Post-nasal Drip

girl holding her nose

What is Post-nasal drip, why is it bad and how do you treat it

Post-nasal drip, also known as PND, occurs when too much mucus is produced. The mucus builds up in the nasal cavity and in the back of the throat. This excessive mucus causes many complications such as congestion, clearing the throat often, and what BreathMD is most concerned about: bad breath. The excess mucus is usually caused by allergens but other causes such as laryngopharyngeal acid reflux and swallowing disorders have been know to cause post-nasal drip as well. In the treatment of post-nasal drip it is crucial to determine what is causing your body to produce excessive mucus so that you can remove these from your life and environment.

NOTE: In discussing post-nasal drip a lot of people use the word phlegm whereas the definition of phlegm is limited to the mucus produced by the respiratory system and not the mucus produced in the nasal cavities, which causes the nasal dripping to occur.

Symptoms

How do you know if you suffer from post-nasal drip? Below is a list of symptoms of PND. If you suffer from these regularly, then you probably have post-nasal drip.

Causes

Below is a list of causes of post-nasal drip.

Allergies

Allergies is probably the number one cause of post-nasal drip. Excess mucus is caused by an increase in histamine, which is most often triggered by airborne allergens such as pollen, mold, animal dander, pollution, dust and other similarly inhaled allergens. Food allergies may also be culprits. Specific types of food such as dairy, wheat, gluten, and even corn have been notorious for giving people PND.

Sinusitis

Sinusitis is the inflammation of the paranasal sinuses due to infection, allergy, or structural abnormalities such as a deviated septum, nasal polyps, or concha bullosa. Excess mucus usually comes hand in hand with sinusitis, and this mucus causes the post-nasal drip.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) also known as Acid Reflux Disease is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms. The body reacts by trying to protect the esophagus by creating more mucus than normal to provide a barrier against the acid and keep it down.

Medication

The side effects of some medications are the creation of excess mucus and also the thickening of mucus, both which may lead to postnasal drip. Birth control pills or pregnancy can also cause post-nasal drip because of the elevated levels of estrogen hormones.

Also long-term usage or abuse of antihistamines and decongestants may cause problems. For example vasomotor rhinitis(stuffy nose) may be a result of nasal spray abuse. In taking medication for allergies and post-nasal drip it is important to take the recommended dosage and follow the instructions, and to get off them as soon as you are able to. If you have serious problems with allergies or PND, it is important to see a specialized ENT(ear, nose, and throat) doctor other than self-medicating.

Smoking

It is common knowledge now that smoking is unhealthy. The smoke irritates the delicate mucous membrane lining of the nasal passages. This causes it to become inflamed and increases the amount of mucus secreted. It also damages the cilia which are responsible for moving the mucus. Secondhand smoke is also known to aggravate the sinuses.

Treatment

Remember that prevention is better than cure. It is important to remove what causes you to have post-nasal drip from your life so you don't have to treat the symptoms. For example it would make little sense for you to take decongestants and antihistamines all the time to try and treat the symptoms when what is causing the excess mucus is the instant coffee you have every morning. Think about when, where, and how often you suffer from post-nasal drip. Also think about when it is at its worst. Starting to be aware of these things will help you figure out what is causing you to suffer from post-nasal drip. In this section we will discuss how to find out what is causing your post-nasal drip so you can remove it from your life or at least reduce its symptoms.

  1. Do you have a cold, flu, or sinus infection?

    If you do not suffer from post-nasal drip often, then it is probably due to a temporary sickness. Go to the doctor and get treated for your sickness and as you get better your post-nasal drip will clear as well.

  2. Do you have heartburn a lot?

    If you do, you may suffer from Gastroesophageal reflux disease (GERD) and this may be what is causing the post-nasal drip. Get tested for GERD from a doctor.

  3. What medications are you on that may be causing the excess mucus?

    Reading of the side effects of these drugs may show that some of them thicken or increase mucus production. Either stop taking the medication(if it's not important) or request from your doctor to try a different medication. Birth Control pills are known to cause the body to create excess mucus.

  4. Are you currently suffering from seasonal allergies?

    If every year at the same time you get hay fever, excess mucus, sinus infections, or a stuffy nose, it may be that you are just suffering from seasonal allergies. Temporary use of antihistamines, decongestants, or mucus thinners may alleviate the symptoms. Sudafed, Mucinex, Zyrtec, and Claritin are some examples of these medications. Beware though of becoming dependent on these medications.

  5. Remove Allergens and Irritants from your environment.

    Below is list of things you can do to remove allergens from your home.

