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Postnasal drip

Dr. Suvansh Raj NirulaMBBS

December 16, 2020

January 08, 2021

Postnasal drip
Postnasal drip

If you constantly feel like you have phlegm in your throat or you need to clear your throat often, you might be experiencing postnasal drip.

Postnasal drip is basically excess mucus dripping down the back of the throat (left untreated, postnasal drip can cause a persistent cough that gets worse at night—but more on that later in the article).

Now, mucus is actually a good thing. Produced by glands lining our nose, throat, airways and gastrointestinal tract, this thick and wet substance performs the function of moistening these areas and trapping foreign bodies like dust, bacteria and viruses.

Healthy people usually do not feel the passage of mucus as it mixes with saliva and is swallowed down the back of the throat. But, in certain cases, if the mucus produced by the body is thicker than usual, patients can notice it passing down the throat even after it mixes with the saliva.

When mucus is produced in excessive amounts, it may come out of the nostrils (seen as a runny nose). Or it may pass down to the throat—this, as we said, is known as postnasal drip.

Sometimes children can get excess (smelly) mucus coming out of one nostril and going to the back of their throat. This could happen if they have a small object stuck up that nostril—if you suspect this, it is important to take your child to see a doctor who can carefully remove the object.

Postnasal drip can irritate the throat and cause problems like a persistent cough that gets worse at night, hoarse voice, and sore throat. Read on to know how to manage postnasal drip, when to see a doctor and more.

Postnasal drip symptoms

The most common symptoms of postnasal drip include

  • Patients experience the need to constantly clear the throat due to mucus buildup
  • Cough that may be worse at night 
  • The cough may become persistent 
  • Hoarseness of voice 
  • Sore throat
  • Itchy throat 
  • Patients may develop ear infections due to blockage of the eustachian tube by mucus. The eustachian tube connects the middle ear to the nose and throat
  • Sinus infections may occur as well
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Postnasal drip causes

Excessive mucus that causes a postnasal drip may be the result of:

  • Allergies
  • Sinusitis: Inflammation of sinuses
  • Sinus infection
  • Flu
  • Common cold
  • Foreign body in the nose (commonly observed in children)
  • Medications such as contraceptive pills or antihypertensive medications
  • Pregnancy
  • Anatomical defects like deviated nasal septum. It is the deviation of the septal wall separating the two nasal cavities.
  • Weather fluctuations, dryness of air or areas with cold temperatures
  • Spicy food is known to aggravate mucus production and flow
  • Fumes produced from chemicals, perfumes and smoke
  • Postnasal drip may also be a result of improper clearance of mucus and not excessive production. Issues with proper swallowing can lead to the accumulation of liquids in the throat which presents in a similar way as a postnasal drip. These issues may be a result of increasing age, any blockage or any illnesses like gastroesophageal reflux disease (GERD).

Post nasal drip diagnosis

You should see a doctor

  • If you often feel like you need to clear your throat
  • If your throat is scratchy or sore
  • If you have a cough that has gone on for more than a week—especially if that cough gets worse at night

Your doctor would be able to gauge what may be causing your post nasal drip based on a physical examination. He or she may also ask you further questions about your symptoms.

In case your doctor suspects that an allergy or infection may be the cause, he/she may also recommend some tests like the allergy test or blood tests.

Post nasal drip treatment

There are a large number of treatment options available to treat a postnasal drip. The choice of treatment depends on the underlying cause of the postnasal drip.

The following treatment options may be utilised: 

  • Antibiotics: Antibiotics act by clearing up bacterial infections. However, the green or yellow colour of the mucus alone does not always indicate a bacterial infection. Viral infections are also known to change the mucus colour—antibiotics will do more harm than good in these cases. That is why it is important that you see a doctor for a proper diagnosis rather than self-medicating. 
  • Antihistamines: Antihistamines and nasal decongestants can help in some cases of post nasal drip caused due to sinusitis and viral diseases. Steroid nasal sprays like fluticasone may also aid in the treatment of allergic causes.
    Some over-the-counter antihistamine drugs like diphenhydramine and chlorpheniramine maleate should not be used in cases of postnasal drip as they are known to cause drying and thickening of the mucus that may make the condition even worse.
    Second generation antihistamine drugs like cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine are better suited. They also have fewer side effects and do not cause drowsiness. Some side effects may include dizzinessdryness of mouth and urination problems. 
  • Treatment to aid in the thinning of mucus: Mucus that is thick is more sticky and worsens the symptoms. By thinning it, you may be able to avoid any ear or sinus infections. The following methods may help in thinning of mucus: 
    • Improving hydration
    • Drugs such as guaifenesin
    • Saline nasal sprays to flush out bacteria, allergens and excessive mucus
    • Air humidifiers to help in increasing the moisture in air
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