Postnasal drip syndrome, also widely known as Upper Airway Cough Syndrome (UACS), is a common condition where excess mucus drips down the back of the throat from the nasal passages or sinuses. This sensation can lead to chronic throat irritation, frequent throat clearing, and a persistent cough. Causes: Postnasal drip is often caused by conditions that lead to overproduction of mucus or impaired mucus clearance.

Allergies (Allergic Rhinitis):
- Seasonal Allergies: Pollen (trees, grasses, weeds) can trigger excessive, watery mucus production, especially during specific seasons.
- Perennial Allergies: Indoor allergens like dust mites, pet dander, and mold can cause year-round mucus production and inflammation.
Non-Allergic Rhinitis:
- Vasomotor Rhinitis: Blood vessels in the nose overreact to non-allergic triggers (e.g., changes in temperature, humidity, strong odors, irritants like smoke), leading to runny nose and drip.
- Irritants: Exposure to tobacco smoke, pollution, chemical fumes, or strong perfumes.
- Infections: Viral infections (common cold, flu) or bacterial sinus infections (sinusitis) cause increased and often thicker mucus.
Sinusitis (Sinus Infection): Inflammation of the sinuses can lead to thick mucus buildup and drainage down the throat. This can be acute or chronic.
Gastroesophageal Reflux Disease (GERD) / Laryngopharyngeal Reflux (LPR): Stomach acid or contents back up into the esophagus and sometimes reach the throat and voice box, irritating them and triggering increased mucus production as a protective response.
Anatomical Abnormalities:
- Deviated Septum: A crooked nasal septum can hinder proper drainage.
- Nasal Polyps: Growths in the nasal passages or sinuses can block drainage.
Environmental Factors: Dry air (e.g., from heating systems), low humidity.
Certain Medications: Some blood pressure medications (e.g., ACE inhibitors), hormonal therapies.
Food Sensitivities: Some individuals find certain foods (e.g., dairy) can worsen mucus production.

Symptoms: The primary symptom of postnasal drip is the sensation of mucus running down the back of the throat. Other common symptoms include:

Frequent throat clearing: A persistent urge to clear the throat.
Chronic cough: Often worse at night or upon waking, can be dry or produce phlegm. This is why it's often called Upper Airway Cough Syndrome.
Sore throat or scratchy throat.
Hoarseness or voice changes.
Frequent swallowing.
Feeling of a lump in the throat (globus sensation).
Nasal congestion or stuffiness.
Runny nose.
Bad breath (halitosis).
Ear pressure or fullness.
Nausea (from swallowing excess mucus).

Diagnosis: Diagnosing postnasal drip syndrome involves a thorough medical history, physical examination, and sometimes specific tests to identify the underlying cause.

Medical History and Physical Exam: The doctor will ask detailed questions about your symptoms, triggers, duration, and any related medical conditions (allergies, asthma, reflux). They will examine your nose, throat, and possibly your ears.
Nasal Endoscopy: A thin, flexible, lighted tube with a camera is inserted into the nose to visualize the nasal passages, sinuses, and throat for inflammation, polyps, mucus, or reflux signs.
Allergy Testing: If allergies are suspected, skin prick tests or specific IgE blood tests may be performed.
Sinus CT Scan: If chronic sinusitis is suspected as the cause.
Reflux Evaluation:
- Trial of reflux medications: Taking proton pump inhibitors (PPIs) for a period to see if symptoms improve.
- pH monitoring: In some cases, a small probe is placed in the esophagus to monitor acid reflux over 24 hours.
Sputum Culture: If a bacterial infection is suspected, mucus may be cultured to identify the pathogen.

Treatment: Treatment for postnasal drip syndrome focuses on managing the underlying cause, reducing mucus production, and clearing the airways.

Treating the Underlying Cause:
- Allergies: Allergen avoidance, antihistamines (oral or nasal sprays), nasal corticosteroids, and potentially allergen immunotherapy.
- Sinusitis: Antibiotics for bacterial infections, nasal corticosteroids, saline rinses, and possibly surgery for chronic cases.
- Reflux: Acid-reducing medications (PPIs, H2 blockers), dietary changes (avoiding trigger foods), and lifestyle modifications (e.g., elevating the head of the bed, not eating close to bedtime).
Mucus Management:
- Saline Nasal Rinses/Sprays: Help thin and flush out mucus from the nasal passages.
- Hydration: Drinking plenty of water can help thin mucus.
- Humidifiers: Adding moisture to the air can help, especially in dry environments.
- Mucolytics: Over-the-counter medications like guaifenesin (expectorants) may help thin mucus.
Symptom Relief:
- Decongestants: (e.g., pseudoephedrine, phenylephrine) can help reduce nasal congestion. Use nasal decongestant sprays cautiously for only a few days to avoid rebound congestion.
- Cough suppressants: For severe cough, but addressing the underlying cause is more effective.
Lifestyle Adjustments:
- Avoid irritants: Steer clear of smoke, strong perfumes, and other airborne irritants.
- Elevate head during sleep: Can help reduce reflux and postnasal drip at night.
- Avoid trigger foods: If specific foods worsen mucus.

Long-term management often involves identifying and consistently addressing the primary underlying cause of the postnasal drip.

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Postnasal Drip Syndrome

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