Ask the doctors 9/3

Dear Doctor: Why do I sneeze after a meal? It doesn’t matter what kind of food it is, and it doesn’t have to be after a particularly big meal. Beverages don’t seem to be an issue. What’s going on?

Dear Reader: You’ve described a condition known as gustatory rhinitis. When something irritates the mucous membranes of the nose and causes them to become inflamed or swollen, it’s known as rhinitis. It can result in nasal congestion that ranges from mild to severe, a runny nose, postnasal drip and sneezing. Rhinitis is divided into two categories: allergic and non-allergic. Gustatory rhinitis falls into the latter category. Although the symptoms are similar to those of an allergy such as hay fever, the condition doesn’t involve the same type of immune response.

We tend to think of sneezing as a reaction to inhaling an irritant that “tickles” the nose, such as pollen, dust, pet dander, perfumes, mold, pollutants or smoke. The purpose of the propulsive gust of air delivered by a sneeze is to clear away that irritant. However, sneezing has other triggers. Some people sneeze in response to cold air, fizzy drinks, pungent foods such as chili or peppermint, sexual activity, exercise, when plucking an eyebrow, or when emerging from dim light and then looking at the sun or other bright light. Interestingly, sneezing associated with bright light, known as photic sneeze reflex, occurs in 20% to 35% of the populace and has been linked to genetics. Individuals who have this response often sneeze the same number of times in each episode.

People who sneeze when their eyebrows are plucked are responding to stimulus to the trigeminal nerve, one of the 12 cranial nerves. It has three separate branches, which send sensations from the upper, middle and lower portions of the face to the brain. When the branch of the trigeminal nerve in the forehead is stimulated by tweezing, threading or waxing an eyebrow, the branch of the nerve in the nasal area is activated as well, which can result in a sneeze.

When it comes to the type of gustatory rhinitis you’re experiencing, which some people refer to as “sneezures,” the mechanism isn’t fully understood. In some cases, post-meal sneezing arises as the result of spicy or pungent foods. Common triggers can include horseradish, peppercorns, hot peppers, pickled foods, wasabi and dark chocolate. Temperature can also play a role. For some people, a sip of hot soup can bring on a sneeze. Sneezing at the end of a meal also has been linked to the stomach becoming full and, thus, distended. There is evidence that this, too, has a genetic component. Gustatory rhinitis also becomes more common as people age.

Although not a health risk, sneezing after a meal can be an unpleasant distraction. It’s a good idea to monitor what you’re eating just to rule out a link to the contents of the meal. A pattern you hadn’t noticed before may emerge. It’s also possible that eating smaller meals, which don’t distend the stomach as much, may also bring relief.

Send your questions to askthedoctors@mednet.ucla.edu.