What Is Rhinorrhea

Rhinorrhea is a discharge of fluid from the nose,  a common condition which is a typical sign of viral diseases like the common cold, allergies (hay fever), rhinitis, or exposure to anything that irritates the nose. 

It might also be a consequence effect of sobbing, being exposed to cold temperatures, smoking, abusing cocaine, or going through drug withdrawal from narcotics like methadone.¹

In some cases, rhinorrhea has no causes, which is known as vasomotor rhinitis.

Rhinorrhea is described as excessive watery mucus discharge from the nose, also known as runny nose. It is called a runny nose because when you experience rhinorrhea, there is an excess flow of mucus from the nasal passage. 

Rhinorrhea can be classified as either non-allergic or allergic. 

This is associated with the cause of the rhinorrhea. This article covers what rhinorrhea is, causes, symptoms, diagnosis, management, how to prevent rhinorrhea and when to seek medical aid. 

Causes of rhinorrhea

• Allergies: Rhinorrhea can be a sign of allergic rhinitis. An allergic reaction to allergens, including pollen, dust mites, animal dander, or specific foods can cause allergic rhinitis, a medical disorder marked by inflammation of the nasal passages and the lining of the nasal mucosa.²
• Infections: Rhinorrhea can be brought on by infections, especially viral infections like the flu or the common cold. Viruses that affect the upper respiratory tract cause inflammation in the nasal passages, which increases mucus production.  Additionally, bacterial infections such as sinusitis can cause rhinorrhea. As a protective measure to capture and get rid of the virus or irritants, the body secretes mucus.³

Other causes of rhinorrhea include: 

• Polyps; Nasal polyps have the potential to block the nasal passages, which can result in increased mucus production and long-term irritation and runny noses (rhinorrhea).
• Migraine-like headaches: Although they are not the cause of rhinorrhea, migraines can occasionally be accompanied by symptoms such as a runny nose.
• Tumour: An abnormal growth or tumour in the nasal cavity or sinuses can cause blockages and inflammation, leading to increased mucus production and rhinorrhea.
• Decongestant sprays overuse: When decongestant nasal sprays are used excessively, rhinitis medicamentosa may develop. Because of this condition, the nasal passageways grow reliant on the spray, which can result in rebound rhinorrhea and chronic nasal congestion once the spray's effects wear off.
• Dry air: Increased mucus production occurs as a defensive response to dry air irritating the nasal passages. As a result, the nose may become runny in an effort to protect and moisturize the nasal cavities.
• Tobacco smoke: Both active and passive smokers may experience rhinorrhea and increased mucus production as a result of tobacco smoke exposure, which can also irritate and cause inflammation in the nasal passages.
• Spinal fluid leak: Runny noses can occur in rare instances when a cerebrospinal fluid (CSF) leak occurs, usually as a result of a traumatic injury or other medical disorders. The fluid drains via the nose.
• Respiratory syncytial virus (RSV): RSV is a common respiratory virus that can lead to respiratory tract and lung diseases. RSV infection, especially in newborns and early children, can cause rhinorrhea, nasal congestion, and excessive mucus production.
• Hormonal changes: Hormonal fluctuations, especially during pregnancy or menstrual cycles, can lead to increased nasal congestion and rhinorrhea due to changes in blood flow and mucus production in the nasal passages.
• Environmental irritants: Exposure to environmental irritants such as strong scents, pollution, dust, smoke, cold air, chemicals, or other airborne particles might trigger the defensive mechanisms of the nasal passages. More mucus production and a runny nose could be symptoms of inflammation brought on by the irritants. The body produces excessive amounts of mucus to capture and eliminate these irritants from the respiratory system, resulting in rhinorrhea.
• Medication Side Effects: Nasal symptoms are a side effect of various medications, especially those used to manage blood pressure, nonsteroidal anti-inflammatory drugs (NSAIDs), some antidepressants, and some birth control methods. These drugs may cause nasal dryness or irritation, which may cause the nasal passages to become more sensitive to the drug's effects, increasing mucus production and rhinorrhea.

Symptoms 

Rhinorrhea, also referred to as a runny nose, is characterized by the outflow of a thin, watery fluid or mucus from the nostrils. However, the symptom may differ based on the underlying cause. 

