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A 29-year-old female asked:

I have had major congestion for about the past week. should i see a dr? it started out as just a clear runny nose at the end of a cold. now it's more yellowish green and there is lots of pressure in my head/ears. i've been taking sudafed, which helps on

2 doctor answers3 doctors weighed in
Dr. Bobak Ghaheri
ENT and Head and Neck Surgery 23 years experience
Generally : Generally speaking, i recommend that patients see a doctor when one of two criteria are met: 1) you have a cold that is not getting better after 7 days. Before 7 days, there's no way that a doctor can reliably tell if you have a bacterial vs viral infection. After 7 days, the odds are that it's bacterial, so if you have other signs of infection, antibiotics may be indicated. 2) if you are sick, and as you start to get better, you suddenly worsen (i call this "double worsening"). This indicates a bacterial superinfection on top of an initial viral infection. While sudafed can help, it can also dry out your secretions, making them hard to expel. I would recommend steam, lots of nasal saline spray, and even Mucinex (guaifenesin) to help loosen stuff up until you can get into a doctor for evaluation.
Dr. Tal Dagan
ENT and Head and Neck Surgery 24 years experience
Your : Your symptoms started out as a steretypical viral upper respiratory tract infection/inflammation. Nasal congestion, clear nasal discharge with an occasional facial pressure are likely in the first few days due to the effect of the virus on the mucosal lining of the nose ad sinuses. Sudafed is helpful initially (in the first few days) because of its effect on the nasal anatomy. In generalm it has a drying effect and it can help to shrink the mucosal swelling down to a certain degree which can provide relief from both obstruction of the drainage tracts of the sinuses into the nose and the nasal congestion as well as providing some dryness for a runny nose. However, swelling o the tissues especially in the relatively narrow straights connecting between the sinuses and the nose causes a lack of drainage. Think of a pond that has no influx of water and no outflow to drain to - growth of algea and harmful bacteria is almost assured. The sinuses are hollow cavities in the face that have a lining that secretes mucous. The sinuses are covered with bacteria normally but when the outflow tracts of the sinuses become clogged, there is bacterial overgrowth and an infection ensues. This causes the yellow green nasal discharge that you are experiencing. The build up of pressure inside the sinuses causs the increased pressure in the head (specifically around the forehead, cheeks, or behind the eyes). The flow of infected mucous past the back of the nose affects the connection between the ears and the nose, a channel called the eustachian tube. Inflammation of the eustachian tube can lead to difficulty equalizing the pressure between the middle ear and the nose which can lead to pressure or pain sensation in the ear, popping, crackling in the ears which will only resolve with treatment and resolution of the nose and sinus infection. At this point, i recommend an appointment with an ear nose and throat doctor who can examine you, get more information and treat the likely infection with antibiotics, steroid nasal spray (which does no affect the rest of the body - only a local effect) and some mucinex (guaifenesin).

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Last updated Oct 4, 2016

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