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Gustatory Rhinitis (Read 15424 times)
bongaan
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Gustatory Rhinitis
12/06/12 at 01:19:03
 
Some info and then my question  Smiley

Gustatory rhinitis is triggered by eating. It inflames the nose and is experienced as post nasal drip. Vinegar, tomatoes, citrus fruit, coffee tea alcohol, chocolate, curry & spicey food are common offenders.

Some of you will note that the above foods are  well known histamine liberators or contain histamine (vinegar) or block the DAO enzyme which brake down histamine (alcohol), but then I read elsewhere:

the condition is not caused by the response of the body’s immune system and there is no release of histamines, antihistamines cannot effectively treat gustatory rhinitis.

This does not add up! Consuming food which are well known to liberate histamine cause gustatory rhinitis, but gustatory rhinitis are not caused by histamine?  Cheesy Grin This doesn't make sense to me!? You? Maybe all they mean is that it is a non-allergic reaction, but there is definitely a release/ingestion of histamine.

The reason why I'm questioning this, I battle with gustatory rhinitis and my understanding was that gustatory rhinitis is caused by histamine. And I DON'T need any additional histamine in my system! So I've been avoiding foods that cause gustatory rhinitis like the plague and I don't believe I'm wrong as I definitely know that most of those foods mentioned above make my feel terribly ill in terms of histamine.

I'm worried that if I use something like Gastrocrom to reduce my gustatory rhinitis that I am only going to address the symptoms of histamine and not the cause of histamine.  Undecided
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Joan
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Re: Gustatory Rhinitis
Reply #1 - 12/06/12 at 09:12:07
 
Gastrocrom stabilizes the mast cells so they don't react as much to triggers.  It addresses basic cause, and that is a trigger stimulating the cells to degranulate, better than an antihistamine.  When mast cells degranulate, they release histamine, which then attaches to receptors (called H1, H2, H3, and H4).  Antihistamines, now available for H1 and H2 receptors, attach to those histamine receptors and keep the histamine from doing the same.  Gastrocrom keeps the histamine from being released in the first place.

What you said about different explanations on different sites is true.  It's best to consider first the source and the expertise of the writer.  There are very many misconceptions about MC disease out there, even among scientists and so-called "experts."

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bongaan
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Re: Gustatory Rhinitis
Reply #2 - 12/06/12 at 18:07:38
 
Oh yes, Gastrocrom is cromolyn sodium which is a mast cell stabilizer and therefore it will definitely reduce the histamine as well. Apologies, I'm still learning which brand names are antihistamines and which are mast cell stabilizers. Thank you Joan for correcting my rookie mistake!
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Ann M
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Re: Gustatory Rhinitis
Reply #3 - 02/08/13 at 10:57:37
 
Hello!  I'm a newbie and a total rookie when it comes to understanding m.c., Gustatory rhinitis, non-allergic rhinitis, etc. In fact, I only came across the last two terms this afternoon.  A lister on the Trying_low_oxalates forum suggested that I look into m.c. disorders, so here I am.

I've been on a low-oxalate diet for about 6 months now, and have slowly lessened the burning and associated issues of V.V.P.  I'm grateful for that, but am super perplexed by a new problem.  For the past month I have had allergy-like symptoms (runny nose, watery eyes, occasional sneezing) that don't respond to antihistamine medication (e.g. Claritan) even when combined with a decongestant.

At first, the allergy symptoms would often be combined with a sudden onset of V.P. (burning).  Now it is primarily the nasal histamine release with less or just occasional burning.  I don't have trouble at night because the symptoms seem to come on shortly after eating meals or snacks.

I've been trying to eliminate foods high in histamines, but that doesn't seem to be the key.  I've never been an allergy-prone person, and was always been able to eat just about anything until I became lactose intolerant about 4 years ago.

My questions are these:  Why am I suddenly experiencing this disorder, and what is going on?  Did lowering oxalates in my diet somehow affect my mast cells and cause the release of histamines?  If so, what do I do to get relief and how long will this last?  Is this just a "dumping" (oxalate detox) symptom, or will I have to live with this indefinitely?  The sensitive food lists (acids, histamines, sals, etc.) haven't been all that helpful, to be honest, and I'm having a hard time identifying the triggers.  I shouldn't lose any more weight, but what can I eat or drink that isn't either too high oxalate, or a trigger for these symptoms?