• Nasal discharge: Thin, watery, or thick mucus flowing from the nostrils
• Nasal congestion: Blockage or stuffiness in the nasal passages
• Sneezing: Frequent sneezing may accompany a runny nose
• Postnasal drip: Mucus dripping down the throat from the back of the nose
• Itchy or watery eyes: Often associated with allergic rhinitis
• Sore throat: Irritation caused by postnasal drip or excessive nose-blowing
• Cough: Especially if postnasal drip causes throat irritation. Headache: In certain cases
• Headache: Sometimes, especially when sinus pressure or congestion is present
• Fatigue might be brought on by persistent discomfort and sleep disturbances brought on by rhinorrhea

Diagnosis: 

• Physical examination: physical examination is done by medical personnel to evaluate nasal congestion, discharge, and indications of infection or inflammation in the nasal passages
• Medical history: Knowing your medical history makes it easier to rule out any underlying diseases or triggers for rhinorrhea, such as allergies, recent infections, or irritating exposure
• Screening allergy skin tests: Specific allergens that cause allergic rhinorrhea can be identified with the use of allergy skin tests
• Blood cell count investigated for eosinophilia: An allergic cause of rhinorrhea may be indicated by a high blood eosinophil level
• X-ray films of the paranasal sinuses: Imaging tests, such as CT or X-rays, can give precise views of the sinuses and assist in detecting structural disorders, obstructions, or sinus infections that may be related to rhinorrhea
• Blood cultures help to identify presence of infections⁴: If symptoms are severe or persistent, blood cultures can be useful in determining whether systemic infections are the cause of rhinorrhea.

Management of rhinorrhea

OTC (over-the-counter) drugs:

• Second-generation antihistamines: By inhibiting histamine, these drugs help treat allergic rhinorrhea and lessen symptoms, including runny nose and sneezing

Prescription medicines:

• Anticholinergics: These drugs can lessen nasal secretions and are sometimes prescribed to treat rhinorrhea
• Corticosteroids: Prescribed to lessen nasal passage irritation and relieve allergy or persistent rhinorrhea⁵

NSAIDs and decongestants:

• Oral Decongestants: These drugs aid in reducing rhinorrhea brought on by swelling nasal tissues and nasal congestion.
• Nonsteroidal anti-inflammatory drugs, or NSAIDs, can relieve some of the headache and facial pain that are frequently brought on by rhinorrhea

Other:

• Immune Boosters: Immune system-supporting practices, such as a balanced diet, enough sleep, and frequent exercise, can help fight off infections that result in rhinorrhea
• Surgical Approach: To treat the underlying causes of rhinorrhea, surgery may be suggested in cases of structural abnormalities or persistent sinus problems.or polyps
• Avoiding recognized allergens can greatly lessen the incidence of allergic rhinorrhea. This involves controlling one's exposure to allergens such as pollen, dust, or pet dander.
• Lifestyle Modifications: Using air purifiers, keeping your home tidy, and quitting smoking are a few examples of lifestyle modifications that can help control and prevent rhinorrhea
• Home Remedies: Treatments for rhinorrhea at home, such as humidifiers, steam inhalation, and saline nose rinses, can help reduce symptoms

Preventative tips:

• Good hygiene helps reduce the risk of spreading viruses that can cause rhinorrhea.
• Avoid triggers: The risk of rhinorrhea can be decreased by recognizing and limiting exposure to recognized triggers, which include allergens (dust mites, pollen, pet dander), irritants (cigarette smoke, strong odours), and environmental triggers.
• Vaccination: Getting vaccinated against the flu can lower the risk of contracting influenza, thereby reducing the occurrence of rhinorrhea and other flu-related symptoms.
• Allergy management: For those prone to allergic rhinorrhea, managing allergies is key

When to seek medical help:

• Severe or Persistent Symptoms: It's best to get medical help if rhinorrhea lasts for a long time, especially if it's accompanied by severe symptoms like persistent fever, a strong headache, facial pain, or coloured discharge
• Complications: Seeing a doctor is recommended if you experience any breathing difficulties, chest pain, sinusitis, or any secondary infections as a result of rhinorrhea
• Rhinorrhea in Children: Excessive nasal discharge can make it difficult for children, especially newborns, to breathe or nurse. Seeking medical advice from a paediatrician is crucial if your child displays indications of discomfort, has ongoing symptoms, or has difficulties sleeping or engaging in regular activities due to rhinorrhea.
• Warning Indications: A high temperature, intense headache, stiff neck, or discoloured nasal discharge are some examples of warning indicators.

Summary

Rhinorrhea, also known as runny nose, is a condition which presents as the discharge of mucus from the nasal passages. Many things may trigger it, including infections (like the flu or the common cold), allergies, irritants, environmental factors, prescription drugs, and underlying medical disorders. The main sign is thin, watery, or thick mucus coming out of the nose. Nasal congestion, sneezing, postnasal drip, and occasionally related symptoms like headaches or itchy/watery eyes can accompany this illness. Appropriate management necessitates knowing the underlying cause. Appropriate management may include over-the-counter drugs and prescription medications, avoiding allergens and lifestyle modifications, or, in extreme situations, medical help may be needed.