Is it an infection? Is it an allergy? Is it from smoking? You have throat drainage and you don't know what's causing it.
According to The American Academy of Otolaryngology–Head and Neck Surgery, Glands in your nose and throat continually produce mucus (one to two quarts a day). Mucus moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection.
Although it is normally swallowed unconsciously, the feeling of it accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This sensation can be caused by excessively thick secretions or by throat muscle and swallowing disorders.
Listen in as Steven Lyon, MD explains that often times throat drainage can be caused by an underlying ENT issue.
Selected Podcast
Do You Suffer from Post Nasal Drip?
Featured Speaker:
Steven L. Lyon, MD
Steven L. Lyon, MD is an Otolaryngologist with Stoughton Hospital. Transcription:
Do You Suffer from Post Nasal Drip?
Melanie Cole (Host): Have you ever had that feeling of mucus that accumulates in your throat and you're not sure what that means. My guest today is Dr. Steven Lyon. He's a board certified otolaryngologist at Stoughton Hospital. Welcome to the show, Dr. Lyon. So, people get that feeling: sometimes it causes a cough, sometimes they feel like it's a post-nasal drip. What's going on when we feel that throat drainage?
Dr. Steven Lyon (Guest): Melanie, this is one of the most common things that people come to the office with complaints about. It’s very, very common. So, I think it's important to have people understand some of the major causes and make it so that they can describe these things to their doctors and help the doctor come up with the proper treatment. This is really mostly drainage that you feel but you can't usually see abnormal drainage. You can feel an abnormality in your throat or in your nose and you feel like there's something in there. It's important to remember that the nose--and this is something that really surprises people--because the nose puts out two quart of mucus a day. Of course, your mouth is always putting out saliva and this runs down the back and is actually there to lubricate your mucus membranes. The lining of your nose and your throat are supposed to have that because that's what we call them “mucus membranes”. The idea of post-nasal drainage is kind of a funny misnomer because, really, we all should have mucus and drainage in the throat. The question is, if we feel it what's going on? Why is there that sensation? Why does it feel abnormal to us? Everybody can really produce some of that, you can always spit up a little bit of it but trying to understand what really is behind the problem is going to help you get to the solution. It's really important to understand that it's not all about allergies, though allergies can be a cause. You need to think about the individual symptoms, help your doctor with the diagnosis, and help them help you with the proper treatment. If you go in and you say the word “drainage”, and it's not drainage, you may get treated for drainage, and then it won't get better. The first thing to understand is that these causes aren't necessarily individual causes; they frequently overlap and many people have more than one. You mention things like smoking and other sources of throat irritation. Anything that can irritate your throat can either dry your throat or make it feel like there's something stuck in there. That will give us a sense or enhance the sense of post nasal drainage, so we have to think about all the sources of the throat irritation whether it be smoking, or working in a dusty environment, or irritation from chemicals in the environment, or some people are very sensitive to smells and perfumes and things like that. One thing that I like to have people first understand is that they should separate the sensation of post-nasal drainage or nasal drainage from the dripping of the front--the watery drippy runny nose that people sometimes get. That comes in basically two varieties, there's something that we call nasal rhinitis. It’s frequently when an older person comes in and their nose runs like a faucet and they're constantly having to block drips and blow their nose, and they have handkerchiefs at the ready all the time but they don't have typical symptoms of allergies like sneezing, itching, runny nose, and scratchy eyes but they do have that watery, dripping nose. Sometimes that's made worse by having a meal, smelling a smell, going outside, the cold, and changes in temperature, things like that. That's not post-nasal drip, that's a drippy nose. That's something that requires a different treatment but that's what we're really talking about today. Another one is allergies. Of course, allergies increase the volume of the mucus and they can have that mucus either come out the front and drip, or they can go down the back and that produces some actual increase in the nasal drainage but it's usually accompanied by symptoms that we are pretty familiar with because the allergies are so common: things like sneezing, itchy, runny, watery, and scratchy eyes, scratchy throat and that sort of thing. Sometimes we know that there's an exposure whether it's pollens, or trees, or grass, or animals. We generally have this and there's an exposure that can make this worse or trigger it but some of the causes of the sensation of post-nasal drip aren't necessarily quite so straightforward. There are many patients who have swelling of their mucus membrane and the structures in the nose, and they'll feel a sense of drainage in the nose but when they blow their nose nothing comes out. When they move from one side to the other when they're sleeping, the drainage seems to move from side to side. We all sense this to some extent because some of this is normal as the blood flow switches from side to side with the changes in the position when we