Postnasal Drip: Causes & How to Eliminate the Problem

Q & A: Pull the Plug on Postnasal Drip

Dear Dr. Susan,

Lately I've had an annoying sensation of phlegm on the back of my throat, as though I need to clear my throat, cough, or swallow. Nothing I do makes it go away, and I find that I'm constantly swallowing, which makes my throat sore and fills me up with air. My doctor has looked at my throat and can't see anything wrong. Do you have any ideas? —Janet

Dear Janet,

It sounds like you have postnasal drip, which is a symptom of excessive mucus overflowing from your sinuses and nasal passages, where it's produced constantly to protect those tissues.

However if you do have cold symptoms you may find this article I wrote helpful.

Normally, that mucus is constantly being swept backward and swallowed, but when mucus production is excessive, the sweeping mechanism gets overwhelmed and mucus accumulates. So that explains the sensation of something in the back of your throat that needs to be swallowed or brought up.

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The real question is why has your mucus production increased? There are several possible answers. The one that fits your situation will determine the best treatment.

Here are some causes of postnasal drip:

► Plugs of food and cellular debris stuck in the nooks and crannies of the tissue at the back of your throat. This is especially common in people who consume dairy products.

► Tooth or gum problems, such as an infected tooth or chronic gingivitis. Once again, the associated inflammation ramps up the mucus production.

► Ongoing allergies—for example, hay fever, food allergies, or an allergy to pollen, dust, or mold spores. When exposed to the particular allergen to which you have an allergy, histamine is secreted into your upper respiratory tissues, irritating them and stimulating excess mucus production.

► Acid reflux or gastroesophageal reflux disease (GERD). In many cases, postnasal drip is the only clue that sufferers even have reflux. It occurs when acidic vapors from the reflux waft up into the throat and irritate the tissues there, stimulating more mucus production. In addition to the discomfort of postnasal drip, many sufferers have bad breath because accumulated mucus starts to decompose, giving off an unpleasant odor.

Even more importantly, studies show that while sleeping, accumulated mucus can spill into the lungs and cause pneumonia (In Vivo).

Eliminating Post Nasal Drip

Postnasal drip gives sufferers a valuable heads-up that there's an underlying problem. To figure out what the problem is and get some immediate relief, I suggest starting with pulsatile nasal irrigation using a Grossan Hydro Pulse Sinus Irrigator (available by calling 1-800-211-8562). It cleans nasal and sinus passages and restores the sweeping mechanism that keeps mucus moving

In the process, it flushes out allergens and irritants that stimulate excess mucus production, soothes inflamed tissues, and eliminates bad breath.

Use it daily for two weeks, then once every week or two for general "housekeeping." If, after two weeks of daily use, your postnasal drip is completely gone, you probably just had too much debris and needed a good cleaning of your nasal passages and sinuses. If it has improved but is not completely gone, there's probably still an underlying problem. Here's what I suggest.

► Grab a magnifying mirror and a penlight, open wide, and see if you have food stuck in your tonsils. If you do, what you'll see is one or more holes in the tissues on the sides of your throat where white or yellowish material is peeking out. This rotting organic material irritates the tissues and stimulates increased mucus production.

Some people can remove the particles by pressing the tissue with a Q-tip or aiming the tip of a WaterPik into an adjacent hole. If you are queasy about doing this, you'll need to get help from an ear-nose-throat specialist.

► Eliminate all allergenic foods from your diet, including dairy, wheat, soy, and alcohol, for a full month and see if that makes a difference.

► Get your teeth and gums checked.

► While I do not recommend taking antihistamines on a long-term basis, if you try a low dose of a mild, over-the-counter antihistamine for a day or two and your postnasal drip improves, it's possible you have an allergic rhinosinusitis. If that's the case, refer to the article (links here) for tips on how to treat this condition.

► If after trying all of these things you're still uncomfortable, it's possible you have GERD.

Finally, natural anti-inflammatory supplements can help reduce allergic reactions. I suggest taking one or more of the following:

► Digestive enzymes, including 500-1,000 mg of bromelain; 200-300 mg of papain; and/or 300-500 mg of pancreatic enzymes, either with or immediately following a meal.

► MSM is useful for the treatment of food allergies. Take 250-750 mg of MSM granules three times a day with meals.

► Quercetin, a bioflavonoid found most abundantly in onions, is highly effective in lowering inflammation and inhibiting the release of histamines and other inflammatory substances. I recommend taking 300-600 mg once or twice a day.

To increase absorption rate, take it with bromelain.

Janet, with patience, persistence, and a logical approach to rule out and address underlying issues, I'm sure you'll be able to find the source of your post-nasal drip and resolve it.

Dr Susan

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