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Intro edit

Rhinorrhea, rhinorrhoea, or informally runny nose is the free discharge of a thin mucus fluid from the nose; it is a common condition. It is a common symptom of allergies (hay fever) or certain viral infections, such as the common cold or COVID-19. It can be a side effect of crying, exposure to cold temperatures, cocaine abuse, or drug withdrawal, such as from methadone or other opioids. Treatment for rhinorrhea may be aimed at reducing symptoms or treating underlying causes. Rhinorrhea usually resolves without intervention, but may require treatment by a doctor if symptoms last for more than 10 days or if symptoms are a result of foreign bodies in the nose[1].

The term rhinorrhea was coined in 1866 from the Greek rhino- ("of the nose") and -rhoia ("discharge" or "flow").

Causes edit

A runny nose can be caused by anything that irritates or inflames the nasal tissues, including infections such as the common cold and influenza, and allergies and various irritants. Some people have a chronically runny nose for no apparent reason (non-allergic rhinitis or vasomotor rhinitis). Less common causes include polyps, a foreign body, a tumor or migraine-like headaches. Some causes of rhinorrhea include: acute sinusitis (nasal and sinus infection), allergies, chronic sinusitis, common cold, coronaviruses (COVID-19), decongestant nasal spray overuse, deviated septum, dry air, eosinophilic granulomatosis with polyangiitis, granulomatosis with polyangiitis, hormonal changes, influenza (flu), lodged object, medicines (such as those used to treat high blood pressure, erectile dysfunction, depression, seizures and other conditions), nasal polyps, non-allergic rhinitis (chronic congestion or sneezing not related to allergies), occupational asthma, pregnancy, respiratory syncytial virus (RSV), spinal fluid leak, and tobacco smoke.

Infection edit

Rhinorrhea can be a symptom of other diseases, such as the common cold or influenza. During these infections, the nasal mucous membranes produce excess mucus, filling the nasal cavities. This is to prevent infection from spreading to the lungs and respiratory tract, where it could cause far worse damage. It has also been suggested that viral rhinorrhea is a result of viral evolution whereby virus variants that increase nasal secretion are more resistant to the body’s normal immune defenses and are selected for. Rhinorrhea caused by these infections usually occur on circadian rhythms. Over the course of a viral infection, sinusitis (the inflammation of the nasal tissue) may occur, causing the mucous membranes to release more mucus. Acute sinusitis consists of the nasal passages swelling during a viral infection. Chronic sinusitis occurs when sinusitis continues for longer than three months.[2]

Allergies edit

Rhinorrhea can also occur when individuals with allergies to certain substances, such as pollen, dust, latex, soy, shellfish, or animal dander, are exposed to these allergens. In people with sensitized immune systems, the inhalation of one of these substances triggers the production of the antibody immunoglobulin E (IgE), which binds to mast cells and basophils. IgE bound to mast cells are stimulated by pollen and dust, causing the release of inflammatory mediators such as histamine. In the nasal cavities, these inflammatory mediators cause inflammation and swelling of the tissue, as well as increased mucus production. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can make the condition considerably worse.[3]

Other causes edit

Rhinorrhea can occur as a symptom of opioid withdrawal accompanied by lacrimation.[4] Other causes include cystic fibrosis, whooping cough, nasal tumors, hormonal changes, and cluster headaches. Rhinorrhea can also be the side effect of several genetic disorders, such as primary ciliary dyskinesia, as well as common irritants, like spicy foods, nail polish remover, or paint fumes.

Treatment edit

In most cases, treatment for rhinorrhea is not necessary since it will clear up on its own, especially if it is the symptom of an infection. For general cases nose-blowing can get rid of the mucus buildup. Though blowing may be a quick-fix solution, it increases mucosal production in the sinuses, leading to frequent and higher mucus buildups in the nose in the medium term. Alternatively, saline or vasoconstrictor nasal sprays may be used, but may become counterproductive after several days of use, causing rhinitis medicamentosa.

In some cases, such as those due to allergies or sinus infections, there are medicinal treatments available. Several types of antihistamines can be obtained to treat cases caused by allergies; antibiotics may help in cases of bacterial sinus infections.[5]

References

  1. ^ "Rhinorrhea (Runny Nose)". Cleveland Clinic. Retrieved 2023-09-24.
  2. ^ Kwon, Edward; O'Rourke, Maria C. (2023), "Chronic Sinusitis", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28722963, retrieved 2023-09-24
  3. ^ "Effects of particulate matter on allergic respiratory diseases". Chronic Diseases and Translational Medicine. 4 (2): 95–102. 2018-06-01. doi:10.1016/j.cdtm.2018.04.001. ISSN 2095-882X.
  4. ^ Shah, Mansi; Huecker, Martin R. (2023), "Opioid Withdrawal", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30252268, retrieved 2023-09-24
  5. ^ "Rhinorrhea (Runny Nose)". Cleveland Clinic. Retrieved 2023-09-24.