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Respiratory Problems, Age 12 and Older

Topic 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. See a picture of the respiratory system.

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 of an upper respiratory infection include:

  • Facial pain or pressure.
  • A runny or stuffy nose, which may lead to blockage of the nasal passages and cause you to breathe through your mouth.
  • A sore throat.
  • Laryngitis.
  • Irritability, restlessness, poor appetite, and decreased activity level.
  • Coughing, especially when lying down.
  • Fever that occurs suddenly and may reach 103°F (39°C) or higher.

Lower respiratory system

The lower respiratory system includes the bronchial tubes and lungs. Respiratory problems are less common in the lower respiratory system than upper respiratory system.

The symptoms of a lower respiratory (bronchial tubes and lungs) problem usually are more severe than symptoms of an upper respiratory (mouth, nose, sinuses, and throat) problem.

Symptoms of lower respiratory system infections include:

  • Cough, which continues throughout the day and night, often producing green, yellow, brown, or gray mucus (sputum) from the lungs.
  • Fever, which may be high with some lower respiratory system infections such as pneumonia.
  • Difficulty breathing. You may notice:
    • Shortness of breath.
    • Grunting, which is heard during the breathing out (exhaling) phase of breathing.
    • Wheezing.
    • Flaring the nostrils and using the neck, chest, and abdominal muscles to breathe, causing a "sucking in" between or under the ribs (retractions).
  • 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 of a viral illness 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 that usually go away without treatment. Symptoms may include cough, mild sore throat, nasal congestion, runny nose or sneezing, and occasionally a fever.
  • Influenza (flu) symptoms are usually more severe than a cold. The key symptoms in adults are fever and body aches. Headache, eye pain, muscle aches, and cough are also common. For more information, see the topic Influenza (Seasonal Flu).

Antibiotics are not used to treat viral illnesses and do not alter the course of viral infections. Unnecessary use of an antibiotic exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria.

Bacterial infections

Bacterial infections may develop after a viral illness, such as a cold or influenza, and are less common than viral illnesses. Bacterial infections may affect the upper or lower respiratory system. Symptoms tend to localize to one area. 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 smokers, people exposed to secondhand smoke, and people with chronic lung disease (such as asthma or chronic obstructive pulmonary disease [COPD]) and other chronic medical problems. Antibiotics can effectively 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. For more information, see the topic Allergic Rhinitis.

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 difficulty breathing, wheezing, tightness in the chest, and cough.

Asthma often begins during childhood and may last throughout a person's life. The cause of asthma is not clearly known. It is more common in people who also have allergies. For more information, see the topic Asthma in Children or Asthma in Teens and Adults.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Home Treatment

Home treatment can 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.
  • Let yourself cough if you have a cough that brings up mucus from the lungs. It can help prevent bacterial infections. People who have chronic bronchitis or emphysema need to cough to help clear mucus from their lungs.
  • For a sore throat, gargle at least once each hour with warm salt water [1 tsp (5 g) of salt in 8 fl oz (240 mL) of water] to reduce swelling and discomfort. For more information, see the topic Sore Throat.

Keep in mind the following guidelines for taking nonprescription medicine for your symptoms:

  • Use decongestant nasal sprays sparingly and for only 3 days or less. Continued use may lead to a rebound effect, which causes the mucous membranes to become more swollen than they were before you started using the spray. With the right recipe, you can make saline nose drops at home that will not cause a rebound effect.
  • 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 is important to use medicines correctly and to keep them out of the reach of children to prevent accidental use. Check with the doctor before giving these medicines to children.
  • If you have a dry, hacking cough that does not bring up any sputum, ask your doctor about an effective cough suppressant medicine. For more information, see the topic Coughs, Age 12 and Older.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:
Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Alternative medicines or supplements

Many people use alternative medicines or supplements to prevent colds or to shorten their cold symptoms. Before using any treatment for your cold symptoms, it is important to consider the risks and benefits of the treatment. For more information, see the topic Complementary Medicine. Some of the common alternative medicines or supplements used are:

