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 nose 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.

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 spray, 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, or an ENT (ear, nose, and throat) specialist, or 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 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

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