Врачи объяснили причины насморка при употреблении пищи и способы лечения

For most people, a runny nose is an occasional nuisance during allergy or cold season. But for some people, it happens more often, sometimes in connection with specific actions. Have you ever asked, for instance, why do I get a runny nose after eating? Turns out, it’s more common than you might think. Meet the experts: Meha Fox, M.D., an assistant professor in the department of otolaryngology at Baylor College of Medicine; David A. Gudis, M.D., the chief of rhinology and anterior skull base surgery at Columbia University Irving Medical Center; Benjamin Tweel, M.D., the medical director for the department of otolaryngology at Mount Sinai Health System; Michael Yong, M.D., an otolaryngologist and neurorhinologist at Pacific Neuroscience Institute. Here, doctors explain the top reasons why your nose might be running every time you eat, plus how to treat the problem and when you should see a healthcare provider to address it. Possible reasons why your nose is running after eating A runny nose typically represents a form of rhinitis, which refers to inflammation or irritation of the nasal cavity, said David A. Gudis, M.D., the chief of rhinology and anterior skull base surgery at Columbia University Irving Medical Center. “Everybody has experienced some form of rhinitis before, such as when a common cold causes a runny nose or nasal congestion. But some people suffer from other forms of rhinitis, and these symptoms can be frequent or long-lasting,” he explained. Rhinitis is broadly categorized into either allergic or nonallergic rhinitis, and there are many types of nonallergic rhinitis—and some people may even have more than one type, said Dr. Gudis. Both types can cause a runny nose after eating, though there is one that’s the most likely cause. Allergic rhinitis Allergic rhinitis is inflammation in the nasal cavity that occurs in response to various allergens, said Dr. Gudis. The most common allergens to trigger allergic rhinitis are seasonal allergens, such as grasses and tree pollen, and perennial allergens, such as dust mites, mold, and pet dander, says Meha Fox, M.D., an assistant professor in the department of otolaryngology at Baylor College of Medicine. “Common symptoms of allergic rhinitis are nasal congestion, runny nose, sneezing, and itchy nose and eyes,” she noted. Nonallergic rhinitis Nonallergic rhinitis, on the other hand, is any rhinitis not caused by allergens, said Dr. Fox. Nonallergic rhinitis can include many different types, and is generally characterized by nasal discharge and sometimes also nasal congestion, said Dr. Gudis. Nonallergic rhinitis is a broad term encompassing gustatory rhinitis, vasomotor rhinitis, drug-induced rhinitis, and other “idiopathic” (unknown cause) forms of rhinitis, said Benjamin Tweel, M.D., the medical director for the department of otolaryngology at Mount Sinai Health System. “As far as why individual people develop any of these, it is largely unknown.” Gustatory rhinitis If your nose runs when you eat, the most likely cause is a type of nonallergic rhinitis called gustatory rhinitis, said Dr. Gudis. “Gustatory rhinitis is more common in older people and is characterized by clear watery nasal discharge with eating or just before eating,” he explained. It is not associated with congestion, itching, sneezing, or other nasal symptoms, he added. When we eat, our bodies are cued to produce saliva, said Dr. Tweel. “In some people, this process changes so that instead of just triggering saliva production they are also triggered to produce nasal mucus.” Having a runny nose when eating spicy foods is very common, but the reason for this is unknown, Dr. Tweel noted. Vasomotor rhinitis Gustatory rhinitis and vasomotor rhinitis have similar symptoms of clear watery nasal discharge without congestion, sneezing, or itching, but they have different triggers, said Dr. Gudis. “While gustatory rhinitis occurs from eating, vasomotor rhinitis can be triggered by various different causes including changes in temperature, humidity, and air pressure.” So if you’ve ever had a runny nose after being outside in the cold, now you know why! This problem also becomes more common as people get older, said Dr. Tweel. How to get a diagnosis Many people will be able to self-diagnose to some degree, said Dr. Tweel. “For instance, someone who gets rhinitis symptoms while near cats, and responds well to an over-the-counter antihistamine or allergy pill or allergy nasal spray can reasonably deduce that they have allergic rhinitis. Likewise, someone who gets a runny nose with every meal most likely has gustatory rhinitis,” he explained. But, because rhinitis symptoms can overlap with other