Overview

Most adults and older children have several respiratory infections each year. Respiratory problems can be as minor as the common cold or as serious as pneumonia. They may affect the upper respiratory system (nose, mouth, sinuses, and throat) or the lower bronchial tubes and lungs.

Upper respiratory system

The upper respiratory system includes the nose, mouth, sinuses, and throat. When you have an upper respiratory infection, you may feel uncomfortable, have a stuffy nose, and sound very congested. Other symptoms include:

• Pain or pressure in the face.
• A runny or stuffy nose. It may lead to blocked nasal passages that cause you to breathe through your mouth.
• A sore throat.
• A raspy or hoarse voice (laryngitis).
• Feeling grouchy or restless, having a poor appetite, and being less active than usual.
• Coughing, especially when you lie down.
• Fever.

Lower respiratory system

The lower respiratory system includes the bronchial tubes and lungs. These types of problems are less common than ones in the upper respiratory system. But their symptoms are usually more severe.

Symptoms include:

• A cough that lasts through the day and night. It often brings up green, yellow, brown, or gray mucus (sputum) from the lungs.
• Fever. It may be high with some infections such as pneumonia.
• Difficulty breathing. You may notice:
  • Shortness of breath.
  • Wheezing.
  • Using the neck, chest, and belly muscles to breathe. This causes a "sucking in" between or under the ribs (retractions).
  • Flaring the nostrils when breathing.
• Chest pain with exertion or when you take a deep breath.

Respiratory problems may have many causes.

Viral infections

Viral infections are the most common cause of upper respiratory symptoms. Symptoms often come on quickly (over hours to a day or two) without prior illness. Common viral illnesses include colds and influenza (flu).

• Colds are minor upper respiratory illnesses. They usually go away without treatment. Symptoms may include a cough, a mild sore throat, nasal congestion, a runny nose or sneezing, and sometimes a fever.
• Influenza (flu) symptoms are usually more severe than a cold. Symptoms in adults include a fever and body aches. A headache, eye pain, muscle aches, and a cough are also common.

Antibiotics aren't used to treat viral illnesses. They don't change the course of viral infections. Using an antibiotic when you don't need one exposes you to the risks of an allergic reaction and antibiotic side effects. These side effects include nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill helpful bacteria and encourage the growth of antibiotic-resistant bacteria.

Bacterial infections

Bacterial infections are less common than viral illnesses. They may affect the upper or lower respiratory system. In the upper respiratory system, the most common sites of bacterial infections are the sinuses and throat. In the lower respiratory system, the most common site is the lungs (pneumonia).

Bacterial infections are more common in people who smoke, are exposed to secondhand smoke, or have chronic lung disease (such as asthma or chronic obstructive pulmonary disease [COPD]) and other chronic medical problems. Antibiotics work well to treat most bacterial infections.

Allergies

Allergies, especially hay fever, are another common respiratory problem. Symptoms include sneezing, clear runny drainage from the nose and eyes, itchy eyes or nose, and stuffy (congested) ears and sinuses. The symptoms of allergies often last longer than a typical viral respiratory infection.

Asthma

Asthma is a chronic disease of the respiratory system. It causes inflammation and narrowing in the tubes that carry air to the lungs (bronchial tubes). The inflammation leads to coughing, wheezing, tightness in the chest, and trouble breathing.

Asthma often starts during childhood. It may last throughout a person's life. The cause isn't clearly known. Asthma is more common in people who also have allergies.

Self-Care

Here are some things you can do at home to help you feel more comfortable when you have mild to moderate respiratory symptoms.

• Prevent dehydration.
  • Hot fluids, such as tea or soup, may help relieve congestion in your nose and throat.
  • If you have a productive cough, fluids may help thin the mucus in your lungs so your cough can clear it out.
• Get extra rest.

  Let your symptoms be your guide. If you have a cold, you may be able to stick to your usual routine and just get some extra sleep.

• Cough to clear your lungs.

  Let yourself cough if you have a cough that brings up mucus from the lungs. Coughing can help prevent bacterial infections. People who have chronic bronchitis or emphysema need to cough to help clear mucus from their lungs.

• Use saline (salt water).
  • For a sore throat, gargle at least once each hour with warm salt water. Use 1/2 teaspoon (2.5 mL) salt mixed in 1 cup (250 mL) warm water. This can reduce swelling and discomfort.
  • For a stuffy nose, use saline spray or nose drops to wash out mucus and germs.
• Try moist air.

  Try a vaporizer or humidifier to add moisture to the room. Cool mist may help relieve symptoms. Follow all cleaning instructions and precautions for the machine.

• Be careful with over-the-counter medicines.
  • Carefully read and follow all directions on the medicine bottle and box. Be aware of possible side effects. And make sure to keep medicine out of the reach of children.
  • If you use a decongestant nasal spray, don't use it longer than the label says. Overuse may lead to a rebound effect. This causes the mucous membranes to become more swollen than they were before you started using the spray.
  • If you have a dry, hacking cough that doesn't bring up any sputum, ask your doctor or pharmacist about an effective cough suppressant medicine.
  • Nonprescription medicines may not work very well for respiratory problems. And some of these medicines can cause problems if you use too much of them. It's important to use medicines correctly.
• Be careful with dietary supplements.
  • If you decide to try a dietary supplement such as echinacea or zinc, don't take more than the maximum recommended dose. If you have another health problem or take prescription medicines, talk with your doctor before you take an alternative medicine or supplement.

Using decongestants

Here are some precautions to take when using decongestants.

• Be safe with medicines. Read and follow all instructions on the label.
• Decongestants may not be safe for young children. The U.S. Food and Drug Administration (FDA) recommends not using over-the-counter cough and cold medicines in children younger than age 2. The FDA also recommends avoiding these medicines for children younger than age 4.^{footnote 1} If you use these medicines, always follow the directions about how much to use based on age and in some cases weight. Not everyone needs the same amount of medicine.
• Decongestants can cause problems for people who have certain health problems, such as heart disease, high blood pressure, glaucoma, diabetes, or an overactive thyroid. Decongestants may also interact with some drugs, such as certain antidepressants and high blood pressure medicines. Read the package carefully or ask your pharmacist or doctor to help you choose the best decongestant for you.
• Drink extra fluids when you are taking cold and allergy medicines.
• Don't use decongestant nasal sprays, drops, or gels more times in one day or for more days in a row than the label says. Overuse can cause rebound congestion. It makes your mucous membranes swell up more than before you used the spray.
• If you are pregnant or breastfeeding, check with your doctor or pharmacist before using a decongestant.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse trouble breathing.
• New wheezing.
• New or worse cough.
• Symptoms occur more often or are more severe.

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