I'd really appreciate any insights or help you can give.

Thanks,

Ann

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Ann M
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Re: Gustatory Rhinitis
Reply #4 - 02/08/13 at 10:58:19
 
Hello!  I'm a newbie and a total rookie when it comes to understanding m.c., Gustatory rhinitis, non-allergic rhinitis, etc. In fact, I only came across the last two terms this afternoon.  A lister on the Trying_low_oxalates forum suggested that I look into m.c. disorders, so here I am.

I've been on a low-oxalate diet for about 6 months now, and have slowly lessened the burning and associated issues of V.V.P.  I'm grateful for that, but am super perplexed by a new problem.  For the past month I have had allergy-like symptoms (runny nose, watery eyes, occasional sneezing) that don't respond to antihistamine medication (e.g. Claritan) even when combined with a decongestant.

At first, the allergy symptoms would often be combined with a sudden onset of V.P. (burning).  Now it is primarily the nasal histamine release with less or just occasional burning.  I don't have trouble at night because the symptoms seem to come on shortly after eating meals or snacks.

I've been trying to eliminate foods high in histamines, but that doesn't seem to be the key.  I've never been an allergy-prone person, and was always been able to eat just about anything until I became lactose intolerant about 4 years ago.

My questions are these:  Why am I suddenly experiencing this disorder, and what is going on?  Did lowering oxalates in my diet somehow affect my mast cells and cause the release of histamines?  If so, what do I do to get relief and how long will this last?  Is this just a "dumping" (oxalate detox) symptom, or will I have to live with this indefinitely?  The sensitive food lists (acids, histamines, sals, etc.) haven't been all that helpful, to be honest, and I'm having a hard time identifying the triggers.  I shouldn't lose any more weight, but what can I eat or drink that isn't either too high oxalate, or a trigger for these symptoms?

I'd really appreciate any insights or help you can give.

Thanks,

Ann

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Joan
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Re: Gustatory Rhinitis
Reply #5 - 02/08/13 at 19:39:50
 
Hi Ann,

  So sorry you're having these problems.  Have you been allergy tested, and if so, what came back positive?  Do you know about Atrovent nasal spray?  It's very helpful for gustatory rhinitis.  I don't know if it comes in other forms or not.

  Claritin is a relatively mild H1 antihistamine.  You might want to try a different one, such as Allegra or Zyrtec, and see if that helps.  Ask your doctor if one of those would be okay to take.  Also ask about H2 antihistamines, such as Pepcid or Zantac.  One of those might help.

  Be sure to read on this forum about how a mast cell disorder is diagnosed, and also about mast cell specialists who can rule a MC disorder in or out.  If you think this is what you have, then a mast cell specialist, or a good doctor who is willing to work with a MC specialist,  is usually needed to confirm or disprove the diagnosis.

  Do you have any other symptoms and are you on any other meds?
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Ann M
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Re: Gustatory Rhinitis
Reply #6 - 02/08/13 at 20:23:22
 
Thanks, Joan, for suggesting other stronger antihistamines.  Is the nasal spray OTC?  No, I haven't seen an allergist or been tested for allergies, as this is such a recent problem.  The only other symptoms I have may be attributable to oxalate dumping (occasional sleeplessness, sandy stools, brain fog).  I'm taking a number of supplements recommended by the low-oxalate forum:  calcium and magnesium citrate, B Complex, Biotin, NAG, probiotic, etc., but no Rx apart from the steroid cream prescribed by my GYN for V.P.  I've been studying the elimination diet and will try to find foods that are both low-oxalate and low-histamine.  It's a challenge.  I'm getting very tired of white rice!
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Joan
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Re: Gustatory Rhinitis
Reply #7 - 02/09/13 at 08:32:48
 
If I were in your situation, I'd see an allergist for testing.  True IgE allergies are one thing to rule out before a mast cell diagnosis is considered.  Atrovent nasal spray is Rx only.  An allergist can also prescribe other sprays, too.  Another one that could be helpful is Nasalcrom, a mast cell stabilizer for the nose.  There are also antihistamine nasal sprays, such as Astelin (comes in generic, Azelastine) and steroid nasal sprays that are not absorbed systemically to a great degree.

