Postnasal Drip

Post-nasal drip occurs when excess mucus accumulates or drains down the back of the throat, often leading to throat irritation, coughing, and the persistent feeling of mucus in the throat.

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Understanding Post-Nasal Drip and Its Causes

Glands in your nose and throat continually produce mucus, normally one to two quarts per day. Mucus moistens and cleans the nasal lining, moistens air, traps and clears what is inhaled, and helps fight infection. Mucus is normally swallowed unconsciously, but when there is a feeling of the mucus gathering in the throat or dripping from the back of your nose, it is called post-nasal drip.

What Are the Symptoms of Post-nasal Drip?

Symptoms of post-nasal drip can include:

A feeling of mucus drainage into the throat
Frequent swallowing
Throat clearing
Raspy or gurgling speech
Sore irritated throat
Feeling a lump in the throat

In children, thick or foul-smelling secretions from one side of the nose can mean that something is stuck in the nose, such as a bean, wadded paper, or a piece of a toy. If these symptoms are observed, seek a physician for examination.

Post-nasal drip often leads to a sore, irritated throat. Although there is usually no infection, the tonsils and other tissues in the throat may swell. This can cause discomfort or a feeling that there is a lump in the throat. Successful treatment of the post-nasal drip will usually clear up these throat symptoms.

What Causes Post-nasal Drip?

Causes of post-nasal drip can include:

Bacterial infections
Allergies
Vasomotor rhinitis (overly sensitive nose)
Medications that thicken mucus
Gastroesophageal reflux
Age

Thin, clear secretions can be due to colds and flu, allergies, cold temperatures, bright lights, certain foods or spices, pregnancy, and other hormonal changes. Various drugs (including birth control pills and high blood pressure medications) and irregular nasal cartilage can also produce increased mucus.

Thick secretions in winter often result from dryness in heated spaces. They can also come from sinus or nose infections and allergies, especially to foods such as dairy products. If thin secretions become thick and turn green or yellow, it is possible that a bacterial sinus infection is developing.

What Are the Treatment Options?

Diagnosing post-nasal drip may include a detailed ear, nose, and throat exam, endoscopy (using a camera to look inside the nose and throat), or X-rays. Post-nasal drip can be difficult to cure, and treatment varies according to the cause:

Bacterial infections are usually treated with antibiotics, nasal sprays, decongestants, and nasal saline irrigations. For chronic sinusitis, surgery to open the blocked sinuses may be required.
Allergies are best managed by avoiding the causes. Antihistamines, decongestants, cromolyn, and steroid nasal sprays, or oral steroids may offer relief. Some older, sedating antihistamines may dry and thicken post-nasal secretions more; newer non-drowsy antihistamines do not have this effect. Immunotherapy (desensitization) using allergy shots or drops under the tongue may help. Talk to your doctor before starting any of these medications.
Gastroesophageal reflux treatment includes elevating the head of the bed six to eight inches, avoiding food and beverages for at least three hours before bedtime, weight loss, and eliminating alcohol and caffeine from the diet. Antacids such as TUMS®, Mylanta®, and Gaviscon®, or acid blockers such as Zantac® or Pepcid® also provide benefit. If the reflux does not get better, you should see your primary care provider, an ENT (ear, nose, and throat) specialist, or an otolaryngologist.
Measures that allow mucus secretions to pass more easily may be recommended. Many people, especially older persons, need more fluids to thin out secretions. Drinking more water, eliminating caffeine, and, if possible, avoiding diuretics (medications that remove fluid from the body by increasing urination) will help. Mucous-thinning agents such as guaifenesin (Mucinex®, Robitussin®) make secretions thinner. Saline nasal irrigations alleviate thickened secretions. Nonprescription saline nasal spray (Ocean®, Ayr®) is a natural way to moisten the nose.

Related Conditions

Several other conditions may feel like post-nasal drip but are actually swallowing problems caused by a backup of solids or liquids in the throat. Conditions that may be related to post-nasal drip include:

Sinus conditions
Rhinitis
Gastroesophageal reflux disease
Allergies

What Questions Should I Ask My Doctor?

What is the cause of my post-nasal drip?
Are there any changes in my symptoms that I should be watching out for?
Are there serious complications that could develop?