Does patient suffer from gustatory rhinorrhea?

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Q: I am 85 years old. My problem is both frustrating and embarrassing. When eating, my nose runs profusely as though I have a cold. I am on Xanax that I take for anxiety. Do you think it’s my medication or is there another cause?

A: Believe it or not, this is a common occurrence. The condition may be gustatory rhinorrhea or vasomotor rhinorrhea. Common causes may include consuming hot or spicy foods, a food allergy, or even hay fever. Or, you may have vasomotor rhinorrhea, a condition in which the nasal membranes respond to specific stimuli by producing watery mucus.

Some individuals with an allergy may experience a runny nose, excessive sneezing, or nasal congestion. A nose will run because of irritation and inflammation within the sinus cavity from elevated levels of histamine. Histamine is a part of the body’s natural allergic response to specific substances such as pollen. The eyes may become watery and itch or burn. The sinuses may become congested. The stomach may have cramps and diarrhea may occur. And, the nose may itch and produce mucus. When a person consumes something he or she is allergic to, the body produces antibodies and histamines to protect itself from bacteria and infection. Interestingly, histamines are in a number of the foods we eat, including sour cream, dried fruits, anchovies, beer, wine, yogurt, mayonnaise, pickles, and a whole lot more. Medications that may cause or exacerbate a runny nose include antidepressants, alpha blockers and beta blockers for high blood pressure, birth control pills and some medications for prostatic enlargement.

The answer is a simple one. You may benefit from a nasal or systemic antihistamine or a nasal steroid. Then too, Ipratropium bromide distributed as Atrovent nasal spray used prior to a meal may markedly reduce or completely diminish the habit. This bronchodilator relaxes airway muscles and is used to prevent narrowing of the airways in the lungs in individuals who suffer from COPD, emphysema and bronchitis. This prescription medication has been approved by the FDA for allergic and non-allergic rhinitis. Possible side effects may include blurred vision, pain or burning on urination, a stuffy nose or dry mouth, headache, and more. On the upside, the nasal spray isn’t addictive.

The symptoms of vasomotor rhinorrhea (rhinitis) lack an allergic reaction. Triggers may include stress, changes in the weather, a viral infection, second-hand smoke, perfumes or after shave products, and certain odors or irritants that are inhaled. Medications referred to earlier in my answer that place individuals at higher risk include beta blockers for hypertension, ibuprofen, aspirin, anti-depressants, and sedatives. Symptoms may include a runny nose, sneezing, post nasal drip and a stuffy nose. The symptoms may last for a mere few hours, or they may last for days.

Treatment may be in the form of corticosteroid nasal sprays, antihistamine nasal sprays, decongestants taken by mouth, decongestant nasal sprays, and others. An alternative treatment is intranasal capsaicin.

The place to begin is with your primary care physician who can ask the all-important questions, perform a complete examination, and perhaps order testing to diagnose exactly what it is that causes your unwanted problem. Make an appointment today so you can get to the bottom of this issue and get on with more pleasant things in your life.

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