I get a runny nose every time I eat
WHENEVER I have a meal, my nose starts to run excessively. This only happens when I am eating, but it means I’m too embarrassed to accept invitations to eat out in restaurants. Is there a cure? Tony Tunnah, Bolton.
YOu have what is known as gustatory rhinitis — the medical term for watery nasal discharge or nasal congestion that occurs while eating, usually when the food is hot or spicy.
It’s the most common form of non-inflammatory, non-allergic rhinitis — or, to put it more simply, swelling in the nasal passages that is not due to an allergy.
An example of rhinitis caused by an allergy is hay fever (which is also known as allergic rhinitis).
Rather than a disease or illness, you should think of it instead as a reaction triggered by irritability or sensitivity in the lining of your nose.
Fortunately, there is a good effective treatment which, although not a cure, will control the embarrassing symptom.
I suggest you try a nasal spray containing ipratropium.
This drug — which is sold under the brand name Rinatec — is related to atropine (Atropa belladonna, deadly nightshade) and works by drying up the cells in the nose which secrete mucus.
using it regularly before eating should work well for you.
It is only available on prescription, but you could ask your gP to prescribe this for you to try it.
This could give you a measure of control and help you to regain confidence. It should prove particularly useful when you are dining in company at a restaurant. I HAVE arthritis and constant lower back pain. I use a Revitive and a TENS machine and my wife has bought me an exercise bike. Will using the bike for ten minutes a day help or exacerbate my condition? The GP said to ‘give it a go’. What do you think? George Teasdale, Leeds. The term arthritis is not an exact diagnosis, but refers to inflammation in the joints.
And it comes in many different forms — there are up to 120 distinct types, according to the 1973 book All The Arthropathies by Frank Dudley hart and Ted huskisson (who were my bosses back when I was a junior doctor working in a rheumatology department). These include rheumatoid arthritis and gout, but the most common form of all is osteoarthritis.
ThIs occurs where cartilage, which covers the ends of bones as they come together to form joints, becomes damaged and is worn away.
It varies widely in terms of the parts of the body it affects as well as in severity. In some people it affects only the knuckles. In others it will involve hips or knees.
For some sufferers the spine is affected, which can cause significant pain and stiffness in the back. It can also cause referred pain in the legs — this is partly because new bone can form in the spine as the body attempts to repair itself, causing the nerves that supply the lower limbs to become trapped.
It seems that you have osteoarthritis in the spine, and perhaps also in the knees and hips to a degree.
One problem with arthritis is that the pain can limit movement, which may lead to muscle wasting. This in turn increases disability and can reduce your overall ability to function as normal.
Treatment (perhaps better described as management) is therefore focused on two things: preserving muscle strength and function, and relieving pain.
Your Revitive and exercise bike may help with the first aspect. The Revitive is a device that uses electrical pulses to activate nerves in the body, causing muscles to contract and relax.
It is said to improve blood circulation and muscle strength, but I am not familiar with the device myself so I cannot say for certain whether it will do this.
similarly the exercise bike might help by using those muscles in your legs, keeping them supple, improving strength if they have started to waste, and also maintaining circulation.
And as it’s non-load bearing it does not put pressure on your joints, which would make the pain worse and lead to further wear.
Nobody would quibble with you doing that. Ten minutes every day would be a good start and is unlikely to cause your symptoms to flare up. Meanwhile, the TeNs (transcutaneous electrical nerve stimulation) is a method of pain relief. It involves using a small device which, via two wires connecting to two adhesive pads on the skin, passes an electric current into the tissues, aiming to mask the pain signals going to the spinal cord and brain.
I assume that you use this to ease your back pain. Patients of mine have had some success using TeNs to deal with pain after shingles, but it does require patience, and the use of trial and error to get the best settings and position for the pads.
WORkINg with a physiotherapist is invaluable here and is, I believe, essential in all aspects of arthritis care. The solution does not lie with medication, although judicious use of painkillers at times — such as paracetamol or ibuprofen — is standard advice.
Research is looking at how to restore damaged or eroded cartilage, but these options are not available at the moment.
The bottom line is that you need to ease symptoms, and also maintain function and mobility as much as you can, and I urge you to use the exercise bike optimistically.