How do doctors diagnose post nasal drip?

Doctor's Answer

Postnasal drip is a symptom in which one feels that mucous is flowing from his/her nose down to the throat. A normal person produces up to a litre of mucous in the nose and sinuses each day. Most of the time, the mucous flows down the throat without the person being aware of it. However, when your nose produces too much mucous (e.g. in Sensitive nose aka Rhinitis) or the mucous becomes thicker than usual (e.g. from a sinus infection aka Sinusitis), you will experience postnasal drip.

The other common cause of "postnasal drip" is due to acid irritation of the voice box (aka laryngopharyngeal reflux) causing inflammation of the voice box. An inflamed voicebox will result in feeling of something stuck in the throat (aka globus sensation which sometimes patient feels is like a postnasal drip), frequent throat clearing, sore throat, cough and a hoarse voice.

Postnasal drip is a symptom, not a diagnosis. Your doctor will find out the cause of your postnasal drip through a combination of clinical history and physical examination. In all my patients who present with postnasal drip, I will usually perform a nasoendoscopy (scope through the nose done under local anaesthesia) in the clinic. A nasoendoscopy is a relatively painless procedure that allows me to visualize signs of potential causes of postnasal drip such as Rhinitis, Sinusitis or Laryngopharyngeal Reflux.

The treatment of postnasal drip depends on the underlying cause. Medications to reduce mucous production from Rhinitis (e.g. nasal steroid sprays and antihistamines), to treat sinus infection (e.g. antibiotics, nasal wash and nasal steroid spray), or to treat laryngopharyngeal reflux (e.g. acid suppressant medications and lifestyle modifications) are often the usual treatment options. It is also important to ensure that you are well hydrated as dehydration is also.a cause of a thicker mucous.

If you have been experiencing postnasal drip for a while, I would suggest that you visit an ENT Specialist for an assessment.

Hope this helps and all the best!

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