    • Vacuum and dust regularly.
    • Wash and change bedding at least once every 2 weeks.
    • Change the filter in your AC or heating system. Don't skimp and buy the cheapest.
    • Do not sleep with the bedroom windows open, as pollen and allergens can get in.
    • Purchase an air purifier with an HEPA grade filter to remove pollutants and allergens from the air.
  6. Remove Allergens and Irritants from your diet.

    What you are consuming on a daily basis may be what is causing the post-nasal drip. Below is a list of products that people find that cause their post-nasal drip. Try a food elimination diet to see if it clears up your PND symptoms. A lot of these foods may not be bad in there natural state but when they are processed, chemicals are added that might be the culprit. Give a raw food or non-processed food diet a go if nothing else works.

    • Dairy(milk, yogurt, cheese)
    • Caffeine and diuretics
    • Alcohol
    • Wheat and gluten
    • Foods made with corn or soy
    • Spicy foods
    • Sugar
  7. Drink lots of water.

    Drinking lots of fluids is important in keeping the mucus moving and thin. Also try just drinking pure water because soda, tea, coffee contain sugars and chemicals that aggravate the mucous membrane or that cause the mucus to thicken. Pure water is that, pure, so you do not have to worry about allergens and chemicals that will increase your symptoms. Also make sure the water you drink is from a good source.

  8. Do you live in the desert or in a cold climate?

    If you do the humidity levels are probably pretty low. The low humidity dries out the mucus and makes it thick and difficult for the cilia to move. Invest in a humidifier.

  9. Try Nasal Irrigation.

    Try using bulb syringes, pulsatile nasal irrigator, or neti pots to irrigate your nasal cavity. The irrigation process is carried out usually by using a saline solution and this flushes out excess mucus, bacteria, allergens, and other irritating substances out of the sinuses. Check out our article on Nasal Irrigation for more information on how to do this.

  10. See an ENT Doctor.

    If you have tried everything, and nothing seems to be working, see an ENT (ear, nose, and throat) doctor. You may have structural abnormalities such as a deviated septum, nasal polyps, or concha bullosa that need to be treated surgically. Also there have been reports that tonsillectomies(removal of tonsils) have cured post-nasal drip.

    The reason why this is so low on the list is because usually doctors are just concerned with treating the symptoms, and not with trying to find the cause. Many sufferers of PND have gone to doctors and have been prescribed with medication after medication only to find that when they cut wheat (or whatever was ailing them) out of their diet the post-nasal drip miraculously dried up and went away. Just be wary of the medication you take.

  11. Other methods that have been said to help.

    Here is a list of other things people have tried as remedies for post nasal drip. If you have a home remedy or something that has helped you please post below in order to help other people who are suffering.

    • Tea with lemon helps to get the cilia moving.
    • Oil of oregano(2-3 drops diluted in a bit of juice)
    • Gargle with warm saltwater

Hopefully with these tips you have stopped your post-nasal drip or at least reduced its symptoms. Please let us below in the comments about your journey with post-nasal drip and what has or hasn't worked for you. Thank you and good luck!

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Comments (25)
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Fed up with Bad breath

I have had this for over 10 years and i am still struggling with it,after a lot of research over the Internet i found(but not sure)PND might be the reason,i am having thick saliva producing from the uvula,and white tongue even after scraping it came back within 2 hours.but there is no sore throat,and i didn't feel any discomfort on throat.

by JIbin on Mar 23, 2015 | 2:34 PM

I've had problems clearing my throat for as long as I can remember. Been to hospital after hospital still no help . they haven't checked me for any kind of allergies . its embarrassing to even go out in public . and I've cleared my throat so much over the years that I'm having trouble swallowing . then I panic thinking something bad is wrong like throat cancer . I can't afford to go to the ent . I really truly don't know what to do . my throat feels as if someone's squeezing it .

by Carol Sullivan on Mar 10, 2015 | 7:42 AM

I have read all these comments and it is helping, I have suffered from what the doctors are saying is PND for a few months at a time every year for the past 5 or so years. This year is has started in the hotter dryer season. I have had allergy tests, come back fine, asthma tests, come back fine. I have tried Nasonex and bisolven chesty tablets, seem to help a bit, as I had a bad choking cough most mornings, now it is more a niggling cough. The mucous is still there in my chest and I feel it moreso when I'm around airconditioning, like on a bus, in a car, in a shopping centre etc. I am constantly clearing my throat, people look at me like there is something wrong with me. I just stare at them back until they look away. I can't keep having cough lollies every morning. I will try to eliminate all dairy for a while and see how that goes, no more coffee, and won't drik soft drinks or juice. Just water. I will try that warm water and salt gargle too and see how that goes. I read about another reflyx condition that isn't GERD, that may also be causing this for many people Larynsophagael Reflux disease?? I think it is, and causes no heart burn, so many people think they don't have reflux as many doctors say to you as they have done to me, do you have heartburn? I say no, so they immediately rule that out. But the doctors should know better than in some of these cases no heartburn is present. read up on this and change diet a bit and see how you go. I have an ENT appointment, had to wait months for it, so been struggling with this in the meantime. I don't want to keep using tablets and sprays either as may not be so good. It is very delibilating and makes you feel tired. I also work answering the phone most of the day, so even more a struggle. Very frustrating all around, and I want it gone for good!!!!!!

