Dr. Amin Javer, MD, FRCSC, FARS, Otolaryngologist Post nasal drip causes and treatments

Duration: 2 minutes and 37 seconds

Post-nasal drip is a complicated condition that can result from multiple different causes. One of these causes is from inflammatory issues within the nasal cavity. Bacterial infections are usually treated with antibiotics, nasal spray, decongestants, and nasal saline irrigations. For chronic sinusitis, surgery to open the blocked sinuses may be required.

Allergies can also be at root cause of inflammatory issues in the sinus cavities. If the inflammation is allergy driven, something like an anti histamine spray can be beneficial for people, as well as a nasal saline rinse.

Nasal polyps can contribute to chronic sinusitis in that they can block the drainage of sinus cavities. The mucus produced by the sinuses is meant to wash away irritants and contaminants from the nasal passages. If nasal polyps get too big, they may block the normal flow of mucus and cause it to build up and become infected. Common symptoms of chronic sinusitis with nasal polyps include: Runny, stuffy nose and mucus running down the throat, which is also known as postnasal drip. Treatments for polyps can include steroidal nasal spray, oral steroids and in some severe cases the use of Biologics.

There are other causes for discharge in the nose that aren’t inflammatory in nature and which are the result of dysfunction of the nerve that innervates mucosal glands of the nose. This can occur when there's an imbalance between the parasympathetic and sympathetic nerve innervation, resulting in the gland making excess mucus. For these patients, there is a nasal spray that specifically targets the nerve that helps bring balance again between the two systems therefor alleviating the post- nasal drip symptoms. Essentially, patients may experience post-nasal discharge not because of an allergen, bacteria or virus, but rather due to a problem with their nerves. A lot of these patients tend to have other symptoms such a history of migraines or other neuropathic issues as well.

Another cause that people need to also consider is acid reflux which is when stomach acid regurgitates up into the nasal cavity causing irritation and discharge. Some patients may not say they have indigestion or heartburn, however, there is a condition called silent reflux, which is when stomach acid comes up into the nasal cavity and where patients don't recognize the typical symptoms of reflux. Unfortunately, this condition can cause symptoms of post-nasal discharge. These people benefit from acid reflux therapy in order to help treat their post-nasal drip. If you have post nasal drip that you can’t get rid of and you want to get assessed, please contact your local health care provider or ENT specialist.

Presenter: Dr. Amin Javer, Otolaryngologist, Vancouver, BC

Local Practitioners: Otolaryngologist