What can I do about my runny nose?
- Posted on: May 16 2024
Some of the more common reasons for clear rhinorrhea are allergic rhinitis, non-allergic rhinitis, vasomotor rhinitis, and CSF (cerebrospinal fluid) leak. A visit with your primary doctor or your ENT specialist can help you differentiate between these causes and choose the right treatment.
The most basic way to help with a runny nose is environmental control. Air purifiers can help eliminate dust, mold, pollen, or other allergens from the environment. The cleaner the air you breathe, the less likely you are to activate inflammation in the nose that might cause rhinorrhea. I recommend one air purifier for the bedroom, one for the living room, and one for your office if you spend a lot of time there.
The next level of care is use of nasal saline rinses. The sooner you remove any irritants from the inside of your nose, the less likely the membranes will keep secreting liquids. This irrigation is done with Neto-pot, NeilMed sinus rinse, or the various other devices that can be purchased over the counter. I recommend doing this at least once a day as long as you have symptoms.
A trial of nasal medications is the next step. Nasal steroids like fluticasone (Flonase), mometasone (Nasonex), etc. can help reduce the inflammation in the nose and reduce secretions. Nasal antihistamines like azelastine (Astelin) act in the different manner to stop the inflammatory cascade of the membranes. Some people also respond to oral antihistamines like loratadine (Claritin), cetirizine (Zyrtec), or fexofenadine (Allegra).
If allergic rhinitis is suspected based on symptoms, it is suggested to undergo allergy testing. This can be done by a blood test, or the more accurate skin test. If certain allergies are found, the patient can be educated on ways to avoid exposure. In certain cases, allergy shots would be recommended.
Some people undergo allergy testing and no specific allergies could be found. In that case, they might be diagnosed with non-allergic rhinitis. Most of the treatment is the same as patients suffering from diagnosed allergies.
CSF rhinorrhea is not common. Some of the features of this condition are runny nose only from one side, very clear and watery secretions with a salty taste, and reservoir sign (sudden rush of fluid with tilting head down). Occasionally this condition happens after head trauma or sinus surgery. The diagnosis is confirmed by sending a sample of the secretions for Beta-2 transferrin test, and by performing CT imaging of the sinuses. Many patients would then need surgery to repair the leak.
Lastly, vasomotor rhinitis is a condition where the mucus glands inside the nose make too much secretions. This could be triggered by certain irritants, eating foods, etc. The medical therapy of choice is ipratropium (Atrovent) nasal spray. For patients who do not respond to this regimen, we recommend cryotherapy (freezing) of an area of the inside nose where the nerves enter the membranes. This procedure is commonly done using the Clarifix device. It can be done with local anesthesia in an office setting. The recovery is minimal, and patients can return to work the following day. Most people need just one procedure, but occasionally some might need a repeat procedure after a few years. You can consult your ENT specialist to see if Clarifix therapy is right for you. See this video below for a description of this procedure.
Tagged with: allergic rhinitis, atrovent, clarifix, crotherapy, ear nose throat, ENT, flonase, Isaac Namdar, Isaac Namdar MD, nasonex, New York, new york city, ny, NYC, Otolaryngology, Otorhinolaryngology, rhinitis, saline rinse, vasomotor rhinitis
Posted in: Nose