by Pamela on Feb 23, 2015 | 7:00 PM

heartburn

I went to the doctors and I do have a sinus infection and deff have PND. I never get heartburn and now I have it. Why? Is this caused by the PND? Anything I can do to help?

by Melissa on Feb 21, 2015 | 7:10 AM

I had battled with PND for years, and finally discovered that the main culprit was GERD, and ever since I made some lifestyle changes, like eating smaller meals, and elevating my head when sleeping. I have also cut way back on diary, and even though I have tried different diary alternatives,eg, goat milk products, I am definitely going to be eliminating diary completely because I notice that it really does increase the mucus, and triggers the symptoms, including sour breath. I steer clear of processed foods, and alcohol,and sweetners, which is hard, but has a huge impact. My frustration is that after years of going to doctors,including ENTs, and undergoing sinus surgeries, I discovered that GERD caused mainly by diet, contributed greatly to the PND, throat,and ear irritations. It is definitely worthwhile to experiment with dietary changes, and lifestyle adjustments before subjecting your health to a lifetime of medications that can matters worse, and have many negative side effects.
The neti pot is amazing and the best natural way of irrigating the sinus cavities, and keeping the mucus clear. Raw cider vinegar is very helpful for the GERD, and can be taken in water to alleviate acid indigestion. Even though it is an acid, it does help, and I use it on salads with olive oil.
It definitely is a case of trial and elimination, but I would agree that the more wholesome your diet becomes,the better your health will be.

by Susan on Feb 18, 2015 | 4:01 AM

Finally feeling better!

I had a terrible cough for 12 months. It seemed no matter what, I just couldn't shake it. I saw my general practitioner who gave me cough syrup with codeine which didn't help much. I needed to have my gallbladder removed and it was the surgeon who really took notice of my cough. He said it wasn't ok to have that bad of a cough for that long, and he didn't want to do surgery until it was cleared up. He referred me to a pulmonologist who did several lung function tests. Asthma was ruled out and after my second Z-pack, and inhaler, 2 daily nasal sprays and a dose of prednisone I was able to have my surgery. The cough returned a couple weeks later though. I was told it was most likely post nasal drip or acid reflux. I was referred to an allergist but it turned out I had minimal allergies. Next I was sent to an ENT who owed a CT scan of my sinuses. Then something miraculous happened. After a year of suffering, trying every medication and home remdedy imaginable and seeing several specialists, it just went away. I made one small change. I had begun a diet and cut out all dairy. After 2-3 weeks my cough disappeared. My acid reflux also disappeared ( I was on Prilosec in the morning and Zantac in the evening) I was able to stop taking my daily allergy pill too. I was able to consume dairy again regularly (thank goodness) within a month without any problems, but if I ever find myself with a lingering cough that I so often had for months on end after a virus.. I will cut out dairy again until it's gone. I would recommend this to anyone with a lingering cough who feels they have tried everything else.

by Mak on Feb 13, 2015 | 11:22 PM

miss

The waste deasis ever

by mona on Feb 1, 2015 | 5:03 PM

I'm 58 and had pnd as long as I can remember. In the past 2 years I cut out dairy and processed breads and feel much better. I replaced milk in my oatmeal with almond milk and have no pnd. It takes about 4-6 weeks to notice a difference. Now I eat fresh breads and dairy every now and then. It's all about moderation and noticing what triggers the pnd. Trying to ignore symptoms is not an option.

by Kathleen on Jan 25, 2015 | 2:49 PM

PND

I was suffering from PND and I was coughing due to drip. I consulted homeopathatic doctor and within ten days my symptoms disappeared.

by shaishav mehta on Jan 12, 2015 | 11:04 PM

Putting a little vinegar in some warm water, gargling, then swallowing a little of it and/or spitting rest (or all) of it out, cuts through the stuff in your throat. This is especially helpful if the PND is causing nausea and/or gagging/heaving. GERD sufferers do not overdo this as vinegar is highly acidic and could potentially aggravate GERD.

