Having a runny nose is an extremely common experience. We all have had days when constant wiping of the nose was the biggest highlight of the day. Extremely common in children, a runny nose is seldom a sign of any serious medical problem. Common cold or hay fever are the major culprits causing clear nasal discharge and the clear fluid leaking from the nose is usually produced by the inner lining of the nose.

Common Reasons Why Your Nose Is Leaking Clear Fluid

The nose is lined by mucous membrane and anything which irritates or inflames this lining can lead to excessive production of mucous and fluid and can lead to a runny nose. The most common reasons for a nose leaking clear fluid are allergies and infections like cold and influenza.

Another reason for a constant runny nose is vasomotor rhinitis, where no apparent cause is present for a constant runny nose. Nasal polyps, migraine headaches, foreign bodies and very rarely some tumours can lead to a leaking nose.

The main causes of runny nose are:

• Acute or chronic sinusitis
• Allergies
• Common cold
• Deflected nasal septum
• Over use of decongestant nasal spray
• Drug addiction
• Dry air
• Foreign body
• Hormonal imbalance
• Medication side effects
• Nasal polyps
• Non allergic rhinitis
• Pregnancy
• Spina bifida leak
• Tobacco smoke
• Occupational asthma
• Viral infections (influenza and RSV)
• Chrug-Strauss syndrome
• Wegener's granulomatosis

What You Should Do

Self-Care at Home

If you have nasal discharge it can be very uncomfortable. Try to keep yourself well hydrated and follow these tips for a nose leaking clear fluid:

• Gently blow the nose and clean it with soft tissues. Do not blow very forcefully.
• If you have redness or itching of eyes as well, it indicates an allergy and over the counter anti-allergy medicines can help to relieve the symptoms.
• If you suffer from known allergies, try to keep away from the allergens.
• Use a soft suction bulb for kids and babies to keep the nose clear.
• When there is excessive mucous production, sometimes it starts to dribble at the back of throat which is termed as post nasal drip. If you are experiencing it, the best thing to do is to avoid allergic stimulants, sudden temperature changes and tobacco smoke. Having plenty of fluids and nasal washes can also be very helpful.

Time for a Doctor Visit

Mostly a runny nose gets better in a few days time and does not require any treatment. You must consult your doctor if any of the following happen:

• The discharge turns yellow or greenish indicating the presence of infection
• The symptoms last for more than a week
• The discharge becomes blood stained
• Associated fever or high temperature

Nasal discharge can be serious in infants and children, contact the paediatrician immediately if the child is less than two months old or if any of the following is present:

• The child is having difficulty in breathing or is unable to take food
• There is fever

Could It Be Something More Serious?

Most of the times, a nose leaking clear fluid is caused by allergies of infections but very rarely, it can be a CSF leak or a brain leak.

The brain is surrounded by CSF (Cerebral Spinal Fluid); in extremely rare circumstances when there is some damage to the skull bone, this fluid starts to leak through the nose or the ear. A spontaneous leak starts without any cause and a traumatic leak occurs as a result of damage to the skull bone resulting from injury, surgery or tumours.

Causes

Spontaneous CSF leaks from the nose are extremely rare.

The most common CSF leaks from the nose are traumatic leaks. Traumatic CSF leaks from the nose can result after head injury and fracture of the base of the skull or as a complication after some surgeries. Due to the damage of skull bone the CSF leaks through the nose.

Symptoms

The most common symptom of CSF leak is drainage of clear and watery fluid through one or both sides of the nose. This leakage can increase on bending forwards, tilting the head or straining.

Other associated symptoms include:

• Headachesthat are severe when the head is upright and usually get better on lying down
• Tinnitus
• Nausea
• Diplopia or double vision
• Change in hearing
• Blurred vision
• Numbness of face
• Tingling sensation in the arms

These symptoms are non specific and can occur in many other conditions as well. Post traumatic headache and migraines also lead to a similar picture. Sometimes it can take up to a month to develop the symptoms.

Treatments

CSF leaks can be treated medically or surgically depending upon the severity and patient condition.

Conservative Treatment

Conservative treatment is advised for CSF leaks following head injury or for spontaneous leaks.

• It is recommended to have a couple of weeks' bed rest. Sneezing, straining, coughing and lifting heavy objects is restricted.
• Sometimes a lumbar drain is placed to drain excessive CSF and to reduce pressure on the area of injury. This approach helps in healing process.

Epidural Blood Patch

Another treatment modality is the use of an epidural blood patch. It is used for the patients who do not respond well to conservative treatment measures.

Surgery

If the conservative management is not successful, the hole in the base of the skull can be repaired surgically and closed with the help of a graft. The procedure can be performed through an external incision or using an endoscope. The graft used to close the hole in skull bone can be a synthetic graft or natural body tissue can also be used.

After the surgery, the nose is packed with sterile nasal packs which are removed after a week.

It is extremely important to maintain adequate hydration during the treatment process and sometimes steroids are also used with success.