Ask the doctors: Why hot or spicy foods can trigger a runny nose

Dear Doctors: Every time I eat something hot or a little spicy, my nose starts to run. Sometimes it also makes me sneeze. I don’t have any allergies, so I’m confused about what’s happening. Could this be a new allergy? If so, to what? It happens with lots of different foods.

Dear Reader: Because the symptoms show up soon after you eat, an allergy would be a reasonable first thought. But since the reaction happens with many different foods and seems tied to heat or spice, a different explanation is more likely. What you’re describing is probably nonallergic gustatory rhinitis.

This condition can look a lot like an allergy. Along with a runny nose and sneezing, it may cause postnasal drip and nasal congestion that can be mild or severe. Unlike an allergy, though, it does not involve the immune system in the same way. Instead, it is a nerve reflex set off by irritation of the nasal mucous membranes.

That kind of irritation is often caused by physical triggers such as dust, smoke or perfume. But the same reflex can also be started by a surprising range of other things, including bright sunlight, fizzy drinks, cold air or even plucking an eyebrow. With gustatory rhinitis, the trigger is certain foods, including spicy items such as pepper, chili peppers, mustard, wasabi and horseradish. Strong-flavored foods like wintergreen, peppermint and dark chocolate can also bring it on. Foods that are simply hot in temperature can do the same.

Many sneeze triggers are well known. For instance, plucking an eyebrow hair can activate a branch of the trigeminal nerve. But the mechanism behind gustatory rhinitis is not fully understood, including the runny nose, congestion and sudden bursts of sneezing sometimes jokingly called “sneezures.”

Gustatory rhinitis is not dangerous, but it can still be annoying and affect quality of life. The simplest approach is to avoid the foods that trigger it. If heat is part of the problem, letting food cool before eating may help. For those who prefer not to avoid the foods, especially when dining with others, certain nasal sprays may provide relief. Prescription anticholinergic sprays block acetylcholine, a chemical messenger involved in nasal secretions and sneezing, and when used before meals they can help prevent a runny nose. Some people also find that a saline rinse, especially before eating, reduces the response.

Because gustatory rhinitis is harmless, treatment is really a matter of comfort and preference. But if your symptoms change, become more frequent or severe, or begin to include signs of a true allergic reaction, you should talk with your healthcare provider.