What is post-nasal drip, why is it bad, and how do you treat it?
Post-nasal drip, also known as PND, occurs when too much mucus is produced. The mucus builds up in the nasal cavity and at the back of the throat. This excess mucus causes many problems, such as congestion, frequent throat clearing, and what BreathMD is most concerned about: bad breath. The excess mucus is usually triggered by allergens, but other causes, such as laryngopharyngeal acid reflux and swallowing disorders, are also known to cause post-nasal drip. When treating post-nasal drip, it is crucial to determine what is making your body produce so much mucus, so that you can remove the cause from your life and environment.
NOTE: When discussing post-nasal drip, a lot of people use the word “phlegm.” However, phlegm refers specifically to the mucus produced by the respiratory system, not the mucus produced in the nasal cavities that causes the dripping.
Symptoms
How do you know if you suffer from post-nasal drip? Below is a list of symptoms of PND. If you experience these regularly, then you probably have post-nasal drip.
- Chronic throat clearing
- Rhinitis (stuffy nose)
- Rhinorrhea (runny nose)
- Inflammation of the mucous membrane
- “Hocking up loogies” all the time
- Snorting to clear mucus from the nasal passage that cannot otherwise be cleared by blowing your nose
- Constant throat clearing
- Congestion in the nasal and sinus passages
- Halitosis (bad breath)
- Being able to feel mucus building up at the back of the throat and in the nasal cavities
- Coughing
- Tickling in the throat
- Tonsilloliths (tonsil stones)
- Raspy speech
- Sore throat
Causes
Below is a list of causes of post-nasal drip.
Allergies
Allergies are probably the number one cause of post-nasal drip. The excess mucus is produced in response to a rise in histamine, which is most often triggered by airborne allergens such as pollen, mold, animal dander, pollution, and dust. Food allergies may also be culprits. Specific foods such as dairy, wheat, gluten, and even corn are notorious for giving people PND.
Sinusitis
Sinusitis is inflammation of the paranasal sinuses caused by infection, allergy, or structural abnormalities such as a deviated septum, nasal polyps, or concha bullosa. Excess mucus usually goes hand in hand with sinusitis, and this mucus causes the post-nasal drip.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD), also known as acid reflux disease, is a condition in which the stomach contents (food or liquid) leak backward from the stomach into the esophagus (the tube from the mouth to the stomach). This can irritate the esophagus, causing heartburn and other symptoms. The body reacts by producing more mucus than normal to provide a barrier against the acid and keep it down.
Medication
Some medications have side effects that create excess mucus or thicken it, both of which may lead to post-nasal drip. Birth control pills and pregnancy can also cause post-nasal drip because of elevated estrogen levels.
Long-term use or abuse of antihistamines and decongestants may cause problems too. For example, vasomotor rhinitis (stuffy nose) may result from nasal spray abuse. When taking medication for allergies and post-nasal drip, it is important to take the recommended dosage, follow the instructions, and stop as soon as you can. If you have serious problems with allergies or PND, it is best to see a specialized ENT (ear, nose, and throat) doctor rather than self-medicating.
Smoking
It is common knowledge now that smoking is unhealthy. The smoke irritates the delicate mucous membrane lining the nasal passages, causing it to become inflamed and to secrete more mucus. It also damages the cilia, which are responsible for moving the mucus. Secondhand smoke is known to aggravate the sinuses as well.
Treatment
Remember that prevention is better than cure. It is important to remove the cause of your post-nasal drip from your life so you don’t have to treat the symptoms. For example, it makes little sense to take decongestants and antihistamines all the time to treat the symptoms when the cause of the excess mucus is the instant coffee you drink every morning. Think about when, where, and how often you suffer from post-nasal drip, and when it is at its worst. Becoming aware of these things will help you figure out what is causing it. In this section, we discuss how to find the cause of your post-nasal drip so you can remove it from your life, or at least reduce its symptoms.
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Do you have a cold, flu, or sinus infection?
