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Clear fluid from the nose

Wednesday, March 4th, 2009
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Sometimes when I bend down or tilt my head large amounts of clear fluid come gushing out of my nose. I don’t have a cold. What could be causing this?

Answered by: Maria/MD Health Forum Team

Nasal discharge is not always related to common cold or allergies. Vasomotor rhinitis, for example, is a type of nonallergic rhinitis and it may manifest as profuse watery nasal discharge. The exact cause of vasomotor rhinitis is unknown. Symptoms are said to occur because blood vessels of the nose tend to become over responsive when exposed to certain stimuli. Triggers differ from person to person, some experience symptoms when exposed to environmental irritants like strong odors and smoke. Changes in temperature is also known to exacerbate vasomotor rhinitis.

Runny nose is also among the side effects of some drugs. These include pain relievers containing ibuprofen and aspirin, drugs for erectile dysfunction, blood pressure medications and birth control pills.

Nasal polyps- noncancerous growths originating from the lining of nasal passages, can also cause persistent nasal discharge. Other symptoms of nasal polyps include: reduced sense of smell and taste, headache, blocked feeling in the nose and post nasal drip.

Head trauma and other disorders may also cause the cerebrospinal fluid (CSF) to leak through the nose. CSF is fluid that circulates in the cavities of the brain and the spinal cord. A CSF leak manifests as a clear, watery discharge from the nose (CSF rhinorrhea) or ears (CSF otorrhea).

The initial step to determine what has been causing your symptoms is a thorough health history taking. It is important for your doctor to find out information like onset of symptoms, characteristics of the discharge, history of head injury, medications you have been taking and accompanying symptoms. Physical examination will also be done and tests may be ordered to rule out allergies. IF CSF leak is suspected, the doctor may check on the nasal drainage for beta-2 transferrin, a substance found mainly in the CSF.

Intervention will be based on the underlying cause and your doctor’s evaluation. For vasomotor rhinitis, nasal sprays containing steroids, anti histamine or anticholinergic (anti-drip agents) maybe prescribed to relieve symptoms. Patients with nasal polyps may be recommended to take medicines to address inflammation and allergy. Surgical intervention may be considered if drug treatment fails to reduce the size or eliminate the growths. The management of CSF rhinorrhea will depend on the cause, location, and severity of the leak.

Reference:
Wheeler, P & Wheeler, S 2005 Vasomotor Rhinitis American Family Physician - Volume 72, Issue 6 September 2005


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