Rhinorrhea


What is Rhinorrhea?

Rhinorrhea is a condition where there is excess mucus filling the nasal cavity. This condition may sometimes be referred to as runny nose. People with allergies like hay fever may show rhinorrhea as one of the symptoms.

People with diseases like common cold also manifest rhinorrhea as a symptom. Sometimes, rhinorrhea may be a side effect occurring due to crying or having exposure to cold temperatures. People who use cocaine or those experiencing withdrawal of the drug may also have rhinorrhea.

Rhinorrhea

Rhinorrhea Vs Rhinitis

The terms ‘rhinitis’ and ‘rhinorrhea’ may refer to runny nose, however, these two conditions are different in that; rhinitis is an inflammation of nasal tissues while rhinorrhea is having thin, clear nasal discharge.

Signs and Symptoms

Rhinorrhea manifests in form of excess mucus being produced within the nasal cavities. Mucous membranes produce mucus faster thereby causing a backup in the nasal cavities. The cavities fill up something that blocks the air passageways.

Whenever there is blockage occurring, it makes an individual have difficulties breathing through their nose. There may be air that is trapped in nasal cavities, particularly the sinus cavities, and when the air cannot be released, it may create pressure that could lead in facial pain and headaches.

In the event that the sinus passage does not unblock, this situation could result in sinusitis. When mucus backs up in the Eustachian tube, it could lead to an infection of the ear or pain in ears.

Post nasal drip may occur when there is excess mucus accumulating in back of nose or throat. A sore throat and coughing may also come about.

Causes

Rhinorrhea may be caused by a number of things including:

Rhinorrhea Pathophysiology & Treatment

Causes of Runny nose (Right side)

1. Cold temperature

It is common to have rhinorrhea during winter months and in those seasons when temperatures are low.

This mainly happens as a result of thermodynamics and reactions to cold weather. The nasal mucus helps in warming air that is being inhaled to make it attain body temperatures. This is one of the functions of nasal mucus.

The nasal cavities are therefore coated with liquid mucus to ensure that air entering or being inhaled in body is warm.

However, during the cold season, the lining of the nasal passage becomes dry, this makes the mucous membranes to work harder by releasing more mucus to ensure the cavity is lined. This, in turn, causes the nasal cavity to fill up.

2. Infections

If a person has other diseases like influenza and common cold, it is likely that they will develop rhinorrhea. Therefore, rhinorrhea may be a symptom of an underlying disease. The nasal membranes will produce too much mucus, thereby filling up the nasal cavities.

The excess mucus helps prevent the infection from spreading to respiratory tract and the lungs. A viral infection may also cause inflammation to occur in nasal tissue, thereby causing more mucus to be released by the mucous membranes. The inflammation associated with nasal tissue may be referred to as sinusitis.

3. Allergy reactions

Excess production of mucus may occur as a result of allergy reactions. Individuals allergic to substances like animal danger, shellfish, soy, dust, pollen, and latex will see increased mucus production when they become exposed to these allergies.

People with sensitive immunity may experience inflammation and swelling within the nasal cavities and increased production of mucus when there is a trigger of an allergy.

4. Head trauma

A head injury could lead to rhinorrhea, and this may be a serious condition. Cerebrospinal fluid rhinorrhea or CSF rhinorrhea can occur when there is injury of the head. This condition could result in serious complications or even death if there is no proper treatment offered in time.

5. Lacrimation

Shedding of tears occurring due to eye irritation or some emotional event may bring about rhinorrhea. With excess tears being released, it may cause the fluid to drain through inner corners of a person’s eyelids to reach the nasal cavities. The buildup of the fluid may be expelled through nostrils.

6. Other causes

  • Opioid withdrawal
  • Cystic fibrosis
  • Whooping cough
  • Hormonal changes
  • Nasal tumors
  • Cluster headaches
  • Oxygen-intubation
  • Diagnosis of Rhinorrhea

Diagnosis

History

A patient will provide information to a doctor regarding the condition. Any history of an illness may help determine the kind of discharge the patient has whether mucoid, watery, bloody, or purulent.

Also, the doctor may want to know if the discharge is recurrent or chronic. In the event that the discharge is recurrent, a doctor may want to know what could be causing it, for example, some potential allergy triggers.

The discharge may also be examined to determine if it is occurring in relation to season, location, or some allergens. Having unilaterally clear, water-like discharge after a head injury could mean cerebrospinal fluid leak.

Physical examination

A doctor will examine the symptoms a patient has including fever, facial pain, allergies, and viral infections. The nasal mucosa may be inspected to see its color- whether it is red or pale and swollen. The color and consistency of the discharge may also be examined.

Testing

Unless a patient is diabetic or is immune-compromised and he or she has been suspected to have invasive sinusitis, testing may not be ordered for acute nasal symptoms. Where a CSF leak has been suspected, a test may be ordered to check the sample for beta-2 transferrin.

Treatment

A patient with rhinorrhea, may in most cases not require any treatment because the mucus will clear up particularly, if it is as a result of an infection. However, it is important for the infection to be addressed.

Rhinorrhea Pathophysiology & Treatment

Treatments of Runny nose (left side)

1. Nose blowing

Blowing the nose can help expel the mucus, however, blowing may result in increased production of mucus often leading to increased buildups.

2. Saline nasal sprays

Although these sprays may help, they can become counterproductive with time resulting in rhinitis medicamentosa.

3. Antihistamines

If rhinorrhea is caused by allergy reactions, treatment using antihistamines may be administered.

4. Nasal irrigation

Some people may want to keep their nasal passages clear, for example, singers. These people may use nasal irrigation to treat or prevent rhinorrhea. This technique entails rinsing nasal cavities using saline or salty solutions.

If rhinorrhea has become persistent, you need to talk to your doctor about it. Getting treatment in advance can help address the problem and know if there is an underlying cause. Conditions like CSF rhinorrhea can be dangerous and proper treatment is needed.

Reference List

  1. Rhinorrhea https://en.wikipedia.org/wiki/Rhinorrhea
  2. Runny Nose. Available at http://www.mayoclinic.org/symptoms/runny-nose/basics/causes/sym-20050640
  3. Nasal Congestion and Rhinorrhea. Available at http://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/nasal-congestion-and-rhinorrhea

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