What causes postnasal drip? Related conditions and treatments

Overview: What does postnasal drip look/feel like?

Postnasal drip is the accumulation of mucus in the back of the throat. Mucus is naturally secreted in the nasal passages and throat to protect tissues and flush away bad things like germs and dust. We normally don’t feel the mucus. However, when too much mucus is secreted, or the mucus is thicker than it should be, we do feel it as a minor irritation, tickle, or lump in the throat. Mucus buildup often brings on other symptoms like an unproductive cough, throat clearing, bad breath, hoarseness, swelling, and even a sore throat if it persists long enough. It can lead to complications like ear infections or persistent coughing. Lying down often makes it worse. Fortunately, it usually passes in a few minutes or a few days

What causes postnasal drip?

Postnasal drip causes can vary widely. Not only medical conditions but also environmental factors can bring on a bout of postnasal drip along with other problems like runny nose and nasal congestion. Seasonal allergies are perhaps the most common cause of postnasal drip, but upper respiratory infections like the common cold and flu are a close second.

Medical conditions that cause postnasal drip include:

• Allergies (allergic rhinitis)

• Cold and flu

• Bacterial infections

• Sinus infections

• Sinus inflammation

• Hormone changes

• Pregnancy

• Gastroesophageal reflux disease (GERD)

• Deviated septum, nasal polyps, or other structural abnormalities in the nose or sinuses

• Swallowing problems

• Vasomotor rhinitis

Medicines that may cause postnasal drip as a side effect include:

• Birth control pills 

• Blood pressure medications

• Erectile dysfunction drugs

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Nasal sprays

Environmental causes of postnasal drip, as well as other symptoms of rhinitis, include:

• Dust

• Chemicals

• Fumes

• Tobacco smoke

• Cold temperatures

• Hot spicy foods

• Objects obstructing the nasal passage (in children)

RELATED: Upper respiratory infection symptoms: what are the early signs of upper respiratory infection?

Should I be worried about postnasal drip?

Postnasal drip is not a health-threatening condition, but chronic postnasal drip or postnasal drip syndrome (PNDS) is one of the most common causes of chronic cough as well as other persistent problems like a sore throat and hoarse voice. Other possible complications include those associated with any undiagnosed and untreated medical condition, such as a bacterial infection. Most of the time, however, postnasal drip can be handled at home with over-the-counter medications or home remedies.

See a healthcare professional for postnasal drip if:

• Postnasal drip won’t go away or keeps coming back

• Mucus secretions are foul-smelling

• Mucus secretions are bloody

• There are other symptoms of a serious medical condition such as fever, earache, sinus pain, or stomach pain

How is the cause of postnasal drip diagnosed?

When assessing postnasal drip and any accompanying symptoms, a healthcare provider is primarily interested in finding the cause. In most cases, a medical history and physical examination are enough to determine the most likely cause and most appropriate treatment.

A complete medical history will help identify other symptoms that point to possible causes. Most conditions that cause postnasal drip will have other symptoms, as well. Some of these symptoms may be worse than postnasal drip, such as sinus pain, ear pain, fever, or regurgitation. The complete picture of symptoms will provide valuable clues as to the cause.

The physical examination will focus on the nose, throat, and ears. The healthcare provider will examine the nose and look in the ears with an otoscope, a device familiar to anyone who has had their ears examined by a doctor or other healthcare professional. The healthcare provider may touch or push on the sinuses to determine if there’s any swelling or infection of the sinuses. 

Depending on the symptoms and history, the healthcare provider may need to perform other tests:

• A nasal endoscopy to identify any sinus problems, infections, swelling, or anatomical abnormalities

• Skin tests to identify allergies

• Blood tests to identify allergies or infections

• CT scans of the sinuses

• Barium X-rays or an esophageal endoscopy if GERD is suspected

RELATED: Is it allergies or a sinus infection?

Is postnasal drip contagious? 

Postnasal drip is not contagious, but infections that cause postnasal drip, such as colds and flu, can be spread from person to person.

How long does postnasal drip last?

Postnasal drip will last as long as the cause persists. Most causes, such as colds, flu, hay fever, and environmental irritants, do go away on their own. If the postnasal drip is caused by medication side effects or some environmental causes, such as smoking, then it may not go away until these are stopped or avoided. Some causes, such as bacterial infections or a deviated septum, may require medical treatment. Others, such as GERD, are usually chronic and lifelong conditions.

