Heavy head, running nose

Tapti woke up this morning with body pain. Her nose is running and she is sneezing often. She has travelled from Madurai and is convinced that the change of water has made her come down with a cold. Her mother-in-law, however, swears that the cold came on because she had curd rice last afternoon, immediately after coming in sweating from the hot sun. Is either of them right about the cause of Tapti's cold?

What causes a cold?

A virus causes the common cold. Nasal congestion, sneezing, and runny nose are the usual symptoms. Drinking cold fluids, eating curds or ice cream does not cause a cold. A cold virus spreads through tiny, air droplets that are released when an infected person sneezes, coughs, or blows his nose. That is why travelling or working in a crowded place exposes you to the virus. Children in classrooms are particularly susceptible to picking up the virus from their schoolmates. You can even get a cold when you touch your nose, eyes, or mouth after you have touched something contaminated by the virus.

The viruses that cause colds provoke inflammation that increases the leakage of fluid from the blood vessels into the lining of the nose and into the nose. The swelling of the lining of the nose causes the feeling of a ‘blocked nose' and also leads to a runny nose.

Treatment for a cold

The old saying goes, ‘Without treatment a cold will last a week and with treatment it will last only for seven days!' The fetish for avoiding ‘cold' food such as curds, cold water and juices when you have a cold or cough has no basis in science.

For short-term relief of nasal congestion, nasal decongestants can be used. Nasal decongestants are chemicals (for example, pseudoephedrine and oxymetazoline) that decrease the swelling of the lining of the nose. This relieves the ‘blocked' nose. Nasal decongestants can be used topically within the nose (as nasal drops or spray) or can be taken orally as tablets. Steam inhalation with a menthol preparation can also relieve the symptoms of a cold.

Oral nasal decongestants frequently are combined with an antihistamine, a cough suppressant, or an analgesic in treating cold, flu or allergy symptoms.

Paracetamol and ibuprofen are excellent for relieving the headaches and body pain that accompany a cold and cough.

Cough

A sore throat and cough are usually the result of a viral infection. Most of these will run a benign course and need only symptom relief. However, a cough persisting for more than two weeks or a cough that is associated with chest pain, fever, weight loss, or blood-tinged or discoloured sputum, should be evaluated by a doctor.

Treatment for a cough

Oral cough suppressants

Dry, hacking coughs particularly respond to cough suppressants. Dextromethorphan is an oral cough suppressant that is available over-the counter (OTC). Dextromethorphan acts on the brain to suppress the cough. Diphenhydramine is another non-narcotic medication that acts on the brain to suppress cough. It is also an antihistamine and is found in common cough syrups available OTC. A doctor might prescribe a cough syrup containing codeine which is an oral cough suppressant that is particularly effective for bouts of uncontrollable coughing.

Oral expectorant

Guaifenesin is an oral expectorant that liquefies the thick mucous in the airways and facilitates the clearing of the mucous by coughing. Clearing of mucous from the airways decreases cough.

Topical medications

Camphor and menthol are active ingredients in many topical cough medications. Camphor and menthol ointments are rubbed on the throat and the chest and their vapours help relieve the cough. They are also available as products for steam inhalation. Menthol is also available as lozenges.

When do you need antibiotics?

Common colds and coughs do not need antibiotics. It is a shame that children and adults are loaded with antibiotics the minute they develop any symptom. This only makes them resistant to antibiotics and will make them susceptible to life-threatening bacteria. Antibiotics need to be prescribed only if there is definite proof of an ear infection or sinusitis.

Influenza or ‘flu'

Influenza is caused by a virus and may present with fever, body ache, cold and cough. The treatment is to relieve the symptoms. No antibiotics are required. Plenty of fluids and a normal diet are recommended.