Postnasal drip is the accumulation of mucus in the back of the throat. Mucus is naturally secreted in the nasal passages and throat to protect tissues and flush away bad things like germs and dust. We normally don’t feel the mucus. However, when too much mucus is secreted, or the mucus is thicker than it should be, we do feel it as a minor irritation, tickle, or lump in the throat. Mucus buildup often brings on other symptoms like an unproductive cough, throat clearing, bad breath, hoarseness, swelling, and even a sore throat if it persists long enough. It can lead to complications like ear infections or persistent coughing. Lying down often makes it worse. Fortunately, it usually passes in a few minutes or a few days
Postnasal drip is a common symptom that may be caused by bacterial or viral infections, allergies, a deviated septum, sinus infections, certain types of foods, dry air, cold temperatures, irritants, hormonal changes, pregnancy, chronic acid reflux, medication side effects, and nasal sprays.
Typically, postnasal drip does not require immediate medical attention.
Postnasal drip generally does not require treatment. It typically resolves without treatment when the underlying cause improves, but some causes may require treatment or be long-term, chronic problems.
Treatment of postnasal drip may include treating the underlying cause, decongestants, mucus thinners, saline nasal irrigation, prescription medications, humidifiers, drinking fluids, or surgery.
Postnasal drip can be managed with humidifiers, steam inhalation, Neti pots (saline irrigation), and drinking plenty of fluids.
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Postnasal drip causes can vary widely. Not only medical conditions but also environmental factors can bring on a bout of postnasal drip along with other problems like runny nose and nasal congestion. Seasonal allergies are perhaps the most common cause of postnasal drip, but upper respiratory infections like the common cold and flu are a close second.
Medical conditions that cause postnasal drip include:
Allergies (allergic rhinitis)
Bacterial infections
Sinus inflammation
Hormone changes
Pregnancy
Gastroesophageal reflux disease (GERD)
Deviated septum, nasal polyps, or other structural abnormalities in the nose or sinuses
Medicines that may cause postnasal drip as a side effect include:
Birth control pills
Blood pressure medications
Erectile dysfunction drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nasal sprays
Environmental causes of postnasal drip, as well as other symptoms of rhinitis, include:
Dust
Chemicals
Fumes
Tobacco smoke
Cold temperatures
Hot spicy foods
Objects obstructing the nasal passage (in children)
RELATED: Upper respiratory infection symptoms: what are the early signs of upper respiratory infection?
Postnasal drip is not a health-threatening condition, but chronic postnasal drip or postnasal drip syndrome (PNDS) is one of the most common causes of chronic cough as well as other persistent problems like a sore throat and hoarse voice. Other possible complications include those associated with any undiagnosed and untreated medical condition, such as a bacterial infection. Most of the time, however, postnasal drip can be handled at home with over-the-counter medications or home remedies.
See a healthcare professional for postnasal drip if:
Postnasal drip won’t go away or keeps coming back
Mucus secretions are foul-smelling
Mucus secretions are bloody
There are other symptoms of a serious medical condition such as fever, earache, sinus pain, or stomach pain
When assessing postnasal drip and any accompanying symptoms, a healthcare provider is primarily interested in finding the cause. In most cases, a medical history and physical examination are enough to determine the most likely cause and most appropriate treatment.
A complete medical history will help identify other symptoms that point to possible causes. Most conditions that cause postnasal drip will have other symptoms, as well. Some of these symptoms may be worse than postnasal drip, such as sinus pain, ear pain, fever, or regurgitation. The complete picture of symptoms will provide valuable clues as to the cause.
The physical examination will focus on the nose, throat, and ears. The healthcare provider will examine the nose and look in the ears with an otoscope, a device familiar to anyone who has had their ears examined by a doctor or other healthcare professional. The healthcare provider may touch or push on the sinuses to determine if there’s any swelling or infection of the sinuses.
Depending on the symptoms and history, the healthcare provider may need to perform other tests:
A nasal endoscopy to identify any sinus problems, infections, swelling, or anatomical abnormalities
Skin tests to identify allergies
Blood tests to identify allergies or infections
CT scans of the sinuses
Barium X-rays or an esophageal endoscopy if GERD is suspected
RELATED: Is it allergies or a sinus infection?
Postnasal drip is not contagious, but infections that cause postnasal drip, such as colds and flu, can be spread from person to person.
