Occasional sniffles brought on by dry, frigid winter weather may be a minor inconvenience, but when a runny nose becomes chronic, it can jeopardize quality of life — and good health. Daily dripping, wiping and blowing can make some sufferers self-conscious or embarrassed, and may disrupt sleep. Upper respiratory passages can become inflamed, which blunts both the sense of smell and appetite. Sometimes chronic postnasal drip overwhelms the lower airways’ defenses, increasing the risk of bronchitis and pneumonia.
Age is one of the most common causes of a noninfectious chronic runny nose, known as geriatric rhinitis. At least one-third of Americans over age 65 are affected, but symptoms can begin as early as age 50.
As we grow older, the lining of the nose thins and dries; nasal glands compensate by overproducing mucus. Delicate nerve endings that regulate nasal secretions atrophy, which can result in constant drainage. Aging also causes nasal cartilage and ligaments to weaken over time, while skin loses elasticity. As a result, the nose lengthens and droops, reducing nasal airflow, increasing congestion and promoting a persistent runny nose. Symptoms may also include a constant need to clear the throat or cough up mucus, crusts in the nose, and a feeling of nasal obstruction — especially when reclining.
Because there are many causes of a chronic runny nose, a health care provider should make the diagnosis. Bacterial or viral sinus infections can mimic geriatric rhinitis, as can allergic reactions to triggers such as pollen, pet dander or mold. Hypersensitivity to strong odors — including perfume or bleach — can also cause nasal dripping, as can certain medications, most commonly anti-inflammatories (aspirin or ibuprofen) and antihypertensives (beta blockers such as metoprolol and ACE inhibitors such as lisinopril). Spicy or pungent foods, including chili peppers, garlic and horseradish, may overstimulate nerve endings in the nose and throat and lead to nasal drip, as can hot beverages such as coffee. Underlying health problems may also be responsible, most commonly emphysema, gastric reflux and autoimmune diseases such as diabetes.
There are effective home remedies for geriatric rhinitis. Improved hydration — drinking three 8-ounce glasses of water daily or running a bedside vaporizer — can plump nasal membranes and normalize mucus production, easing symptoms. Avoiding inhaled irritants, such as cigarette smoke or car exhaust, can also make a difference. It’s important to blot or gently wipe a drippy nose; repeated blowing can traumatize delicate nasal membranes and promote infection. Body — and nasal — inflammation may be reduced by following a Mediterranean-style diet rich in vegetables, whole grains, nuts and seeds. Regular exercise can also help by improving circulation and overall health.
Breathing strips have been shown to soothe nighttime symptoms by widening nasal passages. Over-the-counter nasal sprays, such as ipratropium (Atrovent) and steroid sprays (Flonase), can help minimize nasal mucus production. Check with a health care provider before using any nonprescription medication.
Facial pain, dark green nasal mucus, fatigue or fever are not symptoms of geriatric rhinitis and may signal a sinus infection.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.