Post Nasal Drip

Post-nasal drip is a very common complaint. It can be very frustrating for patients and interfere with sleep quality as well as be the trigger for a chronic cough. There are a number of causes of post-nasal drip. A careful assessment by an ear, nose and throat specialist is necessary to successfully identify these and organise appropriate treatment.

What causes post-nasal drip?

Post-nasal drip is caused by mucus flowing from your nose and sinuses back into your mouth and throat. The mucus may be normal mucus produced in excessive amounts or infected, thick mucus. Occasionally the lack of mucus causes a dry, itchy throat and cough.

Conditions which stimulate the nose to produce more mucus will cause post-nasal drip. These include allergic rhinitis (hay fever) and non-allergic rhinitis. Non-allergic rhinitis is a very broad term that describes post-nasal drip that can be caused by a large number of factors. These include strong perfumes, changes in weather, air conditioning, certain foods and red wine. As we age there can also be changes in the way the nerves in the nose regulate the amount of mucus that is produced. If excessive watery mucus and post-nasal drip is produced due to a nerve problem we call it “vasomotor rhinitis”.

How do I work out what is causing my post-nasal drip?

The first step is to visit your GP who will take a careful history and try to determine the most likely cause. They will most likely try you on one or two nasal sprays and possibly a course of antibiotics (if appropriate) to see if these help to reduce the post-nasal drip. If these are unsuccessful, referral to an ear, nose and throat specialist may be appropriate.

An ear, nose and throat specialist will take a careful history about the post-nasal drip. An examination may include a flexible nasendoscopy procedure to look for signs of a sinus infection or polyp disease in the nose. A number of investigations may then be needed including allergy testing, blood tests and a CT scan of the sinuses.

What treatments are available for post-nasal drip?

Depending on the cause, post-nasal drip may be treated by medications, surgery or a combination of both. Medications for post-nasal drip may be targeted at treating allergies, infections or reducing the quantity or the thickness of mucus. Surgery may need to address a deviation of the nasal septum or other blockage, a sinus infection or very large turbinates.