
	Medical Edge


	About

	Television

	Radio

	Newspaper

		Participating Newspapers

	Magazine

	Contact


	About Mayo Clinic

	Make an Appointment at Mayo Clinic

Medical Edge Newspaper Column from Mayo Clinic

ALLERGIES MOST LIKELY CAUSE OF CHRONIC RUNNY NOSE

DEAR MAYO CLINIC: After I sneeze, my nose runs like a faucet. Sometimes, for no apparent reason, my nose will run and I can barely get a tissue fast enough. I also have a cough that triggers nose running. It is quite embarrassing when it happens. My doctor says this is due to allergies, but doesn’t have answers on what kind and what can be done. How do I find some relief? — Lincoln, Neb.

ANSWER: It’s possible that your symptoms are due to allergies, which are the most common cause of runny noses. I’d suggest an appointment with an allergist as a first step.

In addition to allergies, the doctor will consider other potential causes for your runny nose. Possibilities include:

— Nonallergic rhinitis: If allergy tests are negative, you could have nonallergic rhinitis, where the nose lining is very sensitive and prone to inflammation. Odors, smoke, temperature changes or a cough can trigger a runny nose. If you have nonallergic rhinitis, you can learn to identify — and avoid — triggers. Some allergy medications, such as oral decongestants and prescription nasal sprays, can be helpful for nonallergic rhinitis.

— Chronic sinusitis: An infection in the lining of your sinus can cause a stuffy or runny nose. Usually, a sinus infection lasts less than four weeks. But for many people, they just hang on for 12 weeks and longer, or return repeatedly. That could indicate chronic sinusitis — one of the most common chronic illnesses. It can be treated with antibiotics or corticosteriods, which shrink inflamed sinus membranes.

— Nasal polyps: These soft, noncancerous growths on the lining of your nose can cause a runny nose. They develop as a result of long-term inflammation in the lining of your nose. Your care provider can diagnosis them with a visual exam using a nasal endoscope, where a thin flexible tube with a fiber-optic light at the end provides your doctor with an inside view. Sometimes a CT scan of your sinuses is needed. If you have small polyps, the first line of treatment usually is a corticosteroid nasal spray. Other options are oral corticosteroids, other medications, and as a last resort, surgery.

Bottom line: You don’t have carry a tissue box around forever. It’s worth seeing a specialist for a diagnosis and a treatment plan.

— James Li, M.D., Ph.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Allergies
Appointment Information
More Information on Allergies

DEAR MAYO CLINIC: After months of feeling tired, being short of breath and coughing a lot with an achy chest, I started thinking I might be doing more than just fighting off a cold. My doctor took a chest X-ray and said I might have sarcoidosis, and told me to see a lung specialist. I want to know more about it before I do. What is this disease? What tests will the lung doctor do? — Cleveland

ANSWER: Sarcoidosis is an inflammatory condition that most often affects the lungs and lymph nodes. It often affects adults under age 40, though it can occur at any time. Many patients do not require treatment and suffer no significant permanent effects. Other patients have progressive problems that require treatment.

There is no single test that can be done to determine if you have this condition. To evaluate suspected sarcoidosis, the doctor will take a tissue sample from the lungs or lymph nodes and examine it microscopically for abnormalities. This can often be done without surgery.

A diagnosis of sarcoidosis is based upon several lines of evidence: an abnormal biopsy; the exclusion of other diseases known to produce similar abnormalities on biopsy; and an examination of the patient’s symptoms. Sarcoidosis can be hard to correctly diagnose—which is why it’s important to see a doctor experienced with treating it.

While 90 percent of patients with sarcoidosis have lung involvement, the disease can affect multiple organs. Lung symptoms include shortness of breath, dry cough and chest discomfort. Standard chest X-rays and breathing tests are usually used to assess patients, although doctors sometimes use CT scans to obtain further information useful in diagnosis and management.

Corticosteroids (Prednisone, for example) are typically used to treat sarcoidosis, though not all patients require treatment. These drugs reduce inflammation and can improve patients’ symptoms. While under treatment, patients should see their physicians regularly to assess the effectiveness of treatment and to manage the potential negative side effects of the steroid medications.

— James Utz, M.D., Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Sarcoidosis
Appointment Information
More Information on Sarcoidosis
- - -

Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.