lie down or when we are sleeping. But, for some people this is much more pronounced, and so theirs is a situation where it's not really a drainage; it's not really a mucus. It's the filling up of your nasal cavities with the tissue that becomes swollen in your nose. Unless we treat that swelling or understand what's causing the swelling, we won't really get any relief from that and there are certain medications that are common in causing and making this sort of thing worse. One of the most common medications people are on is for their prostate or to be able to urinate because that tends to cause the mucus membrane to swell. As I said, they really don't come alone or singly. Many of them are associated with other problems, whether you have obstruction from a combination of things like what we call a “deviated septum” in the nose, and crooked breathing passages, or a combination of those with allergies, or a chronic sinus problem. Another common source that people refer to as post-nasal drainage is simply actually dryness--dry mouth, where people feel like their mouth is parched and sticks, and it makes it hard to swallow and this sort of thing. In contrast to having more drainage, they actually have less mucus, less drainage in the throat. It doesn't feel normal. It doesn't work normal and neither does the nose. When the nose is dry, it feels stuffy. So, the key here is to increase their intake of water, use maybe a nasal moisturizing spray. Keep a little cup of water or water bottle at the bedside so that you can moisten your throat if you wake up with a dry mouth. Or, you can use things like salivary replacements. This is another thing that is aggravated by smoking because if your mucus membranes are dry, then they're not protected well. If you smoke and you're using your throat like a chimney, then that smoking can aggravate any irritation in your throat and make that sensation worse. Now one of the other frequent causes of the drainage sensation is actually what we call “reflux”, many people refer to this as “silent reflux” because it doesn't cause overt symptoms that you are familiar with like heart burn. What do people get when they have reflux and how can you tell if that's the source of your post-nasal drainage symptoms? Well, people tend to have symptoms that are with reflux that are worse in the morning. They'll feel like there's a glob in the throat or sense that there's drainage stuck in the throat, and they'll clean the throat frequently [indicates by making noise] and this sort of thing but they won't see any actual normal mucus coming out, frequently because the stomach acid has actually traveled up the esophagus and into the back of the throat, they can get hoarse and they can irritate the vocal cord, so they can get a sore throat. So, these people will benefit from dietary changes and potentially being on a medication to reduce the acids up and make it so that it's quite not so irritating but things like eating late, going to bed, or lying down, or exercising with full stomach, with head of the bed elevated and that sort of thing. But, again, this is something that's not clearly associated with a real post-nasal drainage or drainage you could see but it's a sensation of drainage.
Melanie: Dr. Lyon, you've given us so many different bits of good advice about why this could be caused, things that we can do. So, wrap it up and give us some things that you really want people to first try at home and then, if this is still a problem, something that's really aggravating them and, as you say, causing coughing and all of the things that make life very difficult for somebody with severe throat drainage. Give us some home remedies, things you want people to try like humidifiers, nasal sprays, whatever, and then tell them when they really should see a doctor.
Dr. Lyon: I think that's really what it comes down to, is trying to get relief. One simple way to think about it is if it is dry, then wet it. Use nasal saline and then drink an extra drink or two of water. Those are things that are simple to do and give you a simple answer about whether that's playing a significant role in your symptoms. Cutting down your smoking, looking at the sources of potential irritation in your nose and your throat, and removing those sources of irritation. Smoking is a simple one to recognize but not such a simple one to defeat. It's important to take that next step and try and reduce or stop the smoking. Pay attention to signs for instant of chronic sinusitis. Patients who have maybe a pressure sensation and really will have occasional very, very thick or abnormal glue like secretions that come up. Those patients will frequently benefit from nasal irrigation and many patients who have that and other sources of inflammation can use a nasal steroid spray which now are available over the counter for use. I think it's important to take these steps at home, to try and narrow down some of the possibilities. See what gives you relief; see what doesn't give you relief. That's more information you can bring to your doctor so that they can understand what steps you've already taken and what other medications or possibly changes in the medications you're already on because those might be contributing to some of the symptoms too. There are lots of options. Certainly, if people have allergies then the use of the nasal steroids sprays, or, potentially antihistamines to control their sneeze, itchy, watery, runny symptoms can go a long way to helping these symptoms. The important thing is to think about what the possible causes are and try and manage some of the more common causes at home. Decrease the sources of irritation in your nose and your throat and keep good notes so that you can give those ideas to your doctor and use the doctor’s treatment, if the treatment at home doesn't help.
