October 03rd, 2022

Prairie Doc® Perspectives for week of October 2nd, 2022
​Sniff, sniff, sniff.  That darned runny nose. 
by Andrew Ellsworth, M.D.

When your nose runs, although it may not slow you down, it can be annoying. This time of year it’s difficult to know if your runny nose is from a cold, allergies, or another reason. 

Rhinitis can be broadly defined as inflammation of the nasal membrane.

Sometimes a runny nose is from allergies, caused by allergens in the air, such as trees, grass, weeds, molds, dust mites, or pet dander.  Allergy symptoms often include sneezing, an itchy or runny nose, and itchy, watery or red eyes.  

A runny nose can also be caused by a virus, like a cold. As the weather changes and with school back in session, people tend to spend more time indoors which allows airborne viruses to spread more easily. Cold symptoms may include a runny nose, as well as sneezing, sore throat, cough, and congestion. 

Be careful with nasal decongestants. While sprays may temporarily treat rhinitis, regular use of them can cause a rebound effect called rhinitis medicamentosa. Subsequently, a person may use the sprays more, causing a vicious circle. To avoid the rebound effect, try to limit the use of decongestant sprays to less than five days.

Sometimes a runny nose will not ever seem to go away. If allergy pills, steroid nasal sprays, or a change in environment do not help your chronic runny nose, it may be time to consider other causes.  

For many of these causes, your primary care provider can help you sort them out and come up with a treatment plan. There are other treatments beyond avoidance and steroid nasal sprays, such as certain inhalers. As always, talk with your doctor to determine if other factors such as polyps, tumors, or a systemic disease could be causing your condition. 
Accounting for more than half of all non-allergic rhinitis is vasomotor rhinitis. Vasomotor rhinitis is an exaggerated reaction to irritants such as air pollution, perfumes, or temperature changes, especially cold, dry air. 

Cigarette smoke, alcohol, cocaine, and occupational exposures may cause a runny nose along with different medications, such as aspirin or some blood pressure pills. Certain conditions such as pregnancy, acid reflux, as well as the use of your CPAP machine for sleep apnea have been known to affect the nasal membranes.  
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Personally, I know that if I eat something spicy or hot in temperature, I am going to need a Kleenex, for my gustatory rhinitis.  While there might not be a cure for your runny nose, sometimes it is just nice knowing the cause, because I am not going without my favorite pad Thai meal.