What is Post-Nasal Dripping?

Postnasal dripping most correctly refers to a sensation of mucus flowing from the back of the nasal passages into the pharynx (throat). This could be mucus or pus from a sinus infection. There are many reasons and treatments for a sensation of postnasal dripping.

Perhaps the most obvious reason for a sensation of postnasal dripping is nasal issues relating to congestion, allergies, sinus infections, or any reaction to external irritants. The patients may produce more nasal mucus than expected, and this gives them sensation of fullness in the back of the nose. Typically, if the mucus is rather thick in its consistency, it may be difficult to spontaneously get rid of this with blowing the nose or with sniffling. Thick mucus can flow into the back of the nose, and this may be very irritating to patients who cannot otherwise relieve themselves from the sensation easily. For patients suffering from postnasal dripping primarily from nasal concerns, it is most important to irrigate the nasal passages with the saline rinse on a regular basis. This will create a “tsunami” that will hopefully flood at the back of the nose and make the secretions loosen up. The mucus can then get dislodged and more easily eradicated from the back of the nose. The patients can use nasal irrigation on a regular basis, actually a few times a day if necessary. The next level of treatment is to investigate for any environmental allergies, and to take appropriate nasal sprays to treat the sensation of postnasal dripping. Occasionally, it may be also necessary to perform endoscopic sinus surgery for patients who suffer from chronic sinus disease.

Alternatively, many patients who complain of a sensation of postnasal dripping actually do not have a real postnasal dripping. Although they feel something in the back of the throat, the primary organ affected is the throat and not so much the nasal passages. In patients who do not have any other nasal symptoms of congestion, runny nose, stuffiness, seasonal allergies, and recurrent sinus disease, the diagnosis of postnasal dripping may not actually be accurate. This category of patients, when asked about the exact location of their symptoms, usually point to the throat and not so much the sinuses. These patients actually may be suffering from gastroesophageal reflux disease that gives them sensation of fullness in their throat, otherwise known as a globus sensation. A good office examination, including office endoscopy, can easily differentiate between the sensation of postnasal dripping from primarily sinus issues versus acid reflux. Once properly diagnosed, the treatment protocols are radically different.

Patients with the sensation of postnasal dripping are encouraged to see their ear, nose, and throat specialists promptly to differentiate the exact reason for their symptoms. Once the correct diagnosis is established, the treatment can radically change the symptoms.

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Posted in: Sinuses, Voice

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