Post-nasal drip is a mucous accumulation in the back of the nose and throat leading to or giving the sensation of mucus dripping downward from the back of the nose. Chronic rhinitis is characterized by persistent irritation and inflammation of the lining tissues of the nose. One of the most common characteristics of chronic rhinitis is post- nasal drip. Post-nasal drip may lead to chronic sore throat. Post-nasal drip can be caused by excessive or thick secretions or an impairment in the normal clearance of mucus from the nose or throat.
The following conditions are often associated with increased nasal drainage. Also, it would not be unusual to have more than one factor involved in a particular individual.
The following may cause an increase in thin secretions:
Specific foods or spices
Pregnancy or hormonal changes
Drug side-effects (particularly high blood pressure medications)
Structural problems (deviated septum, large turbinates)
Vasomotor rhinitis (an abnormal regulatory problem with the nose)
Decreasing the fluid content of the mucus usually thickens the secretions leading to the impression of increased mucus.
The following may cause thickened secretions:
Sinus or nasal infections
Foreign bodies: (especially if the drainage is from one side)
Environmental irritants: (tobacco smoke, smog)
Structural problems: (deviated septum, enlarged turbinates, enlarged adenoids)
Advanced age: mucus membrane lining the nose can shrink with age leading to a reduced volume of secretions that are thicker
Drug side-effects: (antihistamines)
Swallowing problems can make it difficult to clear normal secretions. This may result in the accumulation of material in the throat which can spill into the voice box causing hoarseness, throat clearing, or cough. The following factors can contribute to swallowing problems:
Advancing age: This will lead to decreased strength and coordination in swallowing.
Stress: Leads to muscle spasm or lump in throat. Also a nervous habit of frequent throat clearing will make the situation worse.
Narrowing of the throat or tumors: This will impair the passage of food.
Nerve or muscle disorders: (stroke, and muscle diseases, etc.)
Treatment of chronic rhinitis and post-nasal drip depends on the underlying condition causing the problem. A complete history and examination is done to determine if the problem is caused by either an impairment in the normal production of mucus or in its normal clearance from the nose.
Treatment options consists of one of more of the following:
Avoidance of allergens: An allergy is an exaggerated "normal body" inflammatory response to an outside substance. These substances that cause allergies are called allergens, and typically include pollen, mold, animal dander, house dust, and even some foods. The best treatment is avoidance of these allergens, but in many cases this may be impossible. Some helpful suggestions include:
Use a pollen mask when mowing the grass or cleaning the house; install an air purifier or at least change the air filters monthly; use cotton or synthetic materials such as Dacron in pillows and bedding; enclose mattress in plastic; consider using a humidifier; keep windows closed during high pollen times; eliminate house plants; and bathe frequently or even give away dander producing pets.
Avoidance of nasal irritants: Nasal irritants usually don't lead to the typical immune response seen with classical allergies, but nevertheless they can mimic or make allergies worse. Examples of these irritants include cigarette smoke, perfume, aerosol sprays, smoke, and smog & car exhaust.
Reflux Medications: Antacids (Maalox, Mylanta) help to neutralize acid contents, whereas other medications (Tagamet, Pepcid, Prilosec) decrease stomach acid production. Non-pharmacological treatments include avoiding late evening meals and snacks and the elimination of alcohol and caffeine. Elevating the head of the bed may help to decrease reflux during sleep.
Surgery: Structural problems with the nose and sinuses may ultimately require surgical correction. Obviously this should be done only after more conservative measures have been tried. Surgery is not a replacement for good allergy control and treatment. Septal deviation, septal spurs, septal perforation, enlargement of the turbinates, and nasal/sinus polyps can lead to pooling of or overproduction of secretions, blockage of the normal pathways leading to chronic sinusitis, and chronic irritation.