Wet nose, warm heart

My sister wants to know why her nose drips when she eats.

This is a common complaint: a nose that drips in response to inappropriate stimuli. Believe it or not, you want a runny nose in certain circumstances. Get a big snootful of dust, or step outside into dry, frigid air, and a runny nose is your best friend. You really don't want that dust in your lungs, nor do you want to inhale cold, dry air. Either one could touch off bronchospasm -- an asthma attack.

Unfortunately, some people get a drippy nose at the worst times. Eating is the most common trigger, but sunlight, wind, and emotional upset are other common triggers.

Vasomotor rhinitis is the name of this condition. Aside from a runny nose, other symptoms include stuffiness, postnasal drip, or sneezing. It is not an allergic condition and will not respond to allergy medications.

What is it? First, a quick introduction to your nose. The nose is a sense organ, of course, important both for smell and taste, but the nose also humidifies, filters, and warms the air that you breathe. Air reaching the lungs should be moist, clean, and warm. If it isn't, you might develop reactive airways (asthma) or other problems.

Thanks to its internal nervous system, the nose can alter its state, becoming more stuffy or less stuffy, wetter or drier, in response to environmental triggers. Vasomotor rhinitis is a disorder of this nervous system. I like to call it a twitchy nose.

Avoidance is the best treatment, but easier said than done. If your triggers are food or sunlight, what are you going to do? Most folks stuff their pockets with handkerchiefs.

Nasal steroid sprays, antihistamines, and decongestants don't work well for vasomotor rhinitis, but if you go to your primary care doctor, that's probably what you're going to get. Certain other nasal sprays work very well for this condition, but they're not for everyone.

Not all drippy noses are vasomotor rhinitis, of course. Allergic rhinitis is way up on the list, too, and the treatment for that condition is much different. Occasionally, a drippy nose can be a sign of other, more serious, nasal problems. That's where your doctor comes in.

My recommendation: educate yourself on rhinitis conditions (vasomotor and allergic), and go to your primary care doc armed with this knowledge. If your doc doesn't know the appropriate medications, hopefully she'll send you to an ENT (or at least call on for advice!)

D.