While mucus itself isn’t harmful—it helps protect you from illness and provides lubrication—postnasal drip can cause itchiness or a tickle in your throat, a cough, frequent throat clearing, and hoarseness.
Postnasal drip may be temporary—for example, clearing up after an infection passes. Or it can be more chronic, as is often the case with allergies or gastroesophageal reflux disease (GERD). Treatment may be directed at easing symptoms, as well as treating an underlying condition, if present.
This article explains the symptoms and causes of postnasal drip, as well as how it’s diagnosed and treated.
Postnasal Drip Symptoms
The effects of postnasal drip are generally mild, and you can have a combination of symptoms:
A burning feeling in your throat Coughing Hoarseness Losing your voice Persistent cough (postnasal drip is also known as upper airway cough syndrome) Scratchy, tickling, or itching in the back of your throat Sore throat The sensation of a lump in the back of your throat Throat clearing Watery eyes
These symptoms can fluctuate throughout the day. And you may feel worse after lying down for a while or after speaking for a long time.
Postnasal drip generally lasts for a few days or weeks, depending on the cause. Sometimes, it can be chronic; you may experience it for months on end.
When to See a Healthcare Provider
If you experience postnasal drip a few times per year, then there is probably nothing to worry about. It rarely requires medical attention and often goes away on its own.
But if you seem to have postnasal drip frequently or for more than a few weeks, you should talk to your healthcare provider about it. This could suggest an infection or other medical issue that requires treatment.
Also see your healthcare provider if you experience any of the following:
Difficulty swallowing, trouble breathing, or a choking feeling Blood in your nasal secretions (especially if it comes from only one nostril) Dyspnea (shortness of breath) Foul-smelling mucus Wheezing Fever, vomiting, or ear pain, which are signs of an infection that requires medical treatment
What Causes Postnasal Drip?
There are a number of different causes of postnasal drip. Some are short-term conditions or sudden triggers, while others are longer-lasting (chronic) issues.
Temporary Conditions
Infections like sinusitis, the common cold, influenza, cytomegalovirus (CMV), respiratory syncytial virus (RSV), adenovirus, and strep throat Seasonal allergies Pregnancy-induced rhinitis Hormone fluctuations
Sudden Triggers
Eating spicy foods Eating dairy products Exercise-induced rhinitis Foreign object stuck in the nose Pet allergies
Chronic Conditions
GERD, or chronic acid reflux Allergies to mold, dust, or dander Anatomical abnormalities such as a deviated septum or enlarged turbinates Medications such as birth control and drugs to lower blood pressure Rebound congestion due to overuse of pseudoephedrine nasal sprays Swallowing problems
Diagnosis
Postnasal drip is generally diagnosed based on your symptoms and a physical exam. If they are unsure of the diagnosis, they may consider allergy testing, imaging, or other evaluations.
Physical Examination
If you have a fever, your postnasal drip may be caused by an infection. Your provider will look in the back of your throat to see if there is any redness or swelling and ask about other signs of infection (such as headaches, fever, chills, and muscle aches).
If your phlegm is tinged with blood, it could be a sign of a gastrointestinal or pulmonary (lung) infection. This type of condition will require further evaluation.
Allergy Testing
If your postnasal drip symptoms recur every few days or weeks and resolve between episodes, then it could be related to an allergic reaction or sensitivity, such as to food.
Your provider may encourage you to keep a diary of your symptoms, noting what you ate and what you may have been exposed to (such as pollen or pets). Allergy testing may help pinpoint the trigger.
Imaging
If you have postnasal drip frequently, or always, it could be traced to an anatomical cause, such as a deviated septum.
You will need a physical examination and imaging tests to look for any variations that could be causing your symptoms.
Interventional Tests
Interventional tests may be necessary if GERD is a suspected cause.
GERD diagnosis may include tests such as direct laryngoscopy (which uses a scope to examine the upper throat), 24-hour pH probe (which can test for acid reflux), or esophagogastroduodenoscopy (which looks at the lining of your esophagus, stomach, and small intestine).
Treatment
There are several strategies for treating postnasal drip. Prescription medications or surgery may be needed in some cases, but most people can find relief with home remedies and over-the-counter treatments.
Home Remedies
Some tips can make you more comfortable, regardless of the cause:
Drink plenty of water to lubricate your throat and keep your mucus thin (and less bothersome). Use a cool mist humidifier at night while you sleep. Try rinsing your nasal passageways with a neti pot. Use a vaporizer or diffuser with essential oils, such as peppermint or eucalyptus.
Over-the-Counter Treatments
Congestion, sore throat, and cough can often be managed with over-the-counter (OTC) therapies including:
Tylenol (acetaminophen) or cough lozenges for sore throat Claritin (loratadine) and Benadryl (diphenhydramine), antihistamines that can ease allergy symptoms Sudafed (pseudoephedrine) for congestion Medicated nasal spray, such as Afrin (oxymetazoline), to make breathing more comfortable Mucinex (guaifenesin) to loosen up mucus Saline nasal spray to clear blocked nasal passages Vapor rubs to help you breathe easier
Prescription Medications
There are also a number of prescription medications used for the treatment of postnasal drip. For example, treatments for hay fever include some prescription medications.
For persistent postnasal drip, or for postnasal drip complicated by asthma, a healthcare provider may prescribe Atrovent (ipratropium bromide) or a steroid. If you have a bacterial or fungal respiratory infection, you may need antibiotics.
GERD requires treatment with a multi-pronged approach, which includes avoiding fatty and spicy foods, taking acid-reducing medications, and sleeping with your head slightly elevated.
Surgery
It’s a big leap from occasional postnasal drip to surgery. But if your symptoms are hard to treat or the cause is anatomical (e.g., the structure of your sinuses), the solution may be a procedure.
Surgeries that may be done include:
Sinus surgery Submucosal resection of the nose Turbinate reduction
Summary
Most people have experienced postnasal drip from time to time and know that it’s usually nothing to worry about. The symptoms can be irritating and include an itchy throat, coughing, hoarseness, and water eyes.
Postnasal drip usually goes away on its own. If it doesn’t, or the symptoms get worse, it’s smart to see a medical professional who can recommend the best treatment for this common-yet-irritating condition.
