What is postnasal drip?
Postnasal drip develops when too much mucus collects at the back of the nose or in the throat. It usually creates the sensation of a “tickle” or itch in the throat that won’t go away. The mucus can be clear and watery or thick with a green, yellow, or white color.
The discomfort associated with postnasal drip usually leads to coughing, throat clearing, and watery eyes. In people with asthma, postnasal drip can make it difficult to breathe.
Causes of postnasal drip include allergies, the common cold, and the flu. It also sometimes accompanies other respiratory bacterial or viral infections or can be brought on by simple irritation, such as eating very spicy foods. Certain medications can cause postnasal drip, such as drugs containing estrogen.
Postnasal drip is not life threatening and usually resolves on its own. However, if the symptom lasts more than a few weeks, and if it is accompanied by foul-smelling discharge, fever, or difficulty breathing, you should contact a medical professional to identify the cause. Seek prompt medical care if you have facial lumps or a non-healing sore in your nose, loose or painful upper teeth, a persistent or mucus-producing cough with sore throat, white patches and redness on your tongue or in your mouth, a persistent fever, or a feeling of something stuck in your throat that will not go away.
What other symptoms might occur with postnasal drip?
Postnasal drip may accompany other symptoms, depending on the underlying disorder.
Respiratory symptoms that may occur along with postnasal drip
Postnasal drip may accompany other symptoms affecting the respiratory system including:
- Cough that is persistent
- Coughing up clear, yellow, light brown, or green mucus
- Pus or white patches covering tonsils or throat
Other symptoms that may occur along with postnasal drip
Postnasal drip may accompany symptoms related to other body systems. Such symptoms include:
- Enlarged lymph nodes in the throat
- Facial or sinus pain, discomfort
- Fever and chills
Symptoms that might indicate a serious condition
In some cases, postnasal drip may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have postnasal drip along with other serious symptoms including:
- Difficulty breathing
- Difficulty swallowing
- Lump in the throat
- Lump or sore in the nose that does not heal
- Pain in upper teeth
- Sinus pain or headache
- Sudden swelling of the tongue or throat
What causes postnasal drip?
Causes of postnasal drip include allergies, a cold, the flu, simple irritation, and an upper respiratory infection. Certain medications can also cause postnasal drip.
Respiratory system-related causes of postnasal drip
Postnasal drip can also be caused by specific respiratory diseases including:
- Abnormal growth in the throat
- Common cold (viral respiratory infection)
- Deviated septum or other structural abnormality of the nose
- Fungal infection (rare)
- Influenza (flu)
- Obstruction in the nasal passages, such as nasal polyps
- Sinusitis (inflammation or infection of the sinuses)
Other causes of postnasal drip
Postnasal drip can also be caused by other factors that produce an increase in thin, clear mucus. These include:
- Blood pressure medications
- Cold temperatures
- Eating spicy foods
- Exposure to bright light for an extended period of time
- Exposure to chemical fumes and other irritants
- Forced-air heating systems
- Hormonal changes
- Medications containing estrogen
Serious or life-threatening causes of postnasal drip
In very rare cases, postnasal drip may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a healthcare provider. These include cancers of the nose, pharynx, and paranasal sinuses.
Questions for diagnosing the cause of postnasal drip
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your postnasal drip including:
- How long have you had postnasal drip?
- Have you had a cough? If you are coughing up mucus, what does it look like?
- Are you having any difficulty breathing? Difficulty swallowing?
- Have the glands in your neck felt swollen or tender to the touch?
- Do you have any unexplained lumps in your face, mouth or throat?
- Have you experienced any fever or chills?
- Have you noticed any white patches or pus in your mouth or throat?
- Have you been tested for allergies?
- What medications are you taking?
- Have you been exposed to any chemicals or fumes?
- Do you have any other symptoms?
What are treatments for postnasal drip?
When deciding how to get rid of postnasal drip, doctors first have to determine the cause. A complete exam by an ENT (ear, nose and throat) doctor is helpful in getting an accurate diagnosis. However, postnasal drip is notoriously hard to cure.
Treating postnasal drip will vary with the underlying cause. Treatments may include the following:
- Antacids, H2 blockers, or PPIs (proton pump inhibitors) to manage GERD
- Antibiotics to treat bacterial infections
- Antihistamines and decongestants taken by mouth or as a nasal spray
- Mucous-thinning strategies, including guaifenesin (Mucinex, Robitussin, others), saline rinses and irrigation, drinking plenty of fluids, and using humidifiers
- Nasal sprays, including cromolyn sodium (NasalCrom), leukotriene inhibitors, and corticosteroids
For stubborn cases, doctors may recommend a prescription product, ipratropium (Atrovent), to inhibit mucous secretion.
When postnasal drip is due to allergies, it can be helpful to take steps to reduce exposure to allergens. This may include:
- Buying a vacuum with a HEPA (high-efficiency particulate air) filter for carpets, rugs, and upholstered furniture or removing carpets and rugs from your home
- Closing windows during allergy season and running the furnace fan to filter the air
- Keeping pets out of bedrooms or only having outside pets
- Preventing mold by using a dehumidifier and exhaust fans
- Using allergen-proof covers on mattresses and pillows
- Washing bedding at least once a week in hot water and drying on the hottest setting
When postnasal drip is due to GERD, these additional steps may help:
- Avoiding alcohol and caffeine
- Elevating the head of the bed by 6 to 8 inches
- Losing excess weight
- Not eating or drinking for at least three hours before bedtime
What are the potential complications of postnasal drip?
Complications from postnasal drip are relatively minor and depend on the cause. However, left untreated, postnasal drip can lead to serious complications. In the rare event that postnasal drip is caused by nasopharyngeal cancers, complications related to spread of the cancer might develop. Once the underlying cause is diagnosed, following the treatment plan that you and your health care professional design specifically for you will help reduce the risk of potential complications including:
- Chronic nasal congestion
- Difficulty breathing
- Difficulty sleeping
- Spread of cancer
- Spread of infection