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Post-Nasal Drip

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Written by
David Lee, MD.
Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Last updated November 4, 2022

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What is post-nasal drip?

Post-nasal drip is mucus that drips from your nose into the back of your throat. The feeling it causes makes it seem like you need to swallow or clear your throat.

Your nose and nasal passages contain mucus glands that constantly secrete mucus. This helps clear the nasal passages and prevents a buildup of debris—like dust or particles from the air. Normally, mucus makes its way to the back of the throat and is swallowed without you even noticing it. But if you have more mucus than usual or it’s thicker than usual, the drip can be very annoying and hard to ignore.

Postnasal drip is caused by many common conditions, including allergies and sinus infections. It rarely needs urgent care and can often be treated with OTC or prescription medications and by avoiding triggers of post-nasal drip, like alcohol and spicy food.

Post-nasal drip symptoms

Symptoms that commonly occur with post-nasal drip include:

  • Constantly needing to swallow or clear the throat
  • Runny nose
  • Feeling of drainage in the back of the throat
  • Changes in speech (raspy or gurgly speech)
  • Sore or irritated throat
  • Itchy, watery eyes
  • Sneezing

Treatment next steps

There are simple ways to treat post-nasal drip at home. These include staying well hydrated, running a humidifier, and sleeping on propped up pillows so mucus doesn’t build up in the back of your throat.

Depending on the cause of post-nasal drip, you may be able to treat it with OTC medications like decongestants (Sudafed), mucus thinners (Mucinex), or antihistamines (Benadryl, Claritin). If these don’t help, you may be prescribed a nasal spray. Post-nasal drip caused by gastric reflux can be treated with OTC or prescription medications.

Causes

1. Allergies

Seasonal or environmental allergies often cause post-nasal drip. Allergies can affect children and adults of all ages and can come and go as people get older. When the nasal passages are exposed to inhaled allergens (pet dander, pollen, etc.), secretions of mucus can increase, leading to post-nasal drip. Seasonal allergies can be common in the spring, summer, or fall depending on what substances trigger them.

Common: Allergy symptoms have been reported in 10–20% of Americans [Source: International Forum of Allergy and Rhinology].

Other symptoms:

  • Runny nose
  • Nasal congestion (clogged nasal passages)
  • Sneezing
  • Itchy, watery eyes

Treatment and urgency: The easiest treatment for allergies is to avoid your allergy triggers. For seasonal allergies, this may include limiting time outdoors during allergy season. Environmental allergies, like cat or dog allergies, can be prevented by avoiding the animals. But if your triggers can’t be avoided, there are several OTC allergy medications like antihistamines (Claritin, Zyrtec, Allegra) and nasal steroids (Flonase, Nasacort, Rhinocort) that can treat symptoms. Allergy immunotherapy (allergy shots) can also be very effective for allergy symptoms.

2. Vasomotor rhinitis

Vasomotor rhinitis, also known as non-allergic rhinitis, is most common in people over age 50. The symptoms it causes—including post-nasal drip—are similar to those of allergies. The exact cause of vasomotor rhinitis is unknown. Attacks can be triggered by irritants (smoke, strong odors), hormone changes, changes in the weather, drinking alcohol, and eating spicy foods. Vasomotor rhinitis usually occurs year-round.

Common: As many as 17 million Americans have non-allergic rhinitis [Source: Annals of Allergy, Asthma & Immunology].

Other symptoms:

  • Stuffy or runny nose
  • Sneezing
  • Mucus in the throat
  • Cough

Treatment and urgency: Avoiding any known triggers is the only way to prevent symptoms. But if you don’t know what they are or you can’t avoid them, nasal steroids (like Flonase) may be recommended to decrease the amount of mucus produced in the nasal passages. A nasal medication that decreases the nervous response to the nasal mucosa, such as Atrovent, may be recommended. For severe symptoms, sinus surgery may be needed.

3. Medications

Swelling and inflammation of the nose (rhinitis) is a side effect of many medications, causing post-nasal drip. Types of medications that can do this include antihypertensive medications (ACE inhibitors, beta blockers), erectile dysfunction medications (Viagra, Cialis), and some psychiatric medications. Treatment includes stopping the medication (if possible).

4. Acid reflux

Acid reflux, or gastroesophageal reflux (GERD), is when the acidic contents of the stomach rise into the esophagus, causing heartburn. In some cases, these acids can travel all the way up to the nasal passages and cause post-nasal drip.

Common: GERD is estimated to affect 18–28% of Americans [Source: Gut].

Other symptoms:

  • Heartburn
  • Regurgitation
  • Chest pain
  • Nausea
  • Problems swallowing or pain while swallowing

Treatment and urgency: Treatment of GERD includes avoiding triggers, like acidic or spicy foods, and not eating late at night before bed. Sleeping with the head of bed elevated can also help. Medications used to treat GERD include antacids (Tums, Mylanta), proton-pump inhibitors (omeprazole, lansoprazole) and H2 blockers (famotidine, cimetidine).

5. Sinus infections/URIs

Sinus infections or upper respiratory tract infections (URIs) increase mucus production and cause post-nasal drip. These infections are usually caused by a virus and wouldn’t require treatment with antibiotics. Symptoms typically last for 7–10 days, though post-nasal drip may last longer than the other symptoms.

Common: Adults may have 2–4 URIs per year, while children in daycare may have 6–7 [Source: Management of Antimicrobials in Infectious Diseases].

Other symptoms:

Treatment and urgency: Sinus infections and URIs usually go away on their own. You can help symptoms by drinking plenty of fluids and taking OTC medications that reduce fever (Tylenol, Advil) and nasal and sinus symptoms (decongestants). See your doctor if your symptoms last longer than 10 days or you have a high fever (above 103°F), difficulty breathing, wheezing, or dizziness.

Does apple cider vinegar help post-nasal drip?

It’s very unlikely, and it may even be harmful. It’s been suggested that drinking apple cider vinegar or inhaling its steam can relieve the sensation of post-nasal drip because the strong odor and taste can loosen mucus and prevent it from building up. But this has not been proven in any studies. In fact, frequently drinking apple cider vinegar can damage your teeth.

What happens if postnasal drip is left untreated?

Post-nasal drip on its own doesn’t cause any long-term damage or side effects. However, it can be very annoying. Post-nasal drip may go away on its own or get to a point where you don’t notice it anymore.

Can post-nasal drip be the only symptom of allergies?

Increased nasal drainage, including post-nasal drip, may be the only symptom, especially if you inhaled the allergen. Since avoiding allergens is the best treatment, it can help to keep track of when and where post-nasal drip symptoms are worst so you can identify what substances or locations are triggering them.

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Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Dr. Lee is a board-certified otolaryngologist and medical consultant for Buoy Health. He completed his undergraduate degree in Biochemistry and Spanish at the University of Arkansas (2011) and went on to complete medical school from the University of Arkansas for Medical Sciences (2015). He completed his residency training in Otolaryngology - Head and Neck Surgery at the University of Cincinnati (...
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