Sneezing : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 30/09/2022

Sneezing normally occurs under the influence of chemical or physical irritants of the nasal mucosa, when in a dry room, pregnancy. A pathological symptom occurs in acute and chronic rhinitis, allergic rhinitis, sinusitis and nasal polyps. Diagnosis includes anterior and posterior rhinoscopy, radiography of the paranasal sinuses, microbiological and cytological analysis of a nasal swab. Local therapy is carried out with nasal drops with hormones, antibiotics, immunomodulators. Treatment is supplemented with antihistamines and non-steroidal anti-inflammatory drugs, allergen-specific immunotherapy, and surgical methods.

Causes of sneezing

Physiological factors

Sneezing is a natural protective reaction of the respiratory organs to irritants. The symptom is provoked by dust particles entering the nose, inhalation of pungent odors (cigarette smoke, perfumery). People sneeze when they go out into cold air from a warm room and vice versa. In 20-25% of people, a "light sneeze reflex" is manifested - when looking at bright light or the sun. Irritation of nerve receptors when cleaning the ears with cotton swabs also stimulates sneezing.

The symptom is often observed with a long stay in a room with dry air. This is especially noticeable in winter, when heating radiators are working, after installing an air conditioner to heat the room. A person sneezes periodically, feels constant dryness and discomfort in the nose. At the same time, a meager amount of viscous mucus is secreted. Sometimes drying of the nasal mucosa leads to damage to the capillaries and blood streaks become noticeable in the secretions.

Rhinitis of pregnant women

The condition is more common in the third trimester. Sneezing is caused by hormonal changes in the body of a woman, which affect the tone of the vessels of the nasal mucosa. The symptom is noted periodically, supplemented by nasal congestion and slight mucous secretions. Sneezing appears against the background of a general satisfactory condition of a woman without typical signs of a respiratory infection.


The inflammatory process is the most common cause of sneezing. Runny nose occurs mainly with respiratory infections: influenza, rhinovirus, adenovirus. Less commonly, the symptom is associated with the action of bacterial pathogens. Sneezing is one of the first signs of incipient rhinitis, which is accompanied by discomfort and tickling in the nose, difficulty breathing. Features of the clinical manifestations of the symptom depend on the nature of the common cold:

  • Acute rhinitis. Typically frequent, repetitive sneezing, which exudes thin, clear mucus. The symptom may be aggravated by washing the nose, instillation of medicinal drops. After 2-3 days, sneezing appears much less frequently, only with the accumulation of mucus in the nose.
  • Vasomotor rhinitis. Characterized by periodic bouts of sneezing (10-2 times), during which abundant transparent mucus is released. Symptoms are aggravated after a night's sleep, when eating food, when in contact with cold or dry air. Outside of the paroxysm, there is no sneezing, but the patient is worried about nasal congestion.
  • Hypertrophic rhinitis. With this form of runny nose, sneezing mainly develops in the morning, when a viscous secret accumulates in the nose. The patient sneezes several times, trying to get rid of the mucus that interferes. Often the secretions are so thick that they have to be removed by washing or manually.
  • Ozen. Sneezing is observed in the initial stages of this form of atrophic rhinitis. Foul-smelling mucus or pus, dried yellow or brown crusts are discharged from the nasal cavity. Gradually, the protective reflex disappears, which is associated with impaired functioning of the nasal nerve endings.

allergic rhinitis

More common is seasonal rhinitis, characterized by bouts of sneezing at the time of contact with the pollen of trees and flowers. The patient feels excruciating itching and tickling in the nose, sneezes continuously 15-2 times or more. Sneezing is combined with copious watery discharge from the nose, lacrimation, redness of the eyes. After interruption of direct contact with the allergen, sneezing stops, but the feeling of congestion remains.

Perennial allergic rhinitis is much less common. It is characterized by the occurrence of paroxysms of sneezing and difficulty in nasal breathing, regardless of the season. The disease is caused by allergens that are constantly present at home or in the environment, so it is more difficult to treat. When you sneeze, a person exudes watery or thicker mucus.



Bronchial asthma

The symptom is usually observed in the allergic form of the disease. Sneezing becomes a harbinger of an attack of bronchial asthma, accompanied by itching in the nose, sore throat, coughing. The physiological reflex is provoked by the inhalation of cold air, tobacco smoke, physical exertion or stress. After 5-1 minutes, sneezing stops, the patient feels shortness of breath, shortness of breath and other typical signs of paroxysm.


With inflammation of the paranasal sinuses, one or two sneezes occur, due to the flow of mucus into the nasal passages. Then there is a release of a moderate amount of mucous or purulent secretion, in which there may be streaks of blood. Repeated sneezing occurs after nasal irrigation procedures, which is due to irritation of the mucous membrane.