If you do not suffer from post-nasal drip often, then it is probably due to a temporary illness. See your doctor and get treated for it, and as you get better, your post-nasal drip will clear up as well.
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Do you have heartburn a lot?
If you do, you may have gastroesophageal reflux disease (GERD), and this may be what is causing the post-nasal drip. Ask your doctor to test you for GERD.
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What medications are you on that may be causing the excess mucus?
Reading the side effects of your drugs may reveal that some of them thicken or increase mucus production. Either stop taking the medication (if it isn’t important) or ask your doctor about trying a different one. Birth control pills are known to make the body create excess mucus.
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Are you currently suffering from seasonal allergies?
If every year at the same time you get hay fever, excess mucus, sinus infections, or a stuffy nose, you may simply be suffering from seasonal allergies. Temporary use of antihistamines, decongestants, or mucus thinners may relieve the symptoms. Sudafed, Mucinex, Zyrtec, and Claritin are some examples. Beware, though, of becoming dependent on these medications.
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Remove allergens and irritants from your environment.
Below is a list of things you can do to remove allergens from your home.
- Vacuum and dust regularly.
- Wash and change your bedding at least once every two weeks.
- Change the filter in your AC or heating system. Don’t skimp and buy the cheapest.
- Do not sleep with the bedroom windows open, as pollen and allergens can get in.
- Buy an air purifier with a HEPA-grade filter to remove pollutants and allergens from the air.
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Remove allergens and irritants from your diet.
What you consume on a daily basis may be what is causing your post-nasal drip. Below is a list of products that people find trigger their symptoms. Try a food elimination diet to see if it clears up your PND. A lot of these foods may not be bad in their natural state, but when they are processed, chemicals are added that might be the culprit. Give a raw or unprocessed food diet a go if nothing else works.
- Dairy (milk, yogurt, cheese)
- Caffeine and diuretics
- Alcohol
- Wheat and gluten
- Foods made with corn or soy
- Spicy foods
- Sugar
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Drink lots of water.
Drinking lots of fluids is important for keeping the mucus thin and moving. Try drinking plain water, because soda, tea, and coffee contain sugars and chemicals that aggravate the mucous membrane or cause the mucus to thicken. Pure water is just that, pure, so you don’t have to worry about allergens and chemicals making your symptoms worse. Also make sure the water you drink is from a good source.
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Do you live in the desert or in a cold climate?
If you do, the humidity levels are probably pretty low. Low humidity dries out the mucus, making it thick and difficult for the cilia to move. Invest in a humidifier.
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Try Nasal Irrigation.
Try using a bulb syringe, a pulsatile nasal irrigator, or a neti pot to irrigate your nasal cavity. Irrigation is usually done with a saline solution, which flushes excess mucus, bacteria, allergens, and other irritants out of the sinuses. Check out our article on Nasal Irrigation for more information on how to do this.
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See an ENT Doctor.
If you have tried everything and nothing seems to be working, see an ENT (ear, nose, and throat) doctor. You may have structural abnormalities, such as a deviated septum, nasal polyps, or concha bullosa, that need to be treated surgically. There have also been reports that tonsillectomies (removal of the tonsils) have cured post-nasal drip.
The reason this is so low on the list is that doctors are usually concerned with treating the symptoms rather than finding the cause. Many PND sufferers have gone to doctors and been prescribed medication after medication, only to find that when they cut wheat (or whatever was ailing them) out of their diet, the post-nasal drip miraculously dried up and went away. Just be wary of the medication you take.
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Other methods that have been said to help.
Here is a list of other things people have tried as remedies for post-nasal drip. If you have a home remedy or something that has helped you, please post it below to help other people who are suffering.
- Tea with lemon helps get the cilia moving.
- Oil of oregano (2-3 drops diluted in a bit of juice)
- Gargle with warm salt water.
Hopefully with these tips you have stopped your post-nasal drip or at least reduced its symptoms.