Postnasal drip syndrome describes an overproduction of nasal secretions by the mucous glands of the sinuses. This is uncomfortable and can lead to viral or bacterial infections and inflammation.
What is postnasal drip syndrome?
Postnasal drip syndrome causes increased production of the body’s mucus glands. These glands are located on the inner walls of the sinuses, and they produce a thick, white fluid that keeps these areas moist and protected against invaders such as viruses and bacteria. With normal mucus production, no one will notice this discharge. The mucus continuously runs down the throat in small amounts and is swallowed automatically. Only if the body produces more secretion than normal or the mucus is significantly thicker will the affected person notice it. An overproduction of this mucus then runs from the front end of the nose and is simply called a runny nose. However, if the mucus runs down the back end of the nose into the throat, it is called postnasal drip syndrome.
Causes
The overproduction of nasal secretions that triggers postnasal drip syndrome can have a variety of causes. These include: Cold, flu, allergy (allergic postnasal drip syndrome), sinusitis, foreign object in the nose (common in young children), pregnancy, medications (especially birth control and blood pressure medications), distorted septum (abnormal growth of the wall between the nostrils) or other malposition, weather change (very cold or dry weather), certain foods (eg. very spicy foods), fumes from chemicals, perfumes, cleaning products, cigarette smoke, or other sources. Sometimes the problem is not due to an overproduction of nasal secretions, but because the fluid cannot be properly cleared. For example, swallowing problems can also lead to postnasal drip syndrome, when nasal secretions build up in the throat and cannot be cleared. Such problems can occur with increasing age or with disorders such as gastroesophageal reflux disease.
Symptoms, complaints, and signs
The characteristic sign of the disease is a constant flow of mucus from the nose down the throat into the lower respiratory tract. The nose is blocked and the constantly produced new secretion cannot drain. So it takes the way inward via the pharynx. As a result, the patient constantly feels the need to clear his throat. The accumulated mucus is spat out or even swallowed. This excessive secretion production is particularly unpleasant when lying down. During the night, it can also lead to shortness of breath due to obstruction of the airways. In addition, those affected suffer from hoarseness, which is noticeable in a rough voice. A chronic dry cough may develop, accompanied by itching in the throat. Patients often complain of having difficulty and pain swallowing. Due to the impeded or completely prevented nasal breathing, the ability to smell and the sense of taste are impaired. A general feeling of illness is often experienced, and patients feel tired and fatigued. Headaches and facial pain may occur. The ears may also be involved and react with pain and a feeling of pressure. A typical accompanying symptom of the disease is bad breath. In severe cases, fever may occur. If the disease is not treated, the pathogens contained in the mucus may eventually affect the bronchi.
Diagnosis and course
Postnasal drip syndrome causes an uncomfortable sensation in the throat that irritates the affected person to swallow continuously. The fluid that builds up in the throat is actually irritating in many cases, as it contains substances that can cause inflammation and lead to a cough. This becomes particularly bad at night in most cases. Postnasal drip syndrome is the most common cause of chronic cough. Associated symptoms include a scratchy throat and a hotter voice. When mucus rises to the Eustachian tube (this connects the throat to the middle ear), it can cause a painful ear infection. A doctor diagnoses postnasal drip syndrome with a physical examination of the patient and questioning about the exact symptoms.
Complications
Because of postnasal drip syndrome, those affected suffer from a variety of symptoms.In the first place, however, it comes to a chronic rhinitis, which can not be treated again with the usual medicines and remedies. The infection can also spread to the bronchial tubes, causing severe respiratory problems. The affected persons appear fatigued and tired and not infrequently suffer from a general feeling of illness. Postnasal drip syndrome also noticeably reduces the patient’s ability to cope with stress. It is not uncommon for patients to find it difficult to speak, so that they constantly have to clear their throat or cough. The cough can also have a very negative effect on the quality of sleep at night, possibly leading to sleep problems or other psychological upsets. In the worst cases, postnasal drip syndrome leads to asthma if left untreated. Self-cure does not usually occur with this disease, so patients are usually dependent on medical treatment. In most cases, there are no particular complications. The symptoms can be well limited and alleviated with the help of medication.
When should one go to the doctor?
