Allergy, Sinus or Something Else?
A constant runny nose is a very common complaint, yet frequently misunderstood. Many people assume it is due to flu or “resdung”, but when nasal discharge persists for weeks or months, it may signal an underlying nasal or sinus condition that requires proper ENT assessment.
As an ENT specialist, I often see patients who have been self-medicating with antihistamines or nasal sprays for years, without addressing the real cause of their symptoms.
What Is a Runny Nose?
A runny nose (rhinorrhoea) refers to excess nasal discharge, which may be:
- Clear and watery
- Thick and yellowish
- Sticky and difficult to clear
- Dripping backwards into the throat (post-nasal drip)
The colour, consistency, and duration of the discharge provide important diagnostic clues.
Common Causes of a Constant Runny Nose
1. Allergic Rhinitis (Resdung)
The most common cause in Malaysia, especially in urban areas like Kuala Lumpur.
Typical features:
- Clear watery discharge
- Frequent sneezing
- Nasal itchiness
- Symptoms worse in the morning or after dust exposure
2. Non-Allergic Rhinitis
Nasal lining becomes over-sensitive despite no true allergy.
Triggers include:
- Cold air
- Strong smells or perfumes
- Smoke or pollution
- Stress
Patients often have a runny nose without sneezing or itchiness.
3. Sinusitis
Inflammation or infection of the sinuses leads to excess mucus production.
Associated symptoms:
- Thick yellow or green discharge
- Facial pain or pressure
- Post-nasal drip
- Reduced smell
4. Post-Nasal Drip
Mucus flows from the nose into the throat rather than out of the nostrils.
Common complaints:
- Constant need to clear the throat
- Sensation of mucus stuck in throat
- Chronic cough
5. Nasal Polyps
Soft tissue swellings inside the nose due to chronic inflammation.
Clues:
- Persistent runny nose
- Nasal blockage
- Reduced or loss of smell
6. Cerebrospinal Fluid (CSF) Leak (Rare but Serious)
Clear watery discharge from one side only, especially when bending forward.
🚨 This is NOT normal and requires urgent ENT assessment.
🚨 When Should You Worry About a Runny Nose?
Seek ENT review if you have:
- Runny nose lasting more than 3–4 weeks
- One-sided persistent discharge
- Thick, foul-smelling discharge
- Runny nose with facial pain or fever
- Clear watery discharge after head injury
Early diagnosis prevents complications and unnecessary long-term medication use.
How an ENT Specialist Evaluates a Constant Runny Nose
Assessment may include:
- Detailed symptom analysis
- Nasal examination
- Nasal endoscopy to visualise the nasal cavity and sinus openings
- Allergy assessment
- Imaging (CT scan) if sinus disease is suspected
This allows targeted treatment, rather than trial-and-error therapy.
Treatment Options for Constant Runny Nose
✅ Medical Treatment
- Intranasal steroid sprays
- Antihistamines (if allergy-related)
- Saline nasal irrigation
- Short-term medication for acute infection
✅ Lifestyle & Trigger Control
- Dust mite control
- Environmental modification
- Avoidance of irritants
✅ Surgical Treatment (If Required)
- Endoscopic sinus surgery
- Polyp removal (polypectomy)
- Turbinate reduction (endoscopic procedure)
Surgery is considered only when medical treatment fails or when structural disease is present.
Frequently Asked Questions (FAQ)
Q: Is a constant runny nose normal?
No. Persistent nasal discharge indicates an underlying problem.
Q: Can sinus problems cause clear discharge?
Yes, especially in early or chronic sinus disease.
Q: Should I stop nasal sprays if my nose keeps running?
Not without medical advice. Incorrect use may worsen symptoms.
When Should You See an ENT Specialist in Kuala Lumpur?
You should consult an ENT specialist if:
- Symptoms persist despite medication
- You rely on nasal sprays daily
- Your runny nose affects sleep, work, or quality of life
- You have warning symptoms such as one-sided discharge
ENT evaluation allows accurate diagnosis and long-term relief.
Dr. Ameen, ENT Specialist in Kuala Lumpur 