  • Echinacea. Study results differ about whether echinacea can keep you from getting a cold or can help you get better faster. Echinacea can cause severe allergic reactions in some people with a history of asthma, allergies, hay fever, or eczema.
  • Vitamin C. Long-term daily use of vitamin C in large doses does not appear to keep you from getting a cold or help you get better faster. There may be a slight reduction in the length of time cold symptoms last when high doses are taken. Additional studies must be done to determine how much vitamin C is needed to reduce the length of time cold symptoms are present.
  • Zinc. Using a product containing zinc may help shorten the length of your cold by up to a day.1 But you have to take the zinc as soon as you have any cold symptoms. In some cases, zinc products that you spray or place into your nose can cause permanent loss of the sense of smell.2

If you decide to use an alternative medicine or supplement, follow these precautions:

  • As with all conventional medicines and supplements, it is important to follow the directions on the label.
  • Do not exceed the maximum recommended dose.
  • If you are or could be pregnant, talk with your doctor before taking any medicine or supplement.
  • If you have another health problem or take prescription medicines, talk with your doctor before taking an alternative medicine or supplement.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Increasing difficulty breathing develops.
  • Wheezing develops.
  • New chest pain develops.
  • Symptoms last longer than 2 weeks.
  • Symptoms become more severe or frequent.

Prevention

There is no sure way to prevent respiratory illnesses. To help reduce your risk:

  • Wash your hands often, especially when you are around people with colds.
  • Keep your hands away from your nose, eyes, and mouth. These are the places where viruses are most likely to enter your body.
  • Do not smoke or use other tobacco products. Smoking irritates the mucous membranes of the nose, sinuses, and lungs, which may make them more susceptible to infections. For more information, see the topic Quitting Smoking.
  • If you live an area that has problems with air pollution or smoke from wildfires:
    • Stay indoors and avoid breathing in smoke, ashes, or polluted air.
    • Do not exercise outdoors if you smell smoke or notice irritation of your eyes, nose, or throat.
    • Keep your motor vehicle windows rolled up and the vents closed when driving.
  • Avoid cleanup activities, such as raking leaves or cutting brush.
  • Avoid exposure to chemicals. Do not spray or apply chemicals unless you are wearing protective clothing, such as a particle-filtering respirator, safety goggles, and gloves.
  • Exercise regularly. For more information, see the topic Fitness.
  • Get a flu shot (influenza vaccine) each year. For more information, see the topic Influenza (Seasonal Flu).
  • Get a pneumococcal shot(What is a PDF document?) if you are age 65 or older; if you have chronic lung disease, such as asthma or chronic obstructive pulmonary disease (COPD); if you smoke; or if you have a health risk that increases the seriousness of your symptoms.
  • Make sure your immunizations are current, such as pertussis to reduce your risk of getting whooping cough. For more information, see the topic Immunizations.
  • For information on preventing allergies or asthma, see the topic Allergic Rhinitis or Asthma in Teens and Adults.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • When did your symptoms start?
  • Is your respiratory problem localized, such as involving only one ear, one side of your sinuses, or the lungs?
  • Did symptoms start as a cold but now appear to be worse than you would expect from a cold?
  • Have you had similar symptoms before? How were they treated?
  • Do you have a productive cough? Are you coughing up clear, white, green, yellow, or blood-tinged mucus? How much mucus are you bringing up? Are you coughing up mucus all day long or mostly at nighttime?
  • Have you had fever and chills?
  • Are you wheezing, or do you have new or worsening shortness of breath?
  • Do you have a severe headache, earache, or sore throat?
  • Do any other members of your family or work group have similar symptoms?
  • Have you recently been exposed to large amounts of dust, fumes, smoke, or chemicals?
  • Do you smoke or use other tobacco products?
  • Have you recently used an indoor hot tub, pool, or spa?
  • What home treatment have you tried? Did it help?
  • What prescription, nonprescription, or alternative medicines have you tried? Did they help?
  • Have you recently traveled inside or outside of your home country?
  • Do you have any health risks?

References

Citations

  1. Singh M, Das RR (2011). Zinc for the common cold. Cochrane Database of Systematic Reviews (3).
  2. Davidson TM, Smith WM (2010). The Bradford Hill criteria and zinc-induced anosmia: A causality analysis. Archives of Otolaryngology—Head and Neck Surgery, 136(7): 673–676.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer David Messenger, MD
Last Revised December 21, 2011

Last Revised: December 21, 2011

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & David Messenger, MD

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