Medical Edge Newspaper Column

When Food Sets Off a Runny Nose

April 16, 2007
Dear Mayo Clinic:
I don't have hay fever or any other allergies, but I have a clear, watery discharge from my nostrils during meals. This is very exasperating and embarrassing, especially when I'm out with friends at restaurants. What might be the cause of this, and can it be treated? -- Oak Lawn, Ill.

Answer:
The condition you describe is actually quite common. Clear, watery drainage from both nostrils that occurs while eating is a form of nonallergic (or vasomotor) rhinitis. Specifically, your condition is called gustatory (relating to taste) rhinitis. It is more annoying than harmful, though obviously it can affect your quality of life.

Rhinitis, of whatever type, is defined as an inflammation inside the nose. Blood vessels dilate and cells lining the nasal cavity secrete mucus. Symptoms of rhinitis include rhinorrhea (watery or mucoid drainage), congestion (swelling of the nasal lining and difficulty breathing through the nose), sneezing, and itching.

In vasomotor rhinitis -- "vasomotor" refers to the nasal lining's exaggerated response to irritation -- symptoms may be provoked not only by the taste or smell of food but also by other factors. These include odors (such as perfume, scented candles, paint fumes), alcoholic beverages, irritants (secondhand smoke, diesel exhaust), environmental factors (exposure to air conditioning or changes in air temperature, humidity, or barometric pressure), stress (emotional or physical), hormone changes (during menstruation, for example) and certain medications, many of which are in common use (aspirin or antihypertensives, among others).

Though there is no simple cure for vasomotor/gustatory rhinitis, significant symptomatic relief can often be obtained by using the anticholinergic drug ipratropium (Atrovent) in nasal-spray form. This product, available by prescription only, is safe for long-term use and may be taken two to three times daily if required. It is also effective if used only sporadically as symptoms occur. The spray is applied topically, so the risk of side effects or interaction with other medications you may be using is minimal. The most common side effect of Atrovent is dryness of the nose or throat, but this can usually be managed by proper dose adjustment.

It's also a good idea to avoid caffeinated beverages, especially when dining out, as they can cause dehydration and aggravate your symptoms.

-- Daniel J. Blum, M.D., Otorhinolaryngology, Mayo Clinic, Rochester, Minn.