If hoarseness, clearing of the throat or the typical lumpy feeling in the throat occurs, a visit to the doctor is recommended. The symptoms indicate a serious condition that needs to be examined and, if necessary, treated by a specialist. If the symptoms occur in connection with an acute or chronic infection in the nasal cavity, postnasal drip syndrome may be present. Sufferers should consult their family doctor or an ENT specialist. If the symptoms occur over a longer period of time, there is probably an underlying chronic disease. Therefore, people suffering from allergic rhinitis or sinusitis should see a doctor quickly if the described complaints occur. Medical advice is required if the symptoms do not subside with nasal rinses and other home remedies. In addition to the ear, nose and throat specialist, postnasal drip syndrome can also be taken to a specialist in diseases of the nasal passages. If the symptoms are severe, an inpatient stay in a specialized clinic is necessary. However, postnasal drip syndrome often resolves on its own once the causative condition is overcome.
Treatment and therapy
Treatment of postnasal drip syndrome depends on its cause. A bacterial infection is usually treated with antibiotics. However, green or yellow nasal discharge is not always a sign of a bacterial infection either. Colds can also discolor mucus, and these are caused by viruses and do not respond to antibiotics. Antihistamines or decongestants can help with postnasal drip syndrome, which is caused by viruses. Special nasal sprays for allergy may also help. Old antihistamines (Benadryl, Chlor-Trimetron) that come in spray form may not be the best solution because they thicken the secretion. This should be discussed with the doctor. Another treatment option is to dilute the secretion that is too thick. This can be done by drinking plenty of fluids, keeping the air moist and taking certain medications (e.g. guaifenesin). If an allergy is present, the allergens should be identified and avoided. If a cold with increased mucus production does not heal for more than ten days, the doctor should be consulted, as it may be a bacterial infection.
Prevention
Viral or bacterial infections are difficult to prevent. To counteract the unpleasant symptoms of postnasal drip syndrome, care should be taken above all to drink plenty of fluids. Only if there is enough fluid in the organism, the nasal secretion remains thin and reduces the risk of infections. Caffeine should also be avoided, as it leads to increased production of nasal secretions.
Aftercare
If postnasal drip syndrome is treated and cured with antibiotics or other medications, it is essential to prevent a new viral or bacterial infection. To do this, it is important to pay attention to a few things: Regular hand washing and disinfection can reduce new infections. It is important to drink enough fluids regularly, especially water. Sufficient fluid intake keeps mucus fluid and also prevents infections. In the aftercare period, caffeine should also be avoided, as this stimulates the production of mucus. Sufficient rest supports recovery in the current phase.If an allergy is the cause, it is important to avoid the allergy triggers during the aftercare and to take the correct medication. After surgical treatment of postnasal drip syndrome it is important to take the prescribed medication as prescribed. This is the only way to ensure successful healing. Most of the time the aftercare is done in the hospital. After two to four days, follow-up treatment can be continued at home. To reduce crusting in the nose, regular use of nasal rinses is recommended after surgery. In case of sudden bleeding or discomfort, a doctor should be consulted. The goal of postnasal drip syndrome follow-up is to prevent recurrence of the condition. Regular visits to an ear, nose, and throat specialist have the effect of detecting new infections and taking early action.
What you can do yourself
If postnasal drip syndrome is caused by bacteria, the doctor will prescribe an antibiotic. Most often, however, viruses cause the infection. There is still no really effective remedy against them. However, the patient is left with many measures to alleviate the symptoms of the disease and to recover in the process. First of all, the sometimes very viscous mucus must be loosened so that further infections, such as bronchitis, do not occur. Drinking a lot is therefore the motto, because only in this way can the mucus liquefy and dissolve. Hot teas that have an expectorant effect, such as the decoction of eucalyptus leaves, thyme or elderflower, are best here. Alcoholic drinks are taboo, however, as they weaken the body. Regular nasal rinses with saline solution cleanse the nose all the way to the sinuses, flushing out pathogens in the process. Nasal irrigators and the bases for physiological saline solutions are available from various manufacturers and in different versions in pharmacies. Furthermore, nasal sprays that have a decongestant effect help. However, they should not be used for more than a week, otherwise they can become addictive. In postnasal drip syndrome, the patient needs a lot of rest – preferably bed rest. He should also be patient, because the body needs a while to completely heal from the viral attack.
