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, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Our kids are having a hard time with social distancing, which seems like it will last forever. My husband and I know some people who have formed a “quarantine bubble” for socializing and getting the kids together. How does that work? Is it safe?

Dear Reader: An important thing to understand about sustained contact during the pandemic, whether it’s with the people in your own household or the quarantine bubbles that have become increasingly popular, is that everyone is only as protected as the least-careful person in the group. The novel coronavirus is highly contagious, and evidence continues to show that it can be spread before an individual develops symptoms. So when talking about groups of people quarantining together, safety is a relative term.

Protecting against the virus requires ongoing vigilance by every individual within a group. This includes frequent and thorough handwashing, sanitizing high-touch surfaces, keeping at least 6 feet apart from any new contacts and wearing a facial covering while in public. As we mentioned recently, emerging research suggests that face masks made with multiple layers of cloth may offer a measure of protection to the wearer as well as the people around them.

All of which brings us to the quarantine bubbles -- some people refer to them as pods or “quaranteams” -- that you are asking about. These are small groups of people who have agreed to engage in non-distanced activities only with each other. Outside of the group, they continue to wear a mask, stay 6 feet apart and limit the time of contact. Quarantine bubbles have been formed with groups of friends as well as with groups of families. They have arisen out of necessity. In the early days of the lockdown, it was possible for people to white-knuckle their way through strict isolation. But as the pandemic stretches on, people are responding to a need to take care of their mental and emotional health as well. Since the pandemic began, depression, anxiety and loneliness have increased dramatically. Each of these are risk factors for physical illness, including heart disease, stroke and premature death. In the language of public health, the formation of quarantine bubbles is a harm-reduction strategy.

You can mitigate risk by following some important guidelines. Be certain that the network you’re forming or joining is as serious about safety measures as you are. It’s important to keep the group small, 10 people at most. Each additional member increases risk for everyone. Each group member agrees to limit non-distanced activities only to the group, with no exceptions. For the concept to work, you need a closed circuit. Have a plan for what happens if someone breaks safety protocols. Indoor venues are risky, so when possible, keep interactions outdoors. And agree on a trial run, maybe a week or two. That lets everyone get comfortable with the mechanics involved, and to figure out if the bubble approach is right for them.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I was treated for pelvic cancer earlier this year, and ever since finishing chemo, I’ve had problems with balance and movement. My doctor thinks it could be parkinsonism. Is that the same as Parkinson’s disease? Did the chemo cause it?

Dear Reader: Although the two conditions share a similar name and similar symptoms, parkinsonism is not the same thing as Parkinson’s disease. Rather, it’s a term that refers to any neurological condition that can cause the symptoms associated with Parkinson’s disease.

For those of you who aren’t familiar with Parkinson’s disease, it’s a progressive disorder of the nervous system that affects and interferes with movement. Symptoms arise due to disruption in a region of the brain that produces dopamine, a neurotransmitter that plays a big role in smooth and continuous muscle movement. When someone has Parkinson’s disease, the cells in the brain that produce dopamine have either stopped working or have died. The cause of this disruption is not yet known.

A common symptom in Parkinson’s disease is something known as resting tremor. This is trembling or shaking that occurs when muscles are at rest, but which disappears when they are engaged. Additional symptoms include loss of balance, difficulty walking, muscle stiffness or rigidity, and poor coordination. Other changes within the brains of Parkinson’s patients can lead to sleep disruption, skin problems, difficulty with speech and depression. Some people experience a change to their handwriting, which becomes small and cramped. The disease also affects the production of norepinephrine, a chemical messenger that controls functions such as heart rate and blood pressure.

There is no single test for Parkinson’s disease. Diagnosis relies on a detailed medical history, a review of symptoms and various movement and neurological tests. The symptoms of Parkinson’s disease, which tend to appear gradually, can be similar to several other neurological disorders. All of this makes diagnosis a challenge.

Although the symptoms of parkinsonism are similar to those of Parkinson’s disease, they tend to manifest more quickly. Most cases are classified as idiopathic, which means that the origin is unclear. When the condition is caused by a different illness, a different neurodegenerative disorder or as a result of certain medications, it’s known as secondary parkinsonism.

Although it was previously believed to be rare, some researchers have begun to identify cases of chemo-induced parkinsonism. A study conducted by researchers at the Albert Einstein School of Medicine in New York identified several cases in a single year of cancer patients who developed tremors and began to have difficulty walking soon after undergoing chemotherapy. In each case, the patients were treated with levodopa, which is a dopamine replacement used in the treatment of Parkinson’s disease. The patients, who had different types of cancers and were treated with different types of chemotherapy drugs, reported an improvement in their symptoms after two months. When the medication was stopped, the symptoms did not recur. The authors of the study suggested that chemotherapy, particularly when delivered in high doses, may be an under-recognized link to the onset of parkinsonism symptoms. Further research will help shed more light on their hypothesis.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)