Dear Doctors: Every time I eat something hot or a bit spicy, my nose starts to run. Sometimes it makes me start sneezing. I'm not allergic to anything, so I'm not sure what's going on. Could it be a new allergy? But to what? This happens with a bunch of different foods.
Dear Reader: Considering the sequence of events -- you eat something and shortly afterward your body registers a protest -- an allergy is a logical guess. But since this happens with a variety of foods and because spice or temperature are consistently involved, it points to a different cause. Based on your description, it is quite likely you are experiencing something known as nonallergic gustatory rhinitis.
It's true that the condition mimics some of the common symptoms of an allergy. In addition to the runny nose and sneezing you described, gustatory rhinitis can cause postnasal drip and nasal congestion that ranges from mild to severe. However, unlike an allergy, it does not involve the same type of immune response. Rather, it is a nerve reflex triggered by an irritation of the mucous membranes of the nose.
This type of irritation commonly arises due to contact with physical irritants such as dust, smoke or perfume. But the nerve reflex can also be caused by a surprising variety of other triggers. These include bright sunlight, fizzy drinks, cold air or plucking an eyebrow. In the case of gustatory rhinitis, it is set off by certain foods, including spicy foods such as pepper, chili peppers, mustard, wasabi and horseradish. Those with sharp flavors, like wintergreen, peppermint and dark chocolate are also common culprits. Foods that are just plain hot -- as in temperature -- can also cause a response.
Many of the triggers for a sneeze response are well-documented. For example, plucking an eyebrow hair can activate a branch of the trigeminal nerve. But when it comes to gustatory rhinitis, the pathway is not fully understood. This is true both of the stuffy or runny nose and the bursts of sneezing, sometimes jokingly called "sneezures."
Gustatory rhinitis is not a risk to health. However, it can affect quality of life. An obvious -- and not terribly satisfying -- approach is to simply avoid the trigger foods. If temperature plays a role, be sure to let food cool before eating. For people who want to indulge, particularly when eating with others, certain types of nasal sprays can be helpful. Known as anticholinergic sprays, these are prescription medications that block acetylcholine. This is a chemical messenger involved in nasal secretions and sneezing. Used before eating, the sprays can help prevent a runny nose. Some people find that a saline rinse, particularly before a meal, can also mute the response.
Since gustatory rhinitis is harmless, treating it becomes a matter of personal preference. But if you notice that your symptoms change, become more frequent or severe, or include signs of a true allergic reaction, we recommend talking to your healthcare provider.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