Postnasal drip will last as long as the cause persists. Most causes, such as colds, flu, hay fever, and environmental irritants, do go away on their own. If the postnasal drip is caused by medication side effects or some environmental causes, such as smoking, then it may not go away until these are stopped or avoided. Some causes, such as bacterial infections or a deviated septum, may require medical treatment. Others, such as GERD, are usually chronic and lifelong conditions.
Most people experiencing postnasal drip usually need to do very little to manage the problem. The symptom usually resolves on its own in a few days or weeks, even if nothing more is done than to bear with it. Fortunately, there is something you can do about it if you wish. Postnasal drip and its associated symptoms can be reduced with over-the-counter symptom relief medications such as antihistamines, decongestants, and mucus thinners. Home remedies are also very effective, including inhaling steam, using a humidifier, saline nasal sprays, and Neti pots.
Some causes of postnasal drip may require treatment not only to resolve postnasal drip but also to help with other symptoms and prevent complications. These treatments may include:
Allergy medications and avoiding allergens if allergies are the cause
Steroid nasal sprays or oral anticholinergics to treat vasomotor rhinitis
Antibiotics to treat bacterial infections
Dietary changes, antacids, stomach acid reducers, and sleeping with the head elevated if GERD is causing postnasal drip
In chronic cases, a clinician may prescribe a nasal steroid spray or ipratropium nasal spray. Surgery or cryotherapy is a treatment option for people with chronic runny nose, nasal congestion, and postnasal drip. These procedures partly destroy the nerves in the nose that stimulate mucus production.
RELATED: How to get rid of a stuffy nose
Whether temporary or chronic, postnasal drip can be managed with a few simple home remedies. Try some of these:
Drink more fluids
Inhale steam, such as in a hot shower
Use a humidifier
Use a nasal rinse or Neti pot
Gargle with salt water
Sleep with the head elevated or in an upright position to minimize symptoms at night
Consider using over-the-counter medications to relieve the symptoms of postnasal drip
Here are a few things to avoid:
Avoid spicy hot foods—they will only make it worse
Avoid any triggers such as allergens, dust, or fumes
Stop smoking
Postnasal drip will usually go away without causing health problems. Complications are uncommon unless the postnasal drip is chronic or keeps coming back. If postnasal drip doesn’t go away or causes other symptoms, a healthcare provider can usually help bring it under control.
Anyone who has eaten a very spicy hot pepper will know that a runny nose, postnasal drip, watery eyes, and flushing all come on very quickly. They will also know that these symptoms clear up in a few minutes, at least if one stops eating the pepper. If postnasal drip is a problem, avoid spicy foods. They will make it worse, but only temporarily. Besides hot foods, postnasal drip can also be brought on by food allergies. Avoiding those foods will help control postnasal drip.
RELATED: 5 mucus-killing foods and foods to avoid for phlegm reduction
Postnasal drip has many causes, but the most common are allergies, hay fever, and upper respiratory infections (URIs). In some cases, postnasal drip may not indicate anything except that the air is smoky, filled with chemical fumes, or filled with other irritants. It is possible to feel postnasal drip when there is no excess mucus. For instance, some people are highly sensitive to the natural levels of mucus in the throat.
For people with chronic or recurrent postnasal drip, prevention will depend on the cause. Avoiding allergens and using an air purifier will help people with allergic rhinitis. Avoiding triggers such as smelling perfumes or drinking ice-cold carbonated water will help people with chronic postnasal drip due to age. Drinking plenty of fluids and using a humidifier will help people who are regularly afflicted by thickened mucus or phlegm.
Allergic rhinitis, StatPearls
Postnasal drip, Indiana University Health
Pregnancy rhinitis: what is it, treatment, and more, Osmosis
Treatments for postnasal drip, Harvard Health Publishing
Vasomotor rhinitis, StatPearls
What is post-nasal drip, American Academy of Otolaryngology-Head and Neck Surgery
Evaluation of in-office cryoablation of posterior nasal nerves for the treatment of rhinitis, Allergy & Rhinology
Ice cold carbonated water: a therapy for persistent hyperawareness of pharyngeal mucus and throat clearing, The Journal of Laryngology & Otology
Allergy treatments and medications, SingleCare
Common cold treatments and medications, SingleCare
Dry cough treatments and medications, SingleCare
Influenza treatments and medications, SingleCare
Sinus infections treatments and medications, SingleCare
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