Melanie: Thank you so much for being with us today, Dr. Lyon. You're listening to Stoughton Hospital Health Talk. For more information you can go to www.stoughtonhospital.com. That's www.stoughtonhospital.com. This is Melanie Cole. Thanks so much for listening.
Do You Suffer from Post Nasal Drip?
Melanie Cole (Host): Have you ever had that feeling of mucus that accumulates in your throat and you're not sure what that means. My guest today is Dr. Steven Lyon. He's a board certified otolaryngologist at Stoughton Hospital. Welcome to the show, Dr. Lyon. So, people get that feeling: sometimes it causes a cough, sometimes they feel like it's a post-nasal drip. What's going on when we feel that throat drainage?
Dr. Steven Lyon (Guest): Melanie, this is one of the most common things that people come to the office with complaints about. It’s very, very common. So, I think it's important to have people understand some of the major causes and make it so that they can describe these things to their doctors and help the doctor come up with the proper treatment. This is really mostly drainage that you feel but you can't usually see abnormal drainage. You can feel an abnormality in your throat or in your nose and you feel like there's something in there. It's important to remember that the nose--and this is something that really surprises people--because the nose puts out two quart of mucus a day. Of course, your mouth is always putting out saliva and this runs down the back and is actually there to lubricate your mucus membranes. The lining of your nose and your throat are supposed to have that because that's what we call them “mucus membranes”. The idea of post-nasal drainage is kind of a funny misnomer because, really, we all should have mucus and drainage in the throat. The question is, if we feel it what's going on? Why is there that sensation? Why does it feel abnormal to us? Everybody can really produce some of that, you can always spit up a little bit of it but trying to understand what really is behind the problem is going to help you get to the solution. It's really important to understand that it's not all about allergies, though allergies can be a cause. You need to think about the individual symptoms, help your doctor with the diagnosis, and help them help you with the proper treatment. If you go in and you say the word “drainage”, and it's not drainage, you may get treated for drainage, and then it won't get better. The first thing to understand is that these causes aren't necessarily individual causes; they frequently overlap and many people have more than one. You mention things like smoking and other sources of throat irritation. Anything that can irritate your throat can either dry your throat or make it feel like there's something stuck in there. That will give us a sense or enhance the sense of post nasal drainage, so we have to think about all the sources of the throat irritation whether it be smoking, or working in a dusty environment, or irritation from chemicals in the environment, or some people are very sensitive to smells and perfumes and things like that. One thing that I like to have people first understand is that they should separate the sensation of post-nasal drainage or nasal drainage from the dripping of the front--the watery drippy runny nose that people sometimes get. That comes in basically two varieties, there's something that we call nasal rhinitis. It’s frequently when an older person comes in and their nose runs like a faucet and they're constantly having to block drips and blow their nose, and they have handkerchiefs at the ready all the time but they don't have typical symptoms of allergies like sneezing, itching, runny nose, and scratchy eyes but they do have that watery, dripping nose. Sometimes that's made worse by having a meal, smelling a smell, going outside, the cold, and changes in temperature, things like that. That's not post-nasal drip, that's a drippy nose. That's something that requires a different treatment but that's what we're really talking about today. Another one is allergies. Of course, allergies increase the volume of the mucus and they can have that mucus either come out the front and drip, or they can go down the back and that produces some actual increase in the nasal drainage but it's usually accompanied by symptoms that we are pretty familiar with because the allergies are so common: things like sneezing, itchy, runny, watery, and scratchy eyes, scratchy throat and that sort of thing. Sometimes we know that there's an exposure whether it's pollens, or trees, or grass, or animals. We generally have this and there's an exposure that can make this worse or trigger it but some of the causes of the sensation of post-nasal drip aren't necessarily quite so straightforward. There are many patients who have swelling of their mucus membrane and the structures in the nose, and they'll feel a sense of drainage in the nose but when they blow their nose nothing comes out. When they move from one side to the other when they're sleeping, the drainage seems to move from side to side. We all sense this to some extent because some of this is normal as the blood flow switches from side to side with the changes in the position when we lie down or when we are sleeping. But, for some people this is much more pronounced, and so theirs is a situation where it's not really a drainage; it's not really a mucus. It's the filling up of your nasal cavities with the tissue that becomes swollen in your nose. Unless we treat that swelling or understand what's causing the swelling, we won't really get any relief from that and there are certain medications that are common