It sounds as though you believe your symptoms might be caused by certain foods or food groups, and an allergist can advise you on elimination diets that might be helpful.  A nutritionist might be able to help, too.  For example, if you tested positive to certain pollens, you might need to avoid some foods that cross-react.

Unfortunately, figuring out food triggers is mostly a process of trial and error if it's not a true allergen.  You should be able to eat a variety of healthy foods, even on a low-oxalate, low histamine diet.  I briefly looked at a low oxalate food list, and there were only a few foods/drinks that would not be recommended on a low histamine diet.  Still, these are only 2 of the many possible elimination diets you can try.  When my daughter was having problems, we cut her back to lamb, rice, pears, and yellow vegetables for 10 days, and then started adding foods, one at a time, every other day.  It was obvious when we found what was causing her problems, so we eliminated those foods permanently.  Starflower posted Dr. Castells' elimination diet, which she found helpful.

It's also important to rotate your diet.  Eating only a few foods can be a problem, as having them every day can sometimes cause sensitivities to surface.  Dietary deficiencies can develop, too, which can cause more symptoms.

If you're negative to all allergens, food and environmental, then you might want to pursue some other things, like mast cell disorders.  I have a mast cell disorder and IgE allergies, and there are times when I get  gustatory rhinitis.  The Atrovent and eating a "gentler" diet usually takes care of the problem within a day or two.

I hope you can figure this out soon!
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Re: Gustatory Rhinitis
Reply #8 - 02/10/13 at 01:48:40
 
Joan didn't mention, but allergy testing can be done through testing your blood. This is advisable rather than skin prick testing so that the offending ingredient isn't introduced to your body.
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Re: Gustatory Rhinitis
Reply #9 - 02/10/13 at 02:21:40
 
I second that!  My experience (as a mast cell patient) with skin prick testing is that it's also very unreliable... not to mention dangerous if you're already taking antihistamines on a daily basis.  For the test to be "accurate" you would have to stop taking antihistamines several days in advance (don't do it!!!).  I've definitely received more useful information from RAST (blood) testing.

By the way... I also have gustatory rhinitis, but as I recall it's not mast-cell related and has  nothing to do with the specific foods you're eating.  It's just your upper GI system overreacting to the mechanical action of eating.  Medscape says it's a type of "non-allergic" rhinitis:

http://emedicine.medscape.com/article/874171-overview#aw2aab6b3

Bongaan - in response to your original post, I wouldn't worry to much about this particular symptom.  Just carry tissues Grin

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Joan
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Re: Gustatory Rhinitis
Reply #10 - 02/10/13 at 15:50:19
 
In many cases, skin testing, prick and/or intradermal, can be done without going off antihistamines.  The mast cell doctors used to say not to go off them for testing, and I don't know if they still say that.  I've done both kinds of skin tests several times without going off the antihistamines and still had responses to allergens.  However, I don't usually have any skin problems at all.  They might not be recommended for people who have eczema, hives or UP or other rashes.

I've read that the older RAST blood testing is being replaced with a newer type of blood test that is more sensitive and more accurate with fewer false positives.  That might be the safest and easiest method for suspected mast cell patients.

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Ann M
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Re: Gustatory Rhinitis
Reply #11 - 02/12/13 at 09:50:05
 
Thank you all for your feedback and advice.  I hope to schedule an appt. with an allergist soon.  Ann M.   Smiley
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Re: Gustatory Rhinitis
Reply #12 - 02/12/13 at 10:25:34
 
Can anyone recommend an allergist in the So Cal Pasadena/Glendale area?
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Re: Gustatory Rhinitis
Reply #13 - 02/28/13 at 03:06:26
 
ann:
For the nasal mast cell issue. Before you go the rx way & not to say you may need to go that way,  Nasalcrom, which is basically gastrcrom in a nasal spray, is an OTC med. I use it when I get a sinus headache or sinus pressure with good results. There is a ketotifen version OTC as well but I haven't been able to find it at the pharmacies that I go to.
mikev
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