Postnasal drip occurs whenmucusin your nose drains down the back of your throat. This may happen because your body produces more mucus than it needs or you are not able to clear it as quickly as usual. In some cases, another condition such as infection requires treatment.
Mucus itself isn't harmful and actually protects you from illness and provides lubrication. Still, you may seek relief from symptoms of postnasal drip (often called upper airway cough syndrome) that include cough, frequent throat clearing, or hoarseness.
Symptoms
The symptoms of postnasal drip are generally mild and include:
- Sore throat
- Coughing
- Hoarseness
- Losing your voice
- Persistent cough (postnasal drip is also known as upper airway cough syndrome)
- Throat that's scratchy, tickling, or itching
- A burning feeling in the throat
- The sensation of a lump in the back of your throat
- Throat clearing
- Watery eyes
These symptoms can get better or worse throughout the day. For example, you may feel worse after lying down for a while or after talking for a long time.
Postnasal drip generally lasts for a few days or weeks, depending on the cause. If it becomes chronic, you may have it for months.
Causes
The cause of postnasal drip can be categorized as short-term conditions, sudden triggers, or longer-lasting (chronic) issues.
Temporary Conditions
Some temporary conditions that can cause postnasal drip include:
- Infections like sinusitis, the common cold, influenza, cytomegalovirus (CMV), respiratory syncytial virus (RSV), adenovirus, and strep throat
- Seasonal allergies
- Pregnancy-induced rhinitis
- Hormone fluctuations
Sudden Triggers
Sudden triggers that can cause postnasal drip and cough include:
- Eating spicy or sour foods
- Eating dairy products
- Exercise-induced rhinitis
- A foreign object stuck in the nose
- Pet allergies
Chronic Conditions
Chronic causes of postnasal drip include:
- GERD, or chronic acid reflux
- Allergies to mold, dust, or dander
- Anatomical abnormalities such as a deviated septum or enlarged turbinates
- Medications such as birth control and drugs to lower blood pressure
- Rebound congestion due to overuse ofpseudoephedrinenasalsprays
- Swallowing problems
Diagnosis
Postnasal drip is usually diagnosed based on your symptoms and a physical exam. If your provider is unsure of the diagnosis, they may want you to have allergy testing, imaging, or other tests to look for a cause. These can include:
- Physical examination: If you have a fever, your postnasal drip could be caused by an infection. Other symptoms include headaches, fever, chills, sore throat, and muscle aches. If your phlegm is tinged with blood, it could be a sign of a more serious infection.
- Allergy Testing: You may have an allergy to food, pollen, or another source if your postnasal drip symptoms come and go. Allergy testingcan help to pinpoint postnasal drip triggers.
- Imaging: If you have postnasal drip most of the time, it could be from an anatomical cause, such as a deviated septum. Imaging tests may be needed to identify a structural cause.
- Interventional Tests: If your provider thinks you have something like GERD, you might need special tests such as an esophagogastroduodenoscopy to check the lining of your esophagus, stomach, and small intestine.
How to Stop Postnasal Drip
There are several strategies fortreating postnasal drip. If it’s mild and you don’t have it all the time, you can probably manage postnasal drip symptoms at home. If it’s more of a constant or severe problem, you might need medication or surgery to fix the cause of postnasal drip.
Home Remedies
There are several postnasal drip home remedies that can help ease symptoms. These lifestyle tips may make it easier to deal with postnasal drip, no matter what’s causing it:
- Drink plenty of water to lubricate your throat and keep your mucus thin(and less bothersome).
- Use a cool-mist humidifier at night while you sleep.
- Try rinsing your nasal passageways with a neti pot.
- Use a vaporizer or diffuser with essential oils, such as peppermint or eucalyptus.
What About Chicken Soup?
Research on classic chicken soup suggests it seemed to help with symptoms. Experts say that any hot liquid (not just soup) can thin mucus and may help with postnasal drip.
Over-the-Counter Treatments
If you also have symptoms like congestion, sore throat, and cough along with postnasal drip, you can try some over-the-counter (OTC) treatments including:
- Tylenol (acetaminophen) or cough lozenges for sore throat
- Claritin (loratadine) and Benadryl (diphenhydramine), antihistamines that can ease allergy symptoms
- Sudafed (pseudoephedrine) for congestion
- Medicated nasal spray, such as Afrin (oxymetazoline), to make breathing more comfortable
- Mucinex (guaifenesin) to loosen up mucus
- Saline nasal spray to clear blocked nasal passages
- Vapor rubs to help you breathe easier
- Nasal irrigation (with a neti pot or another method)
Ask your healthcare provider or pharmacist before using any new treatments or medications, even those you get OTC. You should not use decongestants for more than three days in a row.
Prescription Medications
There are also prescription medications that can be used to treat postnasal drip or the underlying cause of it.
For persistent postnasal drip or postnasal drip that’s complicated by asthma, a provider may prescribe a medication called Atrovent (ipratropium bromide) or a steroid. If you have a bacterial or fungal respiratory infection, you may need antibiotics or antifungals to treat it.
GERD needs a treatment strategy that includes medications and lifestyle changes, such as avoiding fatty and spicy foods, taking acid-reducing medications, and sleeping with your head slightly elevated.
Surgery
It's a big leap from occasional postnasal drip to surgery, but if your symptoms are hard to treat or the cause is anatomical (e.g., the structure of your sinuses), it could be fixed with a procedure.
Surgeries that may be done for various causes of postnasal drip include:
- Sinus surgery
- Submucosal resection of the septum
- Septoplasty
- Turbinate reduction
When to See a Healthcare Provider
If you have postnasal drip a few times per year and it gets better on its own, you probably don’t need to worry about it.
However, if you have postnasal drip often or for more than a few weeks, you should talk to your healthcare provider. You should also call your provider if you have postnasal drip in conjunction with:
- Difficulty swallowing, trouble breathing, or a choking feeling
- Moderate to heavy blood in your nasal secretions
- Dyspnea (shortness of breath)
- Foul-smelling mucus
- Wheezing
- Fever, vomiting, or ear pain (signs of an infection that needs medical treatment)
Summary
Many people have occasional postnasal drip and it's usually nothing to worry about. Symptoms, like an itchy throat, coughing, hoarseness, and watery eyes, can be irritating but are usually not serious.
Postnasal drip usually goes away on its own. If it doesn’t, or the symptoms get worse, see your provider to find out what’s causing it. In some cases, treating postnasal drip comes down to avoiding triggers, making lifestyle changes, or treating an underlying condition. If you have postnasal drip because of a structural problem, you might need surgery to fix it.
15 Sources
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Additional Reading
Hong JY,Kim JH,Park S,Hwang YI,Jung KS,Jang SH. Efficacy and predictors of response to inhaled corticosteroid treatment for chroniccough. Korean J Intern Med.2019 May;34(3):559-568. doi:10.3904/kjim.2017.291
By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.
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