in causing and making this sort of thing worse. One of the most common medications people are on is for their prostate or to be able to urinate because that tends to cause the mucus membrane to swell. As I said, they really don't come alone or singly. Many of them are associated with other problems, whether you have obstruction from a combination of things like what we call a “deviated septum” in the nose, and crooked breathing passages, or a combination of those with allergies, or a chronic sinus problem. Another common source that people refer to as post-nasal drainage is simply actually dryness--dry mouth, where people feel like their mouth is parched and sticks, and it makes it hard to swallow and this sort of thing. In contrast to having more drainage, they actually have less mucus, less drainage in the throat. It doesn't feel normal. It doesn't work normal and neither does the nose. When the nose is dry, it feels stuffy. So, the key here is to increase their intake of water, use maybe a nasal moisturizing spray. Keep a little cup of water or water bottle at the bedside so that you can moisten your throat if you wake up with a dry mouth. Or, you can use things like salivary replacements. This is another thing that is aggravated by smoking because if your mucus membranes are dry, then they're not protected well. If you smoke and you're using your throat like a chimney, then that smoking can aggravate any irritation in your throat and make that sensation worse. Now one of the other frequent causes of the drainage sensation is actually what we call “reflux”, many people refer to this as “silent reflux” because it doesn't cause overt symptoms that you are familiar with like heart burn. What do people get when they have reflux and how can you tell if that's the source of your post-nasal drainage symptoms? Well, people tend to have symptoms that are with reflux that are worse in the morning. They'll feel like there's a glob in the throat or sense that there's drainage stuck in the throat, and they'll clean the throat frequently [indicates by making noise] and this sort of thing but they won't see any actual normal mucus coming out, frequently because the stomach acid has actually traveled up the esophagus and into the back of the throat, they can get hoarse and they can irritate the vocal cord, so they can get a sore throat. So, these people will benefit from dietary changes and potentially being on a medication to reduce the acids up and make it so that it's quite not so irritating but things like eating late, going to bed, or lying down, or exercising with full stomach, with head of the bed elevated and that sort of thing. But, again, this is something that's not clearly associated with a real post-nasal drainage or drainage you could see but it's a sensation of drainage.
Melanie: Dr. Lyon, you've given us so many different bits of good advice about why this could be caused, things that we can do. So, wrap it up and give us some things that you really want people to first try at home and then, if this is still a problem, something that's really aggravating them and, as you say, causing coughing and all of the things that make life very difficult for somebody with severe throat drainage. Give us some home remedies, things you want people to try like humidifiers, nasal sprays, whatever, and then tell them when they really should see a doctor.
Dr. Lyon: I think that's really what it comes down to, is trying to get relief. One simple way to think about it is if it is dry, then wet it. Use nasal saline and then drink an extra drink or two of water. Those are things that are simple to do and give you a simple answer about whether that's playing a significant role in your symptoms. Cutting down your smoking, looking at the sources of potential irritation in your nose and your throat, and removing those sources of irritation. Smoking is a simple one to recognize but not such a simple one to defeat. It's important to take that next step and try and reduce or stop the smoking. Pay attention to signs for instant of chronic sinusitis. Patients who have maybe a pressure sensation and really will have occasional very, very thick or abnormal glue like secretions that come up. Those patients will frequently benefit from nasal irrigation and many patients who have that and other sources of inflammation can use a nasal steroid spray which now are available over the counter for use. I think it's important to take these steps at home, to try and narrow down some of the possibilities. See what gives you relief; see what doesn't give you relief. That's more information you can bring to your doctor so that they can understand what steps you've already taken and what other medications or possibly changes in the medications you're already on because those might be contributing to some of the symptoms too. There are lots of options. Certainly, if people have allergies then the use of the nasal steroids sprays, or, potentially antihistamines to control their sneeze, itchy, watery, runny symptoms can go a long way to helping these symptoms. The important thing is to think about what the possible causes are and try and manage some of the more common causes at home. Decrease the sources of irritation in your nose and your throat and keep good notes so that you can give those ideas to your doctor and use the doctor’s treatment, if the treatment at home doesn't help.
Melanie: Thank you so much for being with us today, Dr. Lyon. You're listening to Stoughton Hospital Health Talk. For more information you can go to www.stoughtonhospital.com. That's www.stoughtonhospital.com. This is Melanie Cole. Thanks so much for listening.