A runny nose, or leaky nose, are the common terms for rhinorrhea or nasal discharge. In most cases, nasal discharge is due to hypersecretion of mucus from the lining of the nasal passages. However, pus and cerebrospinal fluid (CSF) may also exit through the nose. Nasal discharge is in most cases accompanied by sneezing, as the same irritants or persistent inflammation that trigger mucus hypersecretion also elicits the sneeze reflex.
A runny nose and sneezing may also present with other symptoms like :
- Itchy nose
- Blocked nose (nasal congestion)
- Watery eyes (excessive tearing)
- Redness and/or itchy eyes
Depending on the cause, throat, nose, sinus and/or ear symptoms may accompany a runny nose and sneezing. The nature of the nasal discharge and pattern of sneezing may be indicative of the cause.
- Morning and night sneezing bouts with severe rhinitis may be possibly due to allergic or hormones.
- Clear, watery discharge is usually non-infectious.
- White, yellow or green nasal discharge is more likely to be due to an infection. White to pale yellow mucus may be indicative of acute infections, while deeper yellow to green mucus may be due to chronic infections.
- A CSF leak needs to be excluded in a runny nose after head trauma, especially if a clear, sticky ear discharge is also present.
- Foul-smelling discharge may be due to a foreign body, especially in children.
Causes of Runny Nose and Sneezing
Runny nose and sneezing often occurs with rhinitis, which is inflammation of the lining of the nasal passages. Due to various causes, the epithelial lining may trigger hypersecretion of mucus and stimulate the receptors of the nasal mucosa which elicits sneezing.
The causes of a runny nose and sneezing can therefore be categorized according to the different types of rhinitis. Infections and allergies are the more common causes.
- Infections (acute, chronic) – viral, bacterial or fungal.
- Viral infections, like the common cold and flu, are the more common acute causes.
- Bacterial and fungal infections may be seen in both acute or chronic cases, particularly when the sinuses are infected (sinusitis)
- Seasonal (hay fever) or perennial (persistent year-round) may be due to pollen, fungal spores, animal dander, and house dust mite (inhaled allergens)
- Ingested allergens (food allergies) that result in sneezing and runny nose are more frequently seen in children. Milk and dairy products, egg yolk, wheat, nuts and soy are common ingested allergens.
Other factors are referred to as non-allergic non-infectious causes and may be either acute and chronic.
- Hot (pungent), spicy
- Very sour (rare)
- Temperature, moisture – cold, dry, air conditioned
- Quality – pollution, smog
- Smoke – cigarettes, fires, car exhaust
- Strong odors – perfumes
- Gases – carbon monoxide, ammonia, chlorine, hydrogen sulfide
- Dust – wood, latex, textile fibers, spices, metal salts
- Pregnancy, menopause, puberty
- Hormone contraceptives (women)
- Erectile dysfunction drugs
- Anti-inflammatory drugs
- Discontinuing decongestants or nasal corticosteroid sprays
- Nasal, paranasal sinus tumors
- Nasal polyp
- Perforated septum
- Deviated septum
- Atrophic rhinitis
- Wegener’s granulomatosis