Post nasal drip

Post nasal drip is when excess mucus – whether it's a watery or sticky discharge – drips from the back of the nose into the upper part of the throat known as the nasopharynx, it is referred to as postnasal drip. It is often associated with catarrh, which refers to an excessive mucus build-up most often in the sinuses but also in the throat, ears or chest.

Mucus is produced by glands located in the nose, throat and airways as well as in the digestive tract. Normally it is an immune system response to help protect the body by moistening these areas to trap and destroy foreign invaders, including viruses and bacteria. In fact, the mucus from the nose mixes with saliva and usually drips down the back of your throat throughout the day without you noticing it. However, when there is too much mucus produced in the nose or it becomes too thick, it has two options: to run from the front of your nose (a runny nose) or down the back of the throat (a postnasal drip).

What can cause a postnasal drip?

There are a number of reasons that the glands in the nose may produce excess mucus such as:

  • Colds and flu
  • Sinus infections or sinusitis (an inflammation of the sinus)
  • Allergies such as a reaction to pollen, animals and dust mites
  • An object stuck in the nose (usually in a child)
  • Pregnancy
  • Medications (such as blood pressure medicines and contraceptive pills)
  • A deviated septum (a problem with the wall between the two nostrils), nasal polyp (a fleshy swelling inside the nose), of which scleroderma can be a cause or other physical problem within the nose.
  • Cold temperatures, excess dryness or change in weather patterns
  • Spicy foods and other food triggers
  • Fumes produced by cleaning products, perfumes, smoke and other chemicals and irritants

What are the symptoms of a postnasal drip?

People with a postnasal drip may feel a constant need to clear their throat. Mucus contains inflammatory elements so it can irritate the throat, leading to a sore throat and hoarseness, and it can trigger a cough. A chronic cough is often associated with postnasal drip.

Postnasal drip is generally more noticeable at night, especially when lying down to sleep. It can block the Eustachian tube, which joins the throat to the middle ear, leading to a painful ear infection. If sinus passages become blocked, a postnasal drip can cause a sinus infection.

How can postnasal drip be treated?

Treatment will depend on the cause. Often a postnasal drip will clear up by itself. If a viral infection or sinusitis is involved, antihistamines and decongestants may be useful, though decongestants are only for short-term relief. These can also be useful for treating postnasal drip associated with allergies, along with nasal sprays and steroid medications.

You can also provide relief by using a humidifier or vaporiser to moisturise the air or by inhaling steam from a bowl or pan of hot water (it should not be boiling). By propping up your pillows when sleeping at night, the mucus won't sit in the back of your throat, causing irritation.

To reduce postnasal drip triggered by allergies:

  • Consider using anti-allergy covers to protect your pillows and mattress
  • Wash all sheets, duvet covers, pillowcases and mattress covers in hot water
  • Dust and vacuum often, using HEPA air filters in your vacuum cleaner

If the postnasal drip has a foul smell, or you have a fever, are wheezing or symptoms last for more than 10 days, seek medical advice to rule out other causes such as a bacterial infection. Seek prompt medical advice if there is blood in the mucus.

If a postnasal drip persists, your GP may want to investigate to determine if an allergy or nasal polyp may be the cause. A nasal rinse with a saline solution can be used to rinse away allergens. This option is safe for babies. A nasal spray with corticosteroids may be used to help reduce inflammation related to an allergy, while a nasal spray containing steroids may be able to shrink small nasal polyps. Large ones may need to be removed with surgery.

When using a nasal spray, make sure you follow the instructions for the medicine to work as effectively as possible. You should blow your nose first to clear it, and bend your head down, looking towards your feet – and make sure you don't sniff as you use the spray, or it will enter your throat rather than stay in your nose.

How post nasal drip can be linked to scleroderma

Our specialist Professor Chris Denton said "There are several possible ways in which post nasal drip might be related to scleroderma. Nasal symptoms are common in scleroderma and probably reflect the effect of scleroderma on mucosal lining surfaces more generally. Although the mechanism is unclear, the amount and quality of mucosal secretions is usually reduced in scleroderma and leads to dryness of the mouth, eyes and the upper respiratory tract. This is one reason why scleroderma patients may notice a change or hoarseness of the voice."

Prof. Denton continued with, "Scleroderma can cause a change in the lining of the nose which may also lead to a degree of inflammation or local infection and this may contribute to a post nasal drip. In addition, altered blood vessel and nerve regulation may be relevant. Increased blood supply to the nasal mucosa can lead to increased secretions and this could be associated with vascular instability as is seen in scleroderma. I would not recommend any specific medication without discussing it with your doctor, as some of these work by reducing nasal secretions and this might aggravate the symptoms rather than be helpful."

Find out more about how to manage this and download your oral and dental fact sheet.

This is what our community said about post nasal drip

"I have Scleroderma and Raynaud's and in the winter I get constant post nasal drip especially at night - I've heard it is due to the nerves controlling blood flow to the nose lining."

Do you ever get post nasal drip (the feeling that you need to constantly clear your throat, or swallow/ cough/ sore, scratchy throat) and what do you do to combat it?

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