Postnasal drip

Postnasal drip occurs when excess mucus – a watery or sticky discharge – drips from the back of the nose into the upper part of the throat, known as the nasopharynx. Postnasal drip is often associated with catarrh, meaning an excessive build-up of mucus that occurs most commonly within the sinuses but can also affect the throat, ears or chest.

Mucus is produced by glands located in the nose, throat and airways, as well as in the digestive tract. This is usually a perfectly normal response by the body's immune system, to moisten these areas in order to trap and destroy foreign invaders, such as viruses and bacteria. In most cases, the mucus from the nose mixes with saliva and simply drips unnoticed down the back of the throat. However, when too much mucus is being produced in the nose or if it becomes too thick, it will either run out through the nose (a runny nose) or straight down the back of the throat (a postnasal drip). People with scleroderma may find that they experience problems with postnasal drip because of changes occurring inside the nose that may increase the amount of mucus that is being produced.

What are the symptoms of a postnasal drip?

People with a postnasal drip may feel a constant need to clear their throat. Because mucus contains inflammatory elements that can cause irritation, common symptoms also include a sore throat, hoarseness and a cough.

Postnasal drip is generally more noticeable at night, especially when you are lying down to sleep. Possible complications include the blocking of the Eustachian tube, which joins the throat to the middle ear, leading to a painful ear infection. If the sinus passages become blocked, a postnasal drip can cause a sinus infection to develop.

What can cause a postnasal drip?

There are a number of reasons why the glands within the nose may produce excess mucus, including all of the following:

• Colds and flu
• Sinus infections or sinusitis (an inflammation of the sinuses)
• Allergies such as a reaction to pollen, animals or dust mites
• An object stuck in the nose (usually in a child)
• Pregnancy
• Medications (such as blood pressure medicines and contraceptive pills)
• A deviated septum (a problem with the wall between the two nostrils); nasal polyp (a fleshy swelling inside the nose), of which scleroderma can be a cause; or other physical problems within the nose
• Cold temperatures, excess dryness or changes in weather patterns
• Spicy foods and other food triggers
• Fumes produced by cleaning products, perfumes, smoke and other chemicals and irritants

How can postnasal drip be treated?

Treatment options for postnasal drip will depend on the cause. Often the problem will clear up by itself without the need for medical treatment. Antihistamines and decongestants may be helpful in cases involving a viral infection, sinusitis or allergies, although decongestants are only suitable for short-term relief. Allergic symptoms can also be relieved using nasal sprays and steroid medications.

You can also use a humidifier or vaporiser to moisturise the air or try inhaling steam from a bowl or pan of hot water (this should not be boiling). By propping up your pillows to raise your head when sleeping at night, the mucus is less likely to sit in the back of your throat and cause further irritation.

To reduce postnasal drip triggered by allergies:

• Consider using anti-allergy covers to protect your pillows and mattress
• Wash all sheets, duvet covers, pillowcases and mattress covers in hot water
• Dust and vacuum often, using HEPA air filters in your vacuum cleaner

If the mucus has an unpleasant or unusual smell, you develop a fever or wheezing or if the symptoms last for more than 10 days, seek medical advice to rule out other causes such as a bacterial infection. Seek prompt medical advice if there is any blood within the mucus.

If the postnasal drip persists, your GP may want to investigate to determine whether an allergy or nasal polyp may be the cause. A nasal rinse with a saline solution can be used to rinse away any allergens and is a safe option for babies. A nasal spray containing corticosteroids can be used to help reduce inflammation related to allergies, and may also be effective in shrinking smaller nasal polyps, although large ones may require surgery.

When using a nasal spray, make sure you follow the instructions to ensure that the medicine works as effectively as possible. You should blow your nose first to clear it and bend your head down, looking towards your feet. Take care not to sniff when taking the spray since it will then enter your throat rather than stay in your nose.

How postnasal drip can be linked to scleroderma

Some people living with scleroderma also find that they experience postnasal drip. Our specialist Professor Chris Denton explains this in more detail, as follows:

"There are several possible ways in which postnasal drip might be related to scleroderma. Nasal symptoms are common in scleroderma and probably reflect the effect of scleroderma on mucosal lining surfaces more generally. Although the mechanism is unclear, the amount and quality of mucosal secretions is usually reduced in scleroderma and leads to dryness of the mouth, eyes and the upper respiratory tract. This is one reason why scleroderma patients may notice a change or hoarseness of the voice.

"Scleroderma can cause a change in the lining of the nose which may also lead to a degree of inflammation or local infection and this may contribute to a postnasal drip. In addition, altered blood vessel and nerve regulation may be relevant. Increased blood supply to the nasal mucosa can lead to increased secretions and this could be associated with vascular instability as is seen in scleroderma. I would not recommend any specific medication without discussing it with your doctor, as some of these work by reducing nasal secretions and this might aggravate the symptoms rather than be helpful."

Find out more about how to manage this and download your oral and dental fact sheet.

This is what our community said about postnasal drip:

"I have scleroderma and Raynaud's and in the winter I get constant postnasal drip especially at night - I've heard it is due to the nerves controlling blood flow to the nose lining."

"Do you ever get postnasal drip (the feeling that you need to constantly clear your throat, or swallow/ cough/ sore, scratchy throat) and what do you do to combat it?"

Read what the Community said about this on HealthUnlocked.