All You Need to Know About Postnasal Drip

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
April 5, 2022

You’re no doubt familiar with the feeling of a stuffy nose and throat.

The unpleasant sensation can bother you for days.

One of the causes of that sensation is postnasal drip. If it seems especially bad you may start to wonder if it’s something more serious. 

In this article we’ll explore what causes postnasal drip, various ways to treat it, and how to tell if you should see a doctor for it.

What is Postnasal Drip?

Normally, glands in your nose and throat produce mucus continuously.

The mucus keeps the area moist and clean, helps fight infection, and keeps particles you inhale from getting into your lungs. 

Most of the time, you swallow this without thinking about it.

However, sometimes the mucus builds up and you can feel it in the back of your throat or your nose. This is called postnasal drip.

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Symptoms of Postnasal Drip

The most clear symptom of postnasal drip is the dripping you can feel in the back of your throat.

Other symptoms of postnasal drip include:

  • Cough
  • Sore throat
  • Runny nose
  • Chest pain
  • Vomiting
  • Hoarseness
  • Nausea
  • Bad breath
  • Problems breathing
  • Swallowing frequently
  • Feeling like you have a lump in your throat
  • Swollen tonsils

Causes of Postnasal Drip

Postnasal drip can be caused by several common conditions.

Among these include:

Allergies

An allergy is when your body reacts to something foreign by producing histamine. The histamine causes the mucous membranes in your nose and throat to swell and itch.

When those membranes swell, they can produce more mucus.

Viral or bacterial infections

When you get viral infections like the one that causes the common cold or you are infected with bacteria in your sinuses, the same membranes that swell with an allergy can become irritated and produce the extra mucus that causes postnasal drip.

GERD or LPR

Sometimes what causes postnasal drip is not extra mucus but difficulty swallowing.

This can be caused by acid reflux, or heartburn. When stomach acid gets into the esophagus such as with gastroesophageal reflux disease (GERD), it can be harder to swallow.

This can make it harder to swallow the mucus made by your nose and mouth.

Medications

Some prescribed medications, like birth control pills and some blood pressure medications, can cause postnasal drip.

Over-the-counter medications can also contribute to it; nasal sprays and drops you can buy at the drugstore can make nasal congestion worse if used for more than a few days.

Other causes

There are several other less common causes of postnasal drip.

One is a deviated septum, where the wall that separates the nostrils is crooked or formed incorrectly.

Another is a nasal polyp, a growth in the nasal passages. 

It can also be caused by an object stuck in the nose; this is one of the most common reasons for postnasal drip in children.

You may be breathing in something that causes the nose and throat to become irritated, like smoke or a specific type of perfume.

Diagnosing Postnasal Drip

If the symptoms of postnasal drip aren’t causing you serious problems, you may not visit a doctor at all.

But if it continues for a longer period of time, a doctor can help figure out what’s causing it.

An ear, nose, and throat exam will be done to look for any unusual signs in those areas.

A throat or mucus culture may be done to see if your postnasal drip is caused by a sinus infection.

Blood tests and skin tests can be done for allergies.

You may undergo x-rays or a CT scan of the sinuses to look for a blockage.

An endoscopy — a procedure where you are sedated and a flexible tube is passed down your throat and esophagus to look at their lining tissue — may be done if GERD or a throat blockage is suspected.

Sometimes, sinus tissue or bone will be taken for biopsy, though that is rare.

Treatment for Postnasal Drip

 Treatment for your postnasal drip depends on what is causing it.

At-home remedies

Most cases of postnasal drip can be treated with various at-home remedies.

These usually work by thinning the mucus causing it or by moistening the nasal passages to decrease symptoms.

  • Saline nasal sprays and irrigators are one of the first treatments many people try. These work by moistening the nasal passages. They also can flush out excess mucus, bacteria, and various irritants that might be contributing to the postnasal drip.
  • Drinking tea, soup, and other hot liquids help to open up your stuffy throat and nose. The hot liquids also moisten the nasal passages and keep you hydrated, which decreases mucus production.
  • Use a humidifier in the rooms you spend the most time and/or take a hot shower. The steam from either of these keeps your nose and throat open and moist. You can also drape a washcloth soaked in warm water over your face a few times a day.
  • Prop yourself up when you sleep with extra pillows. This gives mucus less of a chance to collect. It can also decrease the symptoms of GERD, if that is one cause of your postnasal drip.
  • Take steps to manage your inhaled allergies. Vacuum and dust your home frequently, use HEPA air filters to remove larger irritants, and frequently wash bedding in very hot water.
  • Adhesive strips that fit over the nose can help widen the nasal passages to make it easier to swallow mucus.

OTC Medication

If the above home remedies don’t work, there are several different over-the-counter (OTC) medications that you can try.

  • Oral decongestants like pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE or Neo-Synephrine) decrease the swollen tissue that is causing the postnasal drip. Nasal decongestants like oxymetazoline (Afrin) can also be used, but only for a day or two; long-term use can make postnasal drip worse.
  • Guaifenesin (Mucinex) reduces the thickness of the mucus entering the throat.
  • Antihistamines can work for postnasal drip caused by allergies or by sinusitis or a sinus infection. They work by reducing histamine, a substance that causes the nasal and throat area to become inflamed. Examples of antihistamines include diphenhydramine (Benadryl), loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).
  • Topical nasal steroids like Fluticasone nasal spray (Flonase) can help decrease inflammation resulting in less mucus production. 

Surgery

Surgery is a last resort for postnasal drip.

It is usually used to correct structural problems in the nose and throat, like nasal polyps or a deviated septum.

Other treatment options

If your postnasal drip turns out to be from a sinus infection, you will be prescribed antibiotics.

Nasal steroid sprays like triamcinolone (Nasacort) or a nasal spray that reduces secretions like Ipratropium (Atrovent) may also be prescribed.

Preventing Postnasal Drip

If postnasal drip is a recurring problem, take steps to prevent it. If it is caused by allergies, speak to your doctor about how to better manage them.

Saline nasal rinses can keep your nasal passages from developing blockages. It’s also important to stay hydrated and keep nasal passages moist.

Risks of Postnasal Drip

Postnasal drip rarely leads to serious problems, but there are a few potential risks from it occurring over a long period of time.

You may develop a sinus infection from the excess mucus clogging your sinuses.

Sometimes, the mucus enters the ears through the pharynx, a passage in back of your head that connects the ears, nose, and throat.

When that occurs, the ears can become clogged and become infected themselves.

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When to See a Doctor

Most cases of postnasal drip don’t need medical attention.

But if you experience any of the following symptoms, it can indicate something serious and is a sign you should see a doctor.

These symptoms include:

  • White or yellow spots on the throat or tonsils
  • A fever with postnasal drip
  • Nasal discharge that is a color besides white or yellow, or has a bad smell
  • Postnasal drip that last for more than three weeks, even with treatment
  • Blurred vision or swelling of the forehead
  • Bloody mucus
  • Cough that lasts more than ten days, or that produces gray or green mucus

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Frequently Asked Questions

Will postnasal drip go away on its own?
Most postnasal drip will go away on its own. However, some cases (like those caused by allergies, structural problems in the nose, and bacterial sinus infections) will not stop without some form of treatment.
Is it common to have postnasal drip constantly?
Postnasal drip is not something that should occur on a regular basis. If you experience postnasal drip constantly, you should see a doctor.
Can postnasal drip lead to an infection if left untreated?
If the sinuses or the ears become clogged with excess mucus from postnasal drip, bacteria can grow in those areas and cause an infection.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).

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Chesney Fowler