How Do You Get Rid of Postnasal Drip?

Postnasal drip is a symptom of many different conditions; treatment of the underlying condition may resolve it, such as with viral respiratory infections. Tissue malformations, hormonal imbalances and other causes may make your case of post-nasal drip trickier to treat.

Postnasal drip (also called upper airway cough syndrome, or UACS) is a condition that occurs when excess mucus accumulates in the back of the nose and drips down the back of the throat.

Symptoms of postnasal drip include: 

• Feeling of mucus draining into the throat
• Feeing of wanting to clear the throat
• Frequent swallowing
• Raspy or gurgling speech
• Sore irritated throat
• Feeling a lump in the throat
• Cough that is often worse at night

Causes of postnasal drip include: 

• Allergies
• Viral infections such as colds, the flu, or COVID-19
• Bacterial infections
• Sinusitis
• Vasomotor rhinitis (overly sensitive nose)
• Gastroesophageal reflux disorder (GERD)
• Airborne irritants such as dust or pollution
• Swallowing disorders (such as an esophageal motility disorder)
• Side effects of medications (including birth control pills and high blood pressure medications)
• Age
• Irregular nose cartilage that can cause increased mucus production
• Pregnancy
• Certain foods or spices
• Cold temperatures
• Hormonal changes
• Dryness in heated spaces, such as during winter
• Something stuck in the nose (in small children)

Postnasal drip is diagnosed with a patient history and an ear, nose, and throat exam, and tests to help determine the cause, such as:

• Endoscopy (using a camera to look inside the nose and throat)
• X-rays
• Sinus computerized tomography (CT) scan

Treatment to get rid of postnasal drip depends on the cause. 

Treatment for postnasal drip caused by infections includes: 

• Antibiotics to treat bacterial infection 
• Nasal spray
• Decongestants
  • Pseudoephedrine (Sudafed) 
  • Phenylephrine (Sudafed PE or Neo-Synephrine) 
• Mucous-thinning drugs such as guaifenesin (Mucinex, Robitussin) 
• Humidifier or steam inhalation during a hot shower
• Staying hydrated to thin mucus
• Sleep on propped up pillows, to keep mucus from collecting in the back of the throat 
• Nasal saline irrigations
• Surgery to open blocked sinuses for chronic sinusitis

Treatment for postnasal drip caused by allergies includes:

• Avoiding the allergen
• Decongestants
• Cromolyn and steroid nasal sprays
• Oral steroids 
• Older, sedating antihistamines to dry and thicken post-nasal secretions
  • Diphenhydramine (Benadryl)
  • Chlorpheniramine (Chlor-Trimeton)
• Newer antihistamines (may help with allergy symptoms but don’t help dry post-nasal secretions as well)
  • Loratadine (Claritin or Alavert)
  • Fexofenadine (Allegra) 
  • Cetirizine (Zyrtec) 
  • Levocetirizine (Xyzal) 
  • Desloratadine (Clarinex)
• Immunotherapy (desensitization) using allergy shots or drops under the tongue 

Treatment for postnasal drip caused by gastroesophageal reflux (GERD) includes:

• Elevating the head of the bed six to eight inches
• Avoiding food and beverages for at least three hours before bedtime
• Weight loss
• Eliminating alcohol and caffeine 
• Antacids such as calcium carbonate chewable tablets (TUMS); aluminum hydroxide, magnesium hydroxide, and simethicone suspension (Mylanta); and aluminum hydroxide and magnesium trisilicate (Gaviscon)
• Acid blockers such as ranitidine (Zantac) or famotidine (Pepcid)

Treatment for postnasal drip that allows mucus secretions to pass more easily includes:

• Drinking more water
• Eliminating caffeine
• Avoiding diuretics 
• Mucous-thinning drugs 
• Saline nasal irrigations 
• Nonprescription saline nasal spray (Ocean, Ayr) to moisten the nose