Rhinorrhea

Did you ever stop to think how much mucous your nose produces in a day? Did you ever care that anyone actually measured the amount of drainage produced by the average person in a 24 hour period? Well, here is something interesting about our noses; we produce on the average about one quart of mucous daily, increasing to between three and four quarts when there is some disease process such as a head cold or severe nasal allergy.
If these items didn’t hit your alert button-then consider this: about 20% of all episodes of acute illness leading to medical attention requiring at least one day of restricted activity were due to upper respiratory infection. The major result of URI is a runny nose (rhinorrhea), along with an urgent “wish I were dead” feeling.

Now just because you have a runny nose doesn’t necessarily mean you have a head cold; there are a lot of other things that can cause rhinorrhea. Allergies are the first things that come to mind, seasonal, due to pollens, and perennial rhinitis due to dusts and molds.

Other frequently found causes are vasomotor in origin; such as certain drugs (reserpine, prazosin, Hitrin, cocaine abuse); abuse of nose drops (rhinitis medicamentosa); and psychological causes (anger, sexual arousal). Vasomotor means affecting the constriction and dilatation of small blood vessels, which, in turn, causes the swelling and shrinkage of the mucosal lining of the nose and sinuses.

Hormonal changes due to a low thyroid condition and pregnancy can also cause rhinorrhea. More serious conditions can lead to increased production of mucous; these include polyps, tumor, deviated septum, crusting, enlarged turbinates due to chronic vasomotor rhinitis, foreign body, and cerebrospinal fluid leak from the meninges of the brain. I’ve had head colds with drainage so bad that I’d swear that I’d blown a hole in my head and was leaking, especially when associated with a headache.

Naturally, most of us have become “experts” on how to treat a head cold and all have our favorite remedy. There are several givens about head colds-a head cold will usually go away in 7 days or one week, whichever is the sooner. Few people die from URI’s-they just wish they were dead. One of my patients had a great remedy-he hung his hat on the bedpost, drank Jack Daniels Sour Mash whiskey until he saw two hats and then slept through the head cold and hangover at the same time.

The nose and sinuses with all the small openings pose a problem in scuba divers who must be able to clear (equalize) the changes in pressures as they go down and come up. That’s why it’s dangerous to dive with a swollen nasal lining, whatever the reason.

So, if your nose runs all the time and you’ve been wondering why-maybe it’s the medication that you’ve been taking. Don’t stop your medicine however, until you check with your doctor-the trade-off for a runny nose may be too dear!

AUTHOR

Ernest S. Campbell, M.D., FACS

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