time progresses to severe nasal congestion, headache, and perhaps even fever and body aches. The symptoms of allergies have an abrupt onset (when exposure to the allergen occurs) with one of the first and most common symptoms being sneezing…..often multiple times in a row.
DURATION OF SYMPTOMS: Cold symptoms persist for anywhere from 5-10 days and then gradually improve. Allergy symptoms may last for months or as long as you are exposed to the allergy trigger. If you are symptomatic greater than 10 days, you will want to consider the possibility of your symptoms being of an allergic nature. Remember, a person can develop allergies at ANY time in their life, so just because you don’t have a history of allergies in the past, doesn’t mean you don’t have them now!
SYMPTOMS: How many times have you been asked in a health care setting, “what color are your nasal secretions” (Interesting question huh?!) This is an important clue to determine the cause of your symptoms. Both conditions may cause a runny nose or nasal congestion but nasal secretions will be consistently clear and watery when you are experiencing allergies. A cold virus may begin with clear nasal secretions but over 3-4 days the mucous becomes yellow/green and opaque as the illness develops. Another important difference is that itching of the eyes, nose, throat, or ears are uncommon with a cold but are very common allergy symptoms. If you have a fever or feel achy, chances are you have a cold and not allergies. It is important to remember that with either allergies or a cold, continued nasal discharge that becomes thick, brown, dark yellow, or green might indicate a sinus infection and may require the use of an antibiotic.
While a cold is a condition that just requires a bit of time to clear up, allergies do necessitate treatment. If you are experiencing allergic symptoms which are persistent in nature, seek the advise of an allergist so that appropriate testing and treatment can be initiated. At Allergy, Asthma, & Immunology, our clinicians and staff are committed to improving your health and your quality of life. We look forward to hearing from you!
One symptom is difficulty swallowing. When the esophagus becomes chronically inflamed it can even spasm and cause food to become lodged or impacted. This is a quite painful reaction, which may result in the individual regurgitating water and saliva. Often these symptoms are quite alarming and patients will seek immediate medical treatment in the emergency room. Fortunately, the symptoms resolve once the food has passed or after it is removed via endoscopy. Foods that typically become impacted are items that are thick in consistency, such as meat, or items that swell with the introduction of fluid, such as bread or rice.
If eosinophilic esophagitis becomes a chronic problem, structural changes of the esophagus may occur. The most common structural changes are the formation of esophageal rings or strictures. These rings in the esophagus cause food to “catch”, and swallowing can be obstructed. If the strictures become severe, a gastroenterologist will perform a procedure called “dilation”. The purpose of this procedure is to break or stretch the rings or adhesions and prevent food from becoming obstructed in the esophagus.
Valley Fever is the common name for Coccidioidomycosis, an infection caused by fungi known as Coccidioides. This fungus is found in the soil in certain lower deserts of the desert southwest including southern Arizona, south and central California, southwestern New Mexico and west Texas. It can also be found in parts of Mexico and Central and South America. The name Valley Fever is actually the shortened older name for Coccidioidomycosis, which was San Joaquin Valley Fever. The association between the disease and the causative agent was made in the San Joaquin Valley in California.
With all this ominous news, how does one know if they have Valley Fever? Well, the incubation period is typically between 7 and 21 days, meaning clinical disease is apparent 7 to 21 days after exposure. Thinking back to our recent Haboob, individuals would start experiencing symptoms around July 12th to July 26th. But symptoms may remain subclinical for weeks or even months. Many times individuals never even realize they had Valley Fever due to the mild nature of their illness. 
There is a special group of individuals that have a unique reaction to aspirin and the NSAlDS. These are a subset of asthmatics. Twenty percent of asthmatics are sensitive to aspirin and NSAIDS. This group of asthmatics have what is called Aspirin Exacerbated Respiratory Disease (AERD). It was originally known as Samter’s Syndrome or Triad Asthma. AERD is a combination of asthma, chronic sinusitis. nasal polyps and then a reaction to aspirin or an NSAlD, This reaction is not a true allergic reaction but an exaggerated response of the body to the biological effect of aspirin or all NSAIDS. This reaction is characterized by watery itchy eyes. runny nose. nasal congestion, sinus-like headache and a severe exacerbation of asthma. An aspirin reaction occurs between twenty minutes and three hours after ingesting the aspirin or NSAlD. 
Hives are a very common condition that our clinic sees on a daily basis; up to 20 percent of the population will have hives at one time or another in their lifetime. Hives have been around a long time, documented as far back as early Egypt on papyrus. Hives, (sometimes called welts) are known by their Latin name “urticaria”. Hives appear as itchy red raised bumps which resemble mosquito bites, but hives may also have clear centers and look like irregular rings. The itching from hives can cause so much discomfort individuals may not be able to sleep at night or have difficulty in concentrating. In addition to itching, hives may also feel warm or burn. In certain situations, hives will come and go as they please with little rhyme or reason. Hives may also form in the deep tissues and cause a dramatic swelling of the body called “angioedema”. Typical locations of angioedema include the lips, eyes, tongue, fingers, toes and even genital areas.