by aw on Jan 10, 2015 | 9:50 PM

Sugar, sugar, sugar is the culprit of PND. I have suffered from PND for years and recently cut back on my sugar intake mainlt from soda and other sugary drink, dessert and milk!!! I feel a lot better and feel less of the PND. My husband and office co-workers have noticed that I no longer snort or clear my throat as much as I have done before around family and friends. As a women this can be embarrassing. Not very lady like! Lol

by rolon4ever on Jan 3, 2015 | 10:16 AM

Netti Pot Best for Me

I've had post nasal drip for over 20 years. I get it every year (usually late fall into winter and of course with it comes the tonsilliths. I discovered the netti pot when suggested by an ENT for my nasal congestion due to a deviated septum but learned it also helped when the PND begins. I also find that benedryl helps in the fall (probably due to some allergy which I've yet to discover since it's usually only in the fall) and mucinex in the winter helps to clear the thickness of the mucus. I took nasonex for nasal congestion and was told it may help my PND but it didn't. The ENT said to try another as they can help with PND but I am fine with the netti pot. I don't use saltwater...having a hard time figuring out how gargling with warm salt water would/could help with mucus that drips from my nasal passages. (Maybe it helps with the mucus in the throat)??? Something I might try as that does become a nuisance at times. Like others I agree that it's sometimes alarming as you feel like the mucus just won't move and it's frightening at times. I find that one small dose of Xanax (.25mg) on those days gets me passed the three or four days (out of weeks) that it's particularly alarming. I also have a VERY sensitive throat and it's my "weak" spot, so whenever I have an issue with my throat it causes me mild anxiety until it goes away. I've read that GERD may be related to PND too and I have been on and off meds for GERD for years and have seen no difference in my PND so I doubt mine is GERD related. Again, I think it's a combo of allergies in the fall and the lack of humidity in the winter (even though I do have a house humidifier)that has my PND return like clockwork. I figure if this is one of the few annoyances I have annually I'm happy since in the scope of medical problems PND and Tonsilliths are minor compared to things we could suffer from.

by NancyDrew on Dec 28, 2014 | 6:46 AM

I've had sinus issues for pass 14 years. I finally went to ENT doc had balloon surgery, been on all types of meds, and still get sinus infections. My right nostril is always congested. I have GERD and take medication for it with relief but it isn't reducing my pnd. Just started using pulsating nasal irrigation n congestion is temporarily relieved but comes back within an hour. I'm take allergy shots n use allerga-D. Nothing is working for permanent relief. I will try diet since I haven't changed much there.

by Desha on Dec 2, 2014 | 8:21 AM

I have had PND for over 3months now seen the ENT, antibiotics, steroid nasal spray, all seems not to work. Now the AMAZING thing is i read here salt and warm water may help, I think it is and an instant solution * big smile* thank u!

by Wd on Nov 6, 2014 | 3:03 AM

I went on an elimination diet, removing gluten and dairy from my diet and found that after about 3 weeks my symptoms went away. However, once I started having some slip ups or trying to integrate some of these foods back in occasionally I started to suffer again. I think for me permanent elimination may be necessary.

by Renee on Oct 26, 2014 | 3:16 PM

in agony

I am new to the whole pnd symptoms but for the last 3 months pure agony!!! I thought i was stressed out because when i have an eppisode i feel panicked but the coughing and gagging and trying to get it out has to be hell on earth!!!i just found out i may have a deviated septum i have to go see the e.n.t dr next week i cant wait hopefully i get the answers im looking for god bless all of u!!! I fond what helps me the most is good ole warm salt water gargle!!!

by lori evans on Oct 25, 2014 | 7:15 PM

I have severe sinutsitis and a nasal polyp. Yesterday I started an elimination diet. No Gluten and no dairy. Can anyone tell me how long it will take before I am noticing improvement. I am still plugged, will it take weeks?
Thanks!

by Mary on Oct 15, 2014 | 10:00 AM

I cleared my pnd by never again eating anything with Bleached white flour. Actually trying to stay away from all white devils, I.e. sugar, flour, etc.

by crabanna on Oct 15, 2014 | 1:39 AM

I am so tired of PND. I've tried lots of different things, but what seems to be working best is eliminating dairy and processed wheat products from my diet. Very sugary drinks also make it worse so I try to avoid those. Even replacement dairy products such as almond milk and soy milk give me lots of extra mucus so I'm thinking to eliminate anything -milk. Super annoying. This process of elimination is no fun.

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by Smitha294 on Oct 15, 2014 | 1:38 AM
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