Postnasal Drainage: What to Expect

Postnasal drainage, also known as a postnasal drip, occurs when mucus from your nasal passageways or sinuses runs down the back of the throat. Some drainage is necessary to help flush irritants out of the nasal cavity and moisten the tissues, but conditions like allergies and infections can trigger excessive mucus production, which can lead to a sore throat or coughing as you try to clear the blockage.

At Oasis Ear, Nose, and Throat in Surprise, Arizona, otolaryngologists Dr. James Osborne and Dr. Bryan Smedley want you to understand how your nose works to keep you healthy and when the symptoms of postnasal drainage you’re experiencing warrant medical attention. Here’s what you need to know.

Causes of postnasal drainage

While some postnasal drainage occurs all the time as part of your nose’s cleaning regimen, a number of different conditions can lead to a worsening of your symptoms. In some cases your body produces more or thicker mucus, and in others, it doesn’t clear away the mucus as quickly as usual, leading to a buildup in the back of your throat.

Common chronic causes include:

• Allergies: pollen, mold, dust, and dander are often the culprits
• Low humidity
• Advanced age: mucus membranes shrink with age, leading to thicker secretions
• Gastroesophageal reflux disease (GERD): irritates the tissues
• Anatomical abnormalities: includes a deviated septum, enlarged turbinates, or swollen adenoids
• Some medications: includes contraceptives, antihistamines, and antihypertensives
• Rebound congestion: overuse of pseudoephedrine nasal sprays
• Smoking (prevents the nasal cilia from clearing mucus)
• Difficulty swallowing

Common temporary conditions include:

• Viral infections: includes sinusitis, rhinoviruses (common cold), influenza, cytomegalovirusvirus (CMV), and adenovirus
• Bacterial infections: includes strep throat
• Seasonal allergies
• Pregnancy-induced rhinitis 
• Hormonal fluctuations

Symptoms of postnasal drainage

Depending on the cause of your postnasal drainage, your symptoms can last a few days, a few weeks, or months on end. Symptoms of postnasal drip include:

• A sore throat
• Persistent feeling of needing to clear your throat
• Feeling there’s a lump in your throat
• An intermittent cough
• A scratchy, tickling, or itching feeling in the back of your throat
• Burning in the back of throat (often from GERD)
• A hoarse voice or loss of voice

Your symptoms can fluctuate throughout the day, and they may get worse after lying down or speaking for a long time.

Most of the time, postnasal drainage doesn’t require medical attention, but you should come in to see the doctor if:

• Your symptoms persist more than a few weeks
• You have trouble swallowing or feel like you're choking
• You have difficulty breathing
• You have a fever, vomiting, or ear pain (signs of an infection that requires medical treatment)

Treating postnasal drainage problems

Some strategies for treating a postnasal drip can help regardless of the cause:

• Drink a lot of water: lubricates throat and keeps mucus thin
• Use a cool mist humidifier while you sleep.
• Use a vaporizer, diffuser, or neti pot infused with essential oils

OTC remedies can help with other symptoms:

• Acetaminophen or cough lozenges for a sore throat
• Saline nasal spray to decrease congestion
• Medicated nasal spray, such as Afrin, to breathe more comfortably
• Vapor rubs to reduce congestion
• Mucinex (guaifenesin) to decrease congestion (for no more than three days)
• Antihistamines to help relieve congestion

Sometimes, you need a prescription to help with the symptoms. If you have a bacterial or fungal respiratory infection, your doctor will probably prescribe antibiotics. For persistent postnasal drip complicated by asthma, he may prescribe Atrovent or steroids.

GERD should be checked out by a gastroenterologist. He’ll advise avoiding fatty and spicy foods, he may prescribe an anti-reflux medication, and he’ll suggest you sleep with your head slightly elevated so the acid remains in the stomach.

In the case of a deviated septum or other anatomical anomaly, corrective surgery may be the only way to permanently treat the postnasal drip.

If you feel chronically congested, have a permanent “lump” in your throat, or have a perpetually runny nose, come see the doctors at Oasis Ear, Nose, and Throat for a diagnosis and targeted treatment. Give us a call at 623-234-4640 to schedule a consultation, or book online today.