6 Things You Should Know About Chronic Runny Nose

Hitting the sales to stock up on tissues? Constant sniffing and wiping? Wondering if you’re going to need to leave a meeting or social event because your nose is running? A chronic runny nose is more than an annoyance. It can significantly affect your quality of life.

“People with a chronic runny nose are forced to keep tissues on themselves at all times to prevent mucus from running down their face,” says John Craig, M.D., an ear, nose and throat (ENT) surgeon who specializes in rhinology (the care and treatment of the sinuses and nasal cavities) at Henry Ford Health.

Dr. Craig notes that there are six key takeaways about a persistent runny nose:

1. Mucus is beneficial. The inner lining of the nose, known as the mucosa, contains different types of mucus glands. Mucus often gets a bad rap, but it actually serves several important roles in your health. Mucus lubricates your nasal and sinus passages, protecting this important tissue from drying out. It also helps trap bacteria and other contaminants before they can reach your lungs and other parts of your body. And it contains antibodies, enzymes and proteins to help fight these invaders.
2. But too much is not. “While some mucus is good, when the nerves that supply the mucus glands become overactive, these glands can create more than your body needs,” Dr. Craig says. “This excess mucus can then run out of your nose, or down the back of your throat. Or both.”
3. Runny nose may only be part of the problem. For some people, runny nose is the only symptom. For others, it can be accompanied by inflammation of the mucosa, a condition known as rhinitis. This inflammation can lead to a blockage of airflow in your nose, and also may (or may not) have runny nose as a symptom.
4. It’s important to get the diagnosis right. Rhinitis also may occur with allergies (allergic rhinitis) or without (nonallergic rhinitis). And some people get a mixed form of these two conditions. They may even get runny nose as the result of another condition. “For example, if you have chronic sinusitis or if your septum, the piece of bone and cartilage that divides your nose in half, is deviated or crooked, these can also cause a chronic runny nose or other nasal issues,” Dr. Craig says.
5. There may be specific triggers. For some, these can be related to seasonal allergies or other allergies, such as those related to pets or food. Other common triggers can include food, alcohol, emotional or hormonal changes (such as those associated with pregnancy), temperature change, and common environmental irritants, such as dust or cigarette smoke.
6. In rare cases, a runny nose may be a sign of a more serious condition. This could include a tumor, polyps or a foreign body that’s lodged in the nasal tissue. It can even be fluid from around your brain, masquerading as mucus. “Especially if you have a one-sided, runny nose with watery mucus, you should get assessed for a potential cerebrospinal fluid leak,” Dr. Craig says.

How Do You Treat Runny Noses?

“Some people think it’s a part of life, but you don’t have to live with a chronic runny nose,” Dr. Craig says.

There are steps you can take yourself. This includes:

• Over-the-counter antihistamines and nasal steroid sprays: Antihistamines help to address runny nose generally caused by allergies by blocking a chemical known as histamine, which makes your mucosa swell up and get itchy. Nasal steroid sprays can help relieve the swelling and congestion in your nasal passages by reducing inflammation and fluid in your mucosa. Either or both may provide temporary relief, and may give enough relief to not require seeing your doctor.
• The importance of fluids: While it may seem counterproductive, keeping your nose from getting too dry can also help, because a dry nose can cause your body to overreact and produce too much mucus. Stay hydrated by drinking enough water and other fluids. Some people also find relief by lubricating the nasal passages with a saline rinse.
• Identify your triggers: If you can identify specific triggers that cause your nose to run, you can work to avoid these. Knowing these also can help when providing a history to your doctor.
• Allergic rhinitis treatments: If you suspect you may have allergies, you can undergo allergy testing. Once a diagnosis has been made, there are several potential treatments, which may include topical nasal steroid sprays or other sprays, or even allergy shots, a form of immunotherapy.
• Nonallergic rhinitis treatments: If you are not allergic, another type of nasal spray known as an anticholinergic spray may provide relief, but this must be prescribed by a physician.
• Intranasal cryotherapy: This is a new treatment that freezes the nasal nerves in the back part of the nose, and is less invasive than surgery. “Anyone who has a watery, runny nose and is not responding adequately to sprays is a potential candidate,” says Dr. Craig, who is one of the few doctors in the nation to offering this advanced treatment. “This includes people with both allergic and nonallergic rhinitis.”
• Surgery: In severe cases where no other treatment works, there are surgical options, including a procedure that severs the nerves that are causing the glands to produce too much mucus. While it is usually successful, a long discussion should be had with your surgeon about potential risks as well.

To schedule an exam with an otolaryngologist, visit henryford.com or call 1-800-HENRYFORD (436-7936).

John Craig is the Henry Ford Division Chief of Rhinology in the Department of Otolaryngology, and is a co-director of the Pituitary, Skull Base, and Endoscopy Center in conjunction with the Department of Neurosurgery. He sees patients at the Henry Ford Medical Center – Fairlane in Dearborn and at Henry Ford West Bloomfield Hospital.