How to stop postnasal drip

Most people experiencing postnasal drip usually need to do very little to manage the problem. The symptom usually resolves on its own in a few days or weeks, even if nothing more is done than to bear with it. Fortunately, there is something you can do about it if you wish. Postnasal drip and its associated symptoms can be reduced with over-the-counter symptom relief medications such as antihistamines, decongestants, and mucus thinners. Home remedies are also very effective, including inhaling steam, using a humidifier, saline nasal sprays, and Neti pots. 

Some causes of postnasal drip may require treatment not only to resolve postnasal drip but also to help with other symptoms and prevent complications. These treatments may include:

• Allergy medications and avoiding allergens if allergies are the cause

• Steroid nasal sprays or oral anticholinergics to treat vasomotor rhinitis

• Antibiotics to treat bacterial infections

• Dietary changes, antacids, stomach acid reducers, and sleeping with the head elevated if GERD is causing postnasal drip

In chronic cases, a clinician may prescribe a nasal steroid spray or ipratropium nasal spray. Surgery or cryotherapy is a treatment option for people with chronic runny nose, nasal congestion, and postnasal drip. These procedures partly destroy the nerves in the nose that stimulate mucus production.

RELATED: How to get rid of a stuffy nose

Living with postnasal drip

Whether temporary or chronic, postnasal drip can be managed with a few simple home remedies. Try some of these:

• Drink more fluids

• Inhale steam, such as in a hot shower

• Use a humidifier

• Use a nasal rinse or Neti pot

• Gargle with salt water

• Sleep with the head elevated or in an upright position to minimize symptoms at night

• Consider using over-the-counter medications to relieve the symptoms of postnasal drip

Here are a few things to avoid:

• Avoid spicy hot foods—they will only make it worse

• Avoid any triggers such as allergens, dust, or fumes

• Stop smoking

FAQs about the causes of postnasal drip

What foods should I avoid with postnasal drip?

Anyone who has eaten a very spicy hot pepper will know that a runny nose, postnasal drip, watery eyes, and flushing all come on very quickly. They will also know that these symptoms clear up in a few minutes, at least if one stops eating the pepper. If postnasal drip is a problem, avoid spicy foods. They will make it worse, but only temporarily. Besides hot foods, postnasal drip can also be brought on by food allergies. Avoiding those foods will help control postnasal drip.

RELATED: 5 mucus-killing foods and foods to avoid for phlegm reduction

What does postnasal drip indicate?

Postnasal drip has many causes, but the most common are allergies, hay fever, and upper respiratory infections (URIs). In some cases, postnasal drip may not indicate anything except that the air is smoky, filled with chemical fumes, or filled with other irritants. It is possible to feel postnasal drip when there is no excess mucus. For instance, some people are highly sensitive to the natural levels of mucus in the throat.

How can I prevent postnasal drip?

For people with chronic or recurrent postnasal drip, prevention will depend on the cause. Avoiding allergens and using an air purifier will help people with allergic rhinitis. Avoiding triggers such as smelling perfumes or drinking ice-cold carbonated water will help people with chronic postnasal drip due to age. Drinking plenty of fluids and using a humidifier will help people who are regularly afflicted by thickened mucus or phlegm.

What’s next? Additional resources for people with postnasal drip

Test and diagnostics

• Allergic rhinitis, StatPearls

Treatments

• Postnasal drip, Indiana University Health

• Pregnancy rhinitis: what is it, treatment, and more, Osmosis

• Treatments for postnasal drip, Harvard Health Publishing

• Vasomotor rhinitis, StatPearls

• What is post-nasal drip, American Academy of Otolaryngology-Head and Neck Surgery

Scientific studies and clinical trials

• Evaluation of in-office cryoablation of posterior nasal nerves for the treatment of rhinitis, Allergy & Rhinology

• Ice cold carbonated water: a therapy for persistent hyperawareness of pharyngeal mucus and throat clearing, The Journal of Laryngology & Otology

More information on related health conditions

• Allergy treatments and medications, SingleCare

• Common cold treatments and medications, SingleCare

• Dry cough treatments and medications, SingleCare

• Influenza treatments and medications, SingleCare

• Sinus infections treatments and medications, SingleCare