Water dripping from nose when bending over

About 6 years ago I took Nasonex for a few weeks. Soon after I started using it I noticed that every time I bent over water started pouring from my nose. After I discontinued using the product, it seemed to go away.  It just started happening again out of the blue. I was bending over to feed the cats and I felt the water pouring out of my nose (which was slightly salty), I thought at first it was a nose bleed.  I am not taking any meds, but I am 19 weeks pregnant. This only seems to happen when i bend at the waist.

I have been getting minor headaches, and I just chalked it up to the pregnancy. I did not worry about this until someone told me I had better get checked to make sure it was not a CFS leak. I have not had any head or neck trauma recently, the only trauma I have ever had is whiplash 15 years ago from a severe car accident.

I thought CFS leaks are rare, especially when there has been no trauma. Could there be any other less dramatic explanation to why this is happening?

[David Tinkelman, M.D.]

The most likely cause of your nasal drainage would be some type of chronic sinus disease, causing fluid accumulation in one or more of your sinuses, the drainage of which is positionally dependent.  Such drainage is a not uncommon scenario when one engages in nasal irrigation (also referred to as nasal washes).  

Another possibility would be a (Zenker’s) diverticulum (out-pouching) of the pharynx, where fluid could accumulate and suddenly gush out with a change in position.

CSF leakage is a possibility, but as you indicate, very rarely occurs in the absence of trauma or following nasal surgery, Spontaneous leakage of CSF would appropriately categorized as extremely rare.

Your doctor may want to request laboratory analysis of the fluid.  In addition, you and your doctor may want to request consultation with a head and neck specialist to determine the most likely source of the fluid and this may require a CT Scan of your nose and sinuses, the areas to be scanned perhaps guided by the characteristics of the fluid.

I could find no reference, with a literature search, of an association between pregnancy and CSF leakage but your doctors, especially an obstetrician who specializes in complications associated with pregnancy, may have personal knowledge of such an association.

Good luck

[Gob123]

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