Just as your eyes tear and your mouth makes saliva almost imperceptibly, your nose cleanses itself and moistens its lining by routinely making just a little bit of a watery mucus. The mucus clears out naturally in the form of a small postnasal (behind the nose) “drip” down your throat…and that postnasal drip becomes noticeable only when there’s either too much mucus or its consistency is too thick.
Thick mucus is especially bothersome when it gets stuck around the epiglottis, the flap behind your tongue. When at rest, the epiglottis allows air to pass into the larynx and lungs. When you swallow, the epiglottis folds backward and covers the opening of the larynx to prevent fluids and food from getting into your windpipe and lungs. Excess or thick postnasal drip can get in the way of normal functions, such as breathing and talking, and causes you to cough to shake it loose and clear it out. (Coughing is an evolutionary reflex that developed to protect the windpipe.)
Excess postnasal drip itself is not a disease but rather a symptom. Finding out the actual cause is key to learning how to stop postnasal drip, explains allergist-immunologist Neil L. Kao, MD. Some of the most common causes include…
If the air in your home or office is very dry, possibly because of indoor heating or air-conditioning, the lack of moisture can cause mucus to become thick. For some people, indoor air that’s too cold—say, 62°F—can trigger more mucus and cause your nose to run. Some people who are very sensitive can walk into a room and know right away that the air quality or temperature is going to affect them. Changes in mucus also can be caused by allergens or irritants in the air, such air pollution, dust, strong fragrances and smoke from cigarettes or even a fireplace.
Too much mucus often is due to a cold or an infection that prompts your nose to overproduce mucus. If the infection is bacterial rather than viral, mucus tends to be thick and green. Sometimes the actual infection is in a sinus or an ear, not in the nose, but all these passages are connected. In these situations, even though you’re blowing your nose, you’re getting out only some of the mucus…the rest is going down your throat.
Excess postnasal drip also can be a sign of COVID, which, for most people, feels much like a common cold. Reminder: If you’re 65 or older or are immunocompromised, it’s important to get vaccinations for COVID and flu as recommended by your physician.
Some diseases, such as cystic fibrosis and, in rare cases, a malignant tumor, can cause you to have a lot of nasal drainage.
This is a common reason for excess postnasal drip, when a child puts something like a bead in his/her nose.
One tried-and-true home remedy may be enough to stop postnasal drip immediately…
When these steps aren’t enough to provide a near cure for postnasal drip or when allergies are to blame, you might want to try an over-the-counter (OTC) medication, though it will take some trial and error to find the most effective one for you…
Steroid nasal sprays, including fluticasone (Flonase) and triamcinolone (Nasacort), decrease inflammation from the allergic response, which can lead to a decrease in excessive mucus.
Medications such as Mucinex and comparable generics that contain guaifenesin thin mucus so that it drains more easily and/or is easier to cough up or blow out (for children, parents can use a bulb syringe to suction it out).
These oral medications can help if excessive mucus accompanies a stuffy nose. OTC products that are only a decongestant are Sudafed PSE (pseudoephedrine) or PE (phenylephrine) or their generic equivalents. Caution: Physicians do not recommend using OTC nasal decongestant sprays, such as Afrin, because of the high risk for addiction and rebound nasal congestion when the medicine wears off. Also, talk to your doctor before taking OTC decongestants if you are being treated for a medical condition or taking any other medications as it could lead to negative side effects.
These are especially helpful for reducing mucus when allergies are the culprit, Allegra, Benadryl, Claritin, Xyzal and Zyrtec are among the most popular antihistamines. The “D” versions of these OTC medications, such as Allegra-D and Claritin-D, include a decongestant to make it easier to breathe through your nose. The response is very individual, so you may need to try more than one to find which is most effective and doesn’t make you sleepy. No matter the drug, you need to take it consistently, as directed on the package, at least until the postnasal drip has stopped and perhaps longer if it returns quickly. Give it up to a week to gauge results. Always follow dosing guidelines to avoid overreliance.
Sometimes the problem is more severe than you think. If excess postnasal drip is simply the result of a cold, it should resolve in seven to 10 days. If you’re still struggling with it after two or three weeks, it is time to see your health-care provider. He/she will look for signs of infection and possibly take a culture to reach a diagnosis.
It is also time to see a doctor if you deal with postnasal drip every day (and are tired of living with it). You may benefit from allergy testing and, depending on the results, need stronger prescription medications.
Worrisome signs that should prompt an immediate doctor visit are blood in the mucus you’re coughing up—that is a sign of a break in the lining of the nose…when the mucus is greenish, which could signal a bacterial infection and the need for antibiotics…or severity—the volume of mucus is too much for you to manage on your own or if the nose or throat are painful.
Many people seek out their primary physician first, but if his/her recommendations don’t work after two visits, it’s time for a specialist such as an ear, nose and throat doctor (ENT) or an allergist who can work through different approaches to identify the true culprit and find effective solutions for you.
