It’s that time of year when plugged noses and sinus pressure seemingly are a constant companion and complaint.

Influenza remains widespread in Nebraska, and a variety of other respiratory illnesses are circulating as usual.

To top it off, recent cold weather and dry, inside air also may be producing what one local doctor calls “winter sinuses.”

They feature the kind of irritation, sneezing, congestion and even burning that can wake sufferers at night. With a bit of time, and some nose-blowing and ample fluid intake, they sometimes ease during the day. Symptoms might worsen again overnight.

How do you know when it’s time to call the doctor? And what can you do at home to relieve symptoms?

It’s important for people to know when antibiotics are appropriate — or not — when it comes to sinus problems, said Dr. Bob Recker, an internist at the Think clinic at 7100 West Center Road.

Antibiotics are appropriate treatment for sinus infections caused by bacteria. But they’re not for the viral variety.

Medical professionals are being encouraged to try to make sure they’re prescribing antibiotics properly given concerns that overprescribing can lead bugs to develop resistance.

But it can be difficult to tell the types of infections apart, Recker said, because there’s no clear-cut difference between them. The symptoms — congestion, drainage and pain — overlap.

Typically, symptoms that last longer than 10 days suggest a bacterial infection, said Recker, who also is medical director of Think’s urgent care.

Another sign — and a good indicator for antibiotics — is what Recker called a double-worsening: a patient has a cold, symptoms appear to get better after three to five days, and then start to worsen.

In such cases, the fluid in the sinuses, the cavities around the nasal passages, can act as an incubator for bacteria.

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For patients who’ve had symptoms for shorter time periods, he said, health care professionals recommend treating symptoms at home.

Recker, who suffers from winter sinuses himself, uses oral decongestants.

Patients, however, should clear those medications with their doctor, he said. Some can have side effects.

Pain relievers and antihistamines also can help with cold symptoms.

Nasal sprays such as Flonase, a corticosteroid, can help with inflammation and irritation from dry conditions that seem to persist even in homes with whole-house humidifiers. “It still doesn’t seem to match the kind of humidity you get in the warmer months,” Recker said.

Of course, severe symptoms can indicate a problem that should be dealt with before the general 10-day mark. “This is medicine,” he said. “There are always exceptions.”

Is there anything you can do to prevent seasonal misery in the first place?

The common cold

Not directly. But your best shot is proper hygiene. Wash your hands frequently — and properly, using soap and water and humming the “Happy Birthday” song twice through — especially after you’ve been out among other people.

Cover your coughs, avoid sick people and stay home if you’re sick. Same goes for the kids.

Sinus infections

If you keep ahead of the congestion, you may be less likely to develop a sinus infection. Use saline nasal rinses, but be careful. You can overdo.

Manage symptoms with decongestants, checking first with a doctor, and pain relievers. Get plenty of rest and fluids.

Julie Anderson is a medical reporter for The World-Herald. She covers health care and health care trends and developments, including hospitals, research and treatments. Follow her on Twitter @JulieAnderson41. Phone: 402-444-1066.

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