POST NASAL DRIP What causes abnormal secretions?
How is it treated?
Allergies are managed by avoiding the causes. Antihistamines and decongestants, cromolyn and steroid (cortisone type) nasal sprays, and other forms of steroids may offer relief. Immunotherapy, either by shots or sublingual (under the tongue drops) may also be helpful. However, some older, sedating antihistamines may dry and thicken post-nasal secretions even more; newer nonsedating antihistamines, available by prescription only, do not have this effect. Decongestants can aggravate high blood pressure, heart, and thyroid disease. Steroid sprays may be used safely under medical supervision. Oral and injectable steroids rarely produce serious complications in short-term use. Because significant side-effects can occur, steroids must be monitored carefully when used for more than one week. Gastroesophageal reflux is treated by elevating the head of the bed six to eight inches, avoiding foods and beverages for two to three hours before bedtime, and eliminating alcohol and caffeine from the daily diet. Antacids such as Maalox®, Mylanta®, Gaviscon®, and drugs that block stomach acid production such as Zantac®, Tagamet®, or Pepcid®) may be prescribed. If these are not successful, stronger medications can be prescribed. Trial treatments are usually suggested before x-rays and other diagnostic studies are performed.
General measures that allow mucus secretions to pass more easily may be recommended when it is not possible to determine the cause. Many people, especially older persons, need more fluids to thin out secretions. Drinking more water, eliminating caffeine, and avoiding diuretics (medications that increase urination) will help. Mucous-thinning agents such as guaifenesin (Humibid®, Robitussin®) may also thin secretions. Nasal irrigations may alleviate thickened secretions. These can be performed two to four times a day either with a nasal douche device or a Water Pik® with a nasal irrigation nozzle. Warm water with baking soda or salt (½ to 1 tsp. to the pint) or Alkalol®, a nonprescription irrigating solution (full strength or diluted by half warm water), may be helpful. Finally, use of simple saline (salt) nonprescription nasal sprays (e.g., Ocean®, Ayr®, or Nasal®) to moisten the nose is often very beneficial. Sinus Conditions Sinuses are air-filled cavities in the skull. They drain into the nose through small openings. Blockages in the openings from swelling due to colds, flu, or allergies may lead to acute sinus infection. A viral cold that persists for 10 days or more may have become a bacterial sinus infection. This infection may increase post-nasal drip. If you suspect that you have a sinus infection, you should see your physician to see if it needs antibiotic treatment. Chronic sinusitis occurs when sinus blockages persist, causing the lining of the sinuses to swell further. Polyps (growths in the nose) may develop with chronic sinusitis. Patients with polyps tend to have irritating, persistent post-nasal drip. Evaluation by an otolaryngologist may include an exam of the interior of the nose with a fiberoptic scope and CAT scan x-rays. If medication does not relieve the problem, surgery may be recommended. Vasomotor Rhinitis describes a nonallergic “hyperirritable nose” that feels congested, blocked, or wet.
Ear, Nose and Throat Physicians of North MS PA