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  • Writer's pictureDr. Koralla Raja Meghanadh

Rhinorrhea - Runny Nose


What is Rhinorrhea?

Rhinorrhea, commonly known as a runny nose, occurs when there's a watery discharge from the nose.


Runny noses occur when the nasal lining (mucosa) secretes a thin fluid in response to irritants like dust, chili powder, or spices.


Rhinorrhea - Runny Nose

Runny Nose Causes

  1. Eating food - Gustatory Rhinitis

  2. Viral infections

  3. Bacterial Infections

  4. Pollution or bad quality of air

  5. Allergy

  6. Sinusitis


Runny nose while eating food - Gustatory Rhinitis

Sometimes, while eating food, few get a runny nose. A runny nose while eating in the elderly is more common.


The term commonly used for this condition is Gustatory Rhinitis, which occurs due to the proximity of the mouth's salivary glands and the nose's mucin-secreting glands. Here's how it happens:


  1. Saliva Production: Our brain sends signals to produce saliva when we eat. This saliva helps with chewing and starts the digestion process.

  2. Cross-Stimulation: In some people, the nerves controlling saliva and nasal secretions are close enough that stimulating the salivary glands also triggers the nasal glands, causing a runny nose.


This condition is harmless and doesn't require treatment.


It's common in some people, and runny noses are more common in the elderly. You can safely ignore it.


The common term for this is "gustatory rhinitis." However, since "rhinitis" usually implies inflammation or infection, which doesn't occur in this condition, the more accurate terms are "gustatory rhinorrhea" or "gustatory stimulation."


Infections that cause Rhinorrhea

  • Viral Infections: Produce watery, thin discharge.

  • Bacterial Infections: Cause thick, purulent discharge that is yellow or white.


Rhinorrhea - Runny Nose Causes

Runny Nose from Bad Air Quality and Pollution

Pollution and bad air quality can irritate the nose and cause rhinitis. Rhinorrhea, or a runny nose, is a symptom of rhinitis. Therefore, you will likely experience a runny nose when you catch a nasal infection.


Runny Nose from Allergy

Allergies can impact the mucosal lining of the respiratory tract. When they affect the mucosa in the nose, it leads to rhinorrhea.


Acute allergies typically cause a thin, watery discharge, whereas long-standing allergies can result in a thick, purulent discharge.


Rhinorrhea - Sinusitis Symptom

Sinusitis is when the walls of the sinus cavity become infected. These walls have a mucosal lining, the same lining that runs in the nose, throat, Eustachian tube, and lungs. This mucosal lining secretes fluids to keep itself clean. When there is an infection, the lining produces more fluids than usual.


If the sinuses are infected, the mucosal lining in the sinuses secretes more fluids. These fluids travel through the nose, back of the nose (nasopharynx), throat, and into the stomach. If the sinus infection is severe, the increased fluids can also come out from the front of the nose, causing a runny nose or rhinitis.


Rhinorrhea is unlikely to occur in chronic sinusitis, but it can occur in the other three stages of sinusitis: acute, subacute, and acute on chronic.


Types of rhinorrhea

Based on the density of the discharge in a runny nose, rhinorrhea can be divided into two types.

  • Thin Rhinorrhea: It can be caused by viruses, acute allergies, gustatory stimulation, or the early stages of bacterial sinusitis.

  • Thick Rhinorrhea: Result of bacterial infections, long-standing allergies, or bacterial sinusitis.


Diagnosis

While rhinorrhea is easily identified, diagnosing the cause can be done based on patient input and sometimes may require a diagnostic nasal endoscopy. For sinusitis, this can reveal edema, polyps, or fungal presence.



Treatment and Preventive Measures

We need to understand the cause and treat it.


  1.  Allergens: Understand what you are allergic to, for which you will need an allergy test. Avoid the allergens and treat your allergies with the appropriate medication suggested by your doctors.

  2. Pollutants: Avoid pollution. Try using a mask. Although masks meant to protect you from pollution are expensive and very uncomfortable to breathe, You can use a wet mask instead, which will reduce your exposure to pollutants, although it is not a definite solution. A simple surgical mask with a little sprinkle of water on it will attract the dust easily. You can do saline irrigation or spray saline into the nose to prevent the effect of the irritation from pollution. You can prepare this solution at home. Take half a liter of water, boil it, and add a spoon of salt to it. You can use this water for nasal irrigation, for which you can use Netipot. This will reduce the effect of the pollution and clean the nose.

  3. Viral infection: We can use Xylometazolene and Oxymetazolene nose drops to get relief. Use it two times a day, two drops in each nostril each time. Do steam inhalations. This not only gives you relief but also prevent the spread of the disease from one part to other and transition of the disease to bacterial infection. We additionally advice antivirals too which needs to be prescribed by the doctor.

  4. Bacterial Infections: For bacterial infections, it is better to get an appropriate diagnosis from a doctor and get a prescription for suitable antibiotics for your condition.

  5. Gustatory Rhinitis or runny nose while eating: As mentioned earlier there is no infection or any problem involved in this condition, so it doesn't need any treatment. There is no need to even follow any preventive measure, because this is not a problem.


Complications

Except for Gustatory Rhinorrhea, runny nose due to other causes like viral or allergy can turn into a bacterial infection if not treated.


Viral Rhinorrhea is said to subside within a week if treated or not. However, treating it will reduce the possibility of it turning into a bacterial infection, which is 2 to 3% will be reduced. Complications of runny nose, such as viral laryngitis, viral pharyngitis, bronchitis, asthma attacks, and otitis media, can be prevented easily.



Frequently Asked Questions (FAQs)

How long does rhinorrhea last?

The duration of rhinorrhea or runny nose depends on the cause.

  • Allergies: Lasts as long as the allergic reaction persists.

  • Viral Infections: Typically lasts up to 5 days; beyond that, a secondary bacterial infection may be suspected.

  • Bacterial Infections: Continues until treated.

  • Pollution: Till the rhinitis subsides or is treated.

  • Gustatory Rhinitis: Only lasts a few minutes while eating.

  • Sinusitis: As mentioned earlier, a runny nose (rhinorrhea) does not occur in chronic sinusitis. Here's a breakdown of how long rhinorrhea can last during sinusitis:

    • Acute Stage: When sinusitis starts and is untreated, it might last for about 15 days. During this time, rhinorrhea is common.

    • Subacute Stage: If the sinusitis symptoms persist beyond 15 days, they can continue for another 30 days. This means the total duration of rhinorrhea is about 45 days. In these 30 days, the severity will be lesser than in the first 15 days.

    • Chronic Stage: After 45 days, sinusitis can become chronic. In this stage, a runny nose is very unlikely.

    • Acute on Chronic Stage: If your immunity drops, chronic sinusitis can turn into acute on chronic sinusitis. This means the runny nose and other symptoms can return and could be more severe than before. These symptoms will last until your immunity improves.

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