Postnasal Drip
The glands in your nose and throat produce mucus every day (about 1-2 liters per day). Mucus moistens and cleans the nasal membranes, humidifies the air, captures and clears foreign particles, and fights infections. If the mucus we unknowingly swallow with each swallow accumulates in the throat and causes a dripping sensation, this is called "postnasal drip." This sensation can occur in situations of excessive secretion or swallowing disorders.
Causes of Postnasal Drip:
Clear discharges
Increased clear discharges, similar to water, can be caused by colds, flu, allergies, cold weather, bright lights, certain foods (especially sour and spicy ones), pregnancy, hormonal changes, and certain medications (such as birth control pills and blood pressure medications). Structural abnormalities like deviations in the bone-cartilage structure inside the nose can also cause increased discharges.
Thick discharges
Especially in winter, increased thick discharges can result from dry air in homes and workplaces due to heating systems. Nasal and sinus infections, allergies, and dairy products can also cause increased thick discharges. The transition of liquid and clear discharges to yellow-green thick discharges indicates developing bacterial sinusitis. Unilateral thick discharges in children may be due to foreign objects (such as beans, paper pieces, toy parts).
How does swallowing get affected?
Swallowing disorders can create a sensation of postnasal drip by causing the accumulation of solid or liquid food in the throat. In cases where the nerves and muscles of the mouth, throat, and esophagus do not work together harmoniously, there can be leakage of food from the throat to the windpipe. This can lead to voice disorders, frequent throat clearing, and coughing. In elderly individuals, coordination weakness in swallowing muscles often leads to such problems.
Stressful situations can create a chronic foreign body sensation in the throat. Frequent throat clearing habits can worsen the situation by irritating the throat area.
Throat reflux, where stomach contents cause irritation in the throat by passing through the esophagus, can lead to symptoms like a foreign body sensation, the need to clear the throat, chest burning, cough, voice disorders, and can be confused with postnasal drip.
How is postnasal drip treated?
A correct diagnosis can be made through a detailed history, endoscopic examination of the ear, nose, and throat, imaging methods, and laboratory tests when necessary. Treatment varies depending on the cause:
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Antibiotic treatments are used in bacterial infections, providing temporary relief, especially in chronic sinusitis. Sinus surgery may be required for a permanent solution.
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Allergies should be controlled by avoiding substances that cause allergies as much as possible. Antihistamines, decongestants, nasal sprays, and corticosteroids can be used. Immunotherapy (allergy treatment) in the form of vaccines or sublingual drops may be applied. Some older-generation antihistamines may thicken secretions, while newer ones have fewer side effects. Decongestants may increase blood pressure and should be avoided or used with caution in hypertensive patients. Corticosteroid sprays are low-risk drugs that can be used safely. Systemic corticosteroids should be used for a short duration and with caution.
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Daily measures for reflux include elevating the head of the bed, avoiding eating and drinking at least 3 hours before bedtime, and staying away from alcohol and caffeine. Reflux medications can be used if necessary.
If the factor causing postnasal drip cannot be identified, general measures to facilitate mucus flow should be taken. In many individuals, especially in older patients, inadequate daily fluid intake is a significant issue, and fluid consumption should be increased to enhance mucus flow. Drinking more water, reducing caffeine intake, and avoiding diuretic use will be beneficial. Expectorant medications are drugs that increase mucus flow. Nasal irrigation with ocean water, saline solution, or salt-bicarbonate solutions can also help alleviate postnasal drip.
Conditions related to sinuses:
Sinuses are air-filled cavities inside the skull. If blockages occur in the openings of these cavities leading to the nose due to reasons such as colds, flu, or allergies, sinus infections can develop. Flu cases lasting more than 10 days can turn into acute sinusitis, increasing postnasal drip. Prolonged blockage of sinus openings can lead to chronic sinusitis, causing inflammation in sinus walls. Chronic sinusitis can lead to the formation of polyps, causing long-term and bothersome postnasal drip. Medication treatments should be applied, and in cases where medication is not sufficient, surgical options should be considered.