conditions, such as chronic sinusitis or nasal polyps, formal diagnosis is best made by a physician, said Dr. Tweel. “In some cases, symptoms of rhinitis can be more pronounced because they are occurring on top of existing symptoms from an underlying condition such as chronic sinusitis.” Dr. Gudis agreed that the best way to get diagnosed is to see an otolaryngology (ear, nose, and throat, or ENT) specialist. “The description of your symptoms and your triggers, in addition to the appearance of the inside of your nose (often visualized with a tiny scope), can help your doctor determine the cause of your symptoms, the type of rhinitis, and the possible treatment options,” he explained. For allergic rhinitis, you can get tested for the most common allergens in your area to discover your allergy triggers, said Dr. Fox. Seeking additional care from an allergist can provide a comprehensive approach to evaluating and treating your symptoms. Can you treat a runny nose when you eat? The good news is that rhinitis is very unlikely to represent a dangerous condition, said Dr. Gudis. “Therefore, if your symptoms are limited to a runny nose while you eat, no treatment is necessary unless it is really bothering you.” As with most medical conditions, there is an array of treatment options for different kinds of rhinitis, and your own treatment plan will likely depend on your associated symptoms and how much your symptoms are affecting your quality of life. Per Michael Yong, M.D., an otolaryngologist and neurorhinologist at Pacific Neuroscience Institute, it’s best to start to treat the condition with topical medications, like sprays and rinses. “This is because these are very safe options as they have very little, if any, systemic absorption, so they don’t have the side effects of oral medications and can be directly applied to the problem area,” he explained. The mainstay of treatment for gustatory rhinitis is a nasal spray called ipratropium, which is generally very effective in preventing a runny nose, said Dr. Tweel. “Some people will use this spray before going out to a restaurant, for instance.” Ipratropium is available with a prescription, and is generally safe although it does have some contraindications, including some types of glaucoma, he noted. For some people who have baseline allergies, antihistamine pills or nasal sprays can help, said Dr. Tweel, “but this is usually not as effective.” More recently, some procedures have been developed to freeze or ablate the nasal nerve which causes the nose to run, said Dr. Tweel. One of these procedures, known as RhinAer, uses temperature-controlled, radiofrequency technology to directly interrupt nerve signals and help reduce chronic rhinitis symptoms, explained Dr. Fox. “The procedure can be performed with a local anesthetic during an office visit, with no incisions, minimal downtime, and little discomfort.” Multiple clinical studies show sustained symptom improvement of at least two years, Dr. Fox noted. Dr. Yong added that about 80% of people see lasting improvement following the procedure, “so it can be helpful for the right person.” But again, Dr. Gudis said that if you’d rather just keep an extra tissue around than consider these treatments, “that’s fine too!” When should you see a doctor for a runny nose when you eat? If the runny nose only happens with meals, it is unlikely to be a sign of something concerning, said Dr. Tweel, “but if the symptom is bothersome or persistent, you should ask your doctor.” If the runny nose is thick or discolored, then it is more likely to be acute or chronic sinusitis, said Dr. Tweel, which is treated differently. “Rhinitis (allergic, non-allergic, gustatory, or vasomotor) tends to be clear.” If you do have any chronic congestion, loss of smell, difficulty breathing through the nose, discolored or thick discharge, or blood, you should get checked out by your primary care physician or an ENT, said Dr. Yong. Additionally, if you have a persistent watery runny nose from one side of your nose, especially faucet-like drainage, this could be a sign of a spinal fluid leak and you should seek medical care right away, said Dr. Tweel. “That is very rare, but important to identify.” Jessica Hui, M.D., is board certified in Allergy-Immunology, Internal Medicine, and Pediatrics. She pursued undergraduate studies at Vanderbilt University, then medical school, residency, and chief residency at Rush University Medical Center. After completing an Allergy-Immunology fellowship at National Jewish Health, she remained on faculty where she engages in clinical and translational research. Her area of interest is in Origins of Allergy, and she loves helping her patients and families in the management and treatment of allergic conditions.