Rhinorrhea

Rhinorrhea, or a runny nose, disrupts the quality of life of a large segment of the population. Rhinorrhea happens when excess fluid drains from the nose. The fluid is mucus that is thin or thick, clear, or opaque, and can be intermittent or constant. The fluid might drip or run out of the nose, down the back of the throat, or both. If it runs down the back of the throat, it's called postnasal drip.

How Does Rhinorrhea Happen?

Anything that irritates the inside of the nose can cause a runny nose. Infections — such as colds, flu, or sinusitis — and allergies often cause runny and stuffy noses. Some people have noses that run all the time without a known reason.

The nose and sinuses normally produce mucus which keeps the nose moist and is typically swept back into the throat and swallowed. Several nasal structures and bodily processes can contribute to a runny nose, including an increase in mucus production and release, an increased vascular permeability, dilation of nasal blood vessels and leakage of fluids through nasal blood vessel walls.

When pathogens cross the mucus lining of the nose. The immune system releases special substances to seek out and destroy the pathogens. Those same substances instruct cells in the nose to generate more mucus to clear out harmful pathogens.

¬The immune system is also involved in allergies. It thinks the allergens are harmful (even though they’re not) and goes into attack mode. The immune system tries to protect the body by releasing histamine. Histamine causes mucous membranes in your nose, eyes, and throat to become inflamed and itchy as they work to eject the allergen. Histamine also causes a runny nose. Allergies typically cause more watery nasal discharge.

Cold Temperatures

Cold, dry air irritates the nasal lining, and as a result, the nasal glands produce excess mucus to keep the lining moist. That can cause heavy drops to drip from the nostrils.

We’re exposed to millions of germs every day that linger on doorknobs, keyboards, and phones. A runny nose is one of the most typical symptoms of the common cold. We are more likely to pick up a cold in the winter because we spend more time inside, and germs are able to survive longer in dry air.

Dry air

Dry air doesn’t only dry out the skin, it can also dry out the nasal passage. This disrupts the fluid balance inside of the nose, causing an inflammatory response and triggering a runny nose.

This can happen in cold weather or when there’s dry air inside of your home due to heat.

Pregnancy

Hormonal changes during pregnancy can also lead to excess mucus and trigger a runny nose. It’s estimated that nonallergic rhinitis affects about 20 percent of pregnant women. In fact, it’s a common issue among women during pregnancy. Patients report nasal congestion as the hallmark feature, but they may also experience clear secretions that vary from watery to thick in consistency. The cause of pregnancy rhinitis is presumed to be the hormonal changes of pregnancy.

A runny nose can develop at any point during pregnancy, but symptoms usually disappear after delivery. Raising the head of the bed about 30 degrees and doing light to moderate exercise may help improve nasal symptoms.

Nasal Polyps

Prolonged causes of allergy or nasal infection may lead to the development of polyps. Nasal polyps are smooth, painless, and non-cancerous outgrowths in the mucosal lining of the nasal cavity. These are grape or teardrop shaped with a watery appearance and are more prominent in men as compared to women. Nasal polyps generally grow in the inflamed tissue of the nasal mucosa. The mucosa swells and becomes red during an allergy or nasal infection and produces fluid that drips out.

Shedding Tears

When your body produces excess tears (such as from crying or an irritant in your eyes), the tears drain through the inner corner of your eyelids, through the nasolacrimal duct and into your nasal cavities. These tears can drip out of the nose and stimulate mucus production, leading to more nasal discharge.

Nasal Foreign Body

If something gets stuck up the nose, it causes your body to create mucus to try to clear it out. Nasal foreign body (NFB) is common in children and usually involves foul-smelling mucus that comes out of one nostril. The most common presentation of an NFB is unilateral purulent rhinorrhea.

Why Does My Nose Run When I Eat?

Gustatory rhinorrhea refers to a condition of excessive and annoying nasal secretions that some persons experience after eating. It may occur after eating certain foods, especially spicy ones, or after any meal. The mechanism of rhinorrhea is probably a simple stimulation of muscarinic parasympathetic nerves.

Lactose intolerance results from deficient intestinal lactase so that dietary lactose ferments in the bowel, with excessive production of gas. Primary lactase deficiency varies in prevalence among different ethnic and geographic populations. Secondary lactase deficiency is transient and may last for 2 weeks or more after an acute gastrointestinal infection. More persistent secondary deficiency complicates chronic gastrointestinal diseases.

Vasomotor Rhinitis

Vasomotor rhinitis (VMR) happens when the tissues inside of the nose become inflamed (swollen). Vasomotor is also called idiopathic rhinitis. It’s a type of nonallergic rhinitis. The inflammation causes unpleasant symptoms most people associate with allergies, like a stuffy or runny nose. However, unlike allergies (allergic rhinitis), VMR doesn’t result from exposure to allergens, like pollen, mold, pet dander, etc. It’s not caused by viruses or bacteria either. Instead, you may experience symptoms because of weather changes, certain smells, eating, exercise, medications, or other triggers that irritate the nose.

Allergic and nonallergic rhinitis (including VMR) affects up to half of the population. VMR accounts for anywhere from 15% to half of these cases.

VMR, unlike allergic rhinitis, doesn’t happen because you’re sensitive to a specific allergen, like tree pollen, dust mites or mold. Instead, various triggers may cause symptoms. It’s likely people with VMR have heightened sensitivity to various substances and environmental changes that would trigger a response in most people — just in higher amounts.

Common environmental triggers include a drop in temperature, air pollution or smog, cold or dry air, perfume or cologne, cigarette smoke, paint fumes, spicy food, or stress.

Certain medications can trigger nasal inflammation and swelling or make it worse. Triggers include: nasal decongestant sprays , some drugs to treat high blood pressure, nonsteroidal anti-inflammatory drugs , hormone medications, antidepressants, and sedatives.

How To Prevent a Runny Nose

Wearing a scarf in cold weather can help, because the air warms before it hits the nose. Frequent hand washing, cleaning surfaces at home and work, sneezing or coughing into the elbow, wearing a mask that fits properly, and staying home when you’re sick are key to avoid picking up and spreading germs. Avoid touching your eyes, nose, and mouth with unwashed hands.

Stay up to date with vaccinations, keep your immune system healthy by eating a balanced diet, exercise regularly, get adequate sleep, avoid areas that will trigger allergic reactions, and avoid secondhand smoke.

Engage in light-to-moderate exercise, an activity that also opens the nasal passages.

Thanks a lot

Dr Magdy Badran