Other infectious diseases

Many infections are manifested by sneezing - rubella, measles, mononucleosis, which are more typical for childhood. The symptom is accompanied by mucous secretions: with measles - abundant and watery, with rubella - scanty, more viscous. Sneezing develops in the prodromal period of the disease, after 2-3 days signs typical for each of the infections are revealed.

nasal polyps

With benign tumors of a small size, patients complain of frequent sneezing and watery discharge from the nose, which are not combined with other signs of SARS. With the growth of polyps, a feeling of a foreign body appears in the nasal cavity, the sneezing reflex turns on less often, the serous secretion is replaced by scanty, unclear mucus. Nasal breathing disorders are typical, nasal voice is noted.

Complications of pharmacotherapy

Periodic sneezing may be a symptom of drug-induced rhinitis due to the uncontrolled use of nasal decongestants (vasoconstrictor drops). As a result, constant congestion, discomfort, sneezing with the release of a small amount of mucus are worried. Only the instillation of drops reduces symptoms, but the effect lasts only 1-3 hours, after which the person is again forced to use the medicine.


An otolaryngologist is engaged in finding out the causes of sneezing. At the first appointment, the doctor asks the patient how long ago the symptoms began, whether treatment was carried out at home. With an objective examination, the specialist pays attention to the presence of skin rashes, listens to the lungs in order to detect the spread of the disease to the lower respiratory tract in time. For diagnosis, laboratory and instrumental methods are used:

  • Rhinoscopy. The most informative method by which the doctor examines the nasal mucosa. The pathology manifested by sneezing is evidenced by hyperemia or cyanosis of the walls of the nasal passages, swelling, the presence of bloody or purulent crusts. During rhinoscopy, nasal polyps are visualized in the form of grape-like growths.
  • Radiography. An x-ray of the paranasal sinuses (PNS) is required to rule out sinusitis. In chronic rhinitis with sneezing, the picture shows parietal swelling of the maxillary sinus mucosa. CT scan of the paranasal sinuses is recommended to evaluate the size and location of polyps.
  • Microbiological research. When sneezing, be sure to take a swab from the nasal mucosa or a sample of secretions for analysis for viruses and bacteria. A cytological study of the biomaterial (rhinocytogram) is necessary to determine the number and ratio of eosinophils, neutrophils, and lymphocytes.
  • Allergy tests. After achieving remission of hay fever or atopic bronchial asthma, skin prick tests are performed for the most common allergens. The technique is used to identify provoking factors and, if possible, exclude their effect on the patient's body.




Help before diagnosis

With a common cold caused by SARS, special therapeutic measures are not required. It is necessary to use saline solutions for washing the nasal cavity in order to remove pathogen particles and exudate, to moisten the mucous membrane. With a feeling of congestion and shortness of breath, you can use vasoconstrictor drops for no longer than 7 days, strictly following the instructions.

To reduce allergic sneezing, you should limit contact with irritating factors: be less outdoors during the flowering period of trees, regularly do wet cleaning to get rid of dust. With an exacerbation of allergic rhinitis, it is desirable to exclude foods that enhance the production of histamine (strawberries and citrus fruits, chocolate and coffee, peanuts).

Conservative therapy

Topical treatment is selected to reduce sneezing and other nasal symptoms. There are several types of nasal drops, the choice of which takes into account the causes of rhinitis. Patients with a disease of bacterial etiology are recommended antimicrobial drugs, with viral diseases - immunomodulators, interferons. To quickly deal with allergic sneezing, there are nasal sprays with corticosteroid hormones.

Systemic drugs are prescribed to treat the underlying disease that triggers the sneeze reflex. In the case of ARVI, antipyretics, immunostimulants are used, and for influenza, specific antiviral drugs. For the treatment of allergic pathologies, antihistamines, leukotriene inhibitors are indicated. With their insufficient effect, they resort to allergen-specific immunotherapy (ASIT).

In chronic rhinitis, nasal electrophoresis with calcium, diphenhydramine or vitamins is used. The technique reduces dryness and swelling of the mucosa, normalizes the tone of the vessels of the nasal cavity. Of the areas of physiotherapy for sneezing, UHF, OKUV therapy, paraffin therapy and acupuncture work best. In rare cases, treatment is supplemented by methods of homeopathic medicine.


Surgical intervention is required in chronic forms of the common cold (especially in the hypertrophic form), when it is impossible to restore breathing with medical methods. An ENT surgeon uses laser vasotomy, ultrasonic disintegration of the nasal passages, or classical submucosal conchotomy. With lakes, the reverse operation is shown - a decrease in the lumen of the nasal passages.

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