|Post Nasal Drip|
MEDICALLY PROVEN SINUS RELIEF
The glands in your nose and throat continually produce mucus (one to two quarts a day). It moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection. Although mucus normally is swallowed unconsciously, the feeling that it is accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This feeling can be caused by excessive or thick secretions or by throat muscle and swallowing disorders.
Increased thin clear secretions can be due to colds and flu,
allergies, cold temperatures, bright lights, certain foods/spices,
pregnancy, and other hormonal changes. Various drugs (including birth
control pills and high blood pressure medications) and structural
abnormalities can also produce increased secretions. These abnormalities
might include a deviated or irregular nasal septum (the cartilage and bony
dividing wall that separates the two nostrils).
Increased thick secretions in the winter often result from too little moisture in heated buildings and homes. They can also result from sinus or nose infections and some allergies, especially to certain foods such as dairy products. If thin secretions become thick and green or yellow, it is likely that a bacterial sinus infection is developing. In children, thick secretions from one side of the nose can mean that something is stuck in the nose (such as a bean, wadded paper, or piece of toy, etc.).
Vasomotor Rhinitis describes a nonallergic "hyperirritable nose" that feels congested, blocked, or wet.
Swallowing problems may result in accumulation of solids or liquids in the throat that may complicate or feel like post-nasal drip. When the nerve and muscle interaction in the mouth, throat, and food passage (esophagus) aren't working properly, overflow secretions can spill into the voice box (larynx) and breathing passages (trachea and bronchi) causing hoarseness, throat clearing, or cough.
Several factors contribute to swallowing problems:
Swallowing problems may be caused also by gastroesophageal reflux
disease (GERD). This is a return of stomach contents and acid into the
esophagus or throat. Heartburn, indigestion, and sore throat are common
symptoms. GERD may be aggravated by lying down especially following eating.
Hiatal hernia, a pouch-like tissue mass where the esophagus meets the
stomach, often contributes to the reflux.
Chronic Sore Throat
Post-nasal drip often leads to a sore, irritated throat. Although there is usually no infection, the tonsils and other tissues in the throat may swell. This can cause discomfort or a feeling of a lump in the throat. Successful treatment of the post-nasal drip will usually clear up these throat symptoms.
Treatment For Post-Nasal Drip
A correct diagnosis requires a detailed ear, nose, and throat exam and possible laboratory, endoscopic, and x-ray studies. Each treatment is different:
Bacterial infection, when present, is treated with antibiotics.
These drugs may provide only temporary relief. In cases of chronic
sinusitis, surgery to open the blocked sinuses may be required.
Allergy is managed by avoiding the cause if possible.
Antihistamines and decongestants, cromolyn and steroid (cortisone type)
nasal sprays, and other forms of steroids may offer relief. Immunotherapy
(allergy shots) also may be helpful. However, some older, sedating
antihistamines may dry and thicken post-nasal secretions even more; newer
nonsedating antihistamines, available by prescription only, do not have this
effect. Decongestants can aggravate high blood pressure, heart, and thyroid
disease. Steroid sprays generally may be used safely under medical
supervision. Oral and injectable steroids rarely produce serious
complications in short-term use. Because significant side-effects can occur,
steroids must be monitored carefully when used for more than one week.
Gastroesophageal reflux is treated by elevating the head of the
bed six to eight inches, avoiding foods and beverages for two to three hours
before bedtime, and eliminating alcohol and caffeine from the daily diet.
Antacids (e.g., Maalox®, Mylanta®, Gaviscon ®) and drugs that block stomach
acid production (e.g., Zantac®, Tagamet®, Pepcid®) or more powerful
medications may be prescribed. A trial treatment may be suggested before
x-rays and other diagnostic studies are performed.
General measures for thinning secretions so they can pass more
easily may be recommended when it is not possible to determine whether an
existing structural abnormality is causing the post-nasal drip or if some
other condition is to blame. Many people, especially older persons, need more fluids to thin
secretions. Drinking more water, eliminating caffeine, and avoiding
diuretics (fluid pills) will help. Mucous-thinning agents such as
guaifenesin (Humibid®, Robitussin®) may also thin secretions.
Nasal irrigations may alleviate thickened secretions. These can be performed two to four times a day either with a nasal irrigation device. Warm water with baking soda or salt (1/2 to 1 tsp. to the pint) or Alkalol®, a nonprescription irrigating solution (full strength or diluted by half warm water), may be helpful. Finally, use of simple saline (salt) nonprescription nasal sprays (e.g., Ocean®, Ayr®, or Nasal®) to moisten the nose is often very beneficial.
Post nasal drip is an unscientific term that refers to the sensation of thick phlegm in the throat, which can become infected. It is annoying because normally the throat is moistened by the nasal secretions and throat mucous glands. This is part of the mucous - nasal cilia system that defends us from disease. When the amount of liquid secreted by the nose and sinus is reduced, and the cilia of the nose and sinus slow down, the fluid thickens and you become aware of its presence. Since the thick phlegm associated with post nasal drip is unpleasant and often infected because it is "just laying there" and not moving, our bodies naturally try to get rid of it, to the annoyance of our partners. Whether post nasal drip is caused by pollution, chemical exposure, or severe infection, the treatment requires that the cilia mucous system be brought back to normal.
Copyright ©2002 content. The information provided by Health Solutions Medical Products Corp. is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition.
© 1995 American Academy of Otolaryngology-Head and Neck Surgery, Inc.
Health Solutions Medical Products Corp.