Understanding Post-Nasal Drip and Respiratory Reflux: Your Complete Treatment Guide

What Is Post-Nasal Drip? Understanding the Basics

Post-nasal drip occurs when sticky excess mucus accumulates in the back of the throat or nose, leading to uncomfortable symptoms. The human body naturally produces over a quart of mucus daily, and normal mucus is usually swallowed unnoticed. Mucus has three important functions:  

1. Lubrication: This creates a mucus blanket that covers the lining of the respiratory tract and lubricates the moving parts; imagine how it would feel to swallow if everything were dry.

2. Barrier function: Traps most foreign matter and microorganisms swallowed and destroyed by stomach acid. 

3. Immune protection: Contains antibodies, mostly immunoglobulin IgA, that attack common pathogens. 

Post-nasal drip occurs when the mucus is thick, sticky, and hard to move, especially when it gets on the vocal cords; most people with post-nasal drip also have chronic throat clearing. Surely, you have a friend or work associate whose chronic throat-clearing is persistent and annoying … tell them they have respiratory reflux.  FYI, the word phlegm is a synonym for the thick mucus of post-nasal drip. 

Most people with post-nasal drip have silent nocturnal respiratory reflux (SNoRR), the most common acid reflux pattern today. Respiratory reflux is the primary cause of postnasal drip, period! 

Causes of Post-Nasal Drip

Thick Mucus (Phlegm) Causes

• Respiratory reflux (RR) – responsible for 90% of cases
• Upper respiratory infection
• Sjögren’s Syndrome
• Sinus infections
• Pregnancy
• Dehydration
• Head and neck irradiation
• Drying medications, e.g., antihistamines 

Thin Mucus Causes

• Seasonal allergies, e.g., pollen, grass, and/or ragweed sensitivity
• Environmental irritants

Seasonal inhalant allergies produce thin, clear mucus that does not cause post-nasal drip symptoms or throat clearing, and it virtually never gets on the vocal cords. Typically, there are also associated symptoms such as sneezing and nasal congestion. 

Sjögren’s Syndrome: Warning Signs

Early in the course of the disease, Sjögren’s Syndrome can cause post-nasal drip. Sjögren’s is a relatively common autoimmune disease that attacks the lacrimal glands for tears and the salivary glands for saliva. As Sjögren’s progresses, dry eyes and mouth become more problematic than postnasal drip.

Sjögren’s Syndrome, affecting 1-3% of the population, can cause thick, dry mucus. Key differences include:

• Dry vs. sticky consistency
• Associated dry eyes and mouth
• Usually accompanied by acid reflux
• Requires specific diagnostic tests: 
  • Schirmer’s test for tear production
  • Saliva gland volume examination
  • Lip biopsy for definitive diagnosis 

Almost everybody with Sjögren’s also has acid reflux because they don’t have enough saliva, which is part of an esophageal defense against reflux; swallowing saliva with bicarbonate can help neutralize acid in the esophagus. Because Sjögren’s Syndrome is not reversible, people with it may require lifelong antireflux treatment.

Effective Post-Nasal Drip Treatment

Natural Remedies That Help

• Maintain proper hydration (8 glasses of water daily) and consume beneficial foods:
• Broths and soups
• Hot tea
• Ginger
• Fresh fruits
• Vegetables

Foods to Avoid

• Dairy products
• Processed meats
• Coffee
• Chocolate
• Alcoholic beverages
• Carbonated drinks

Lifestyle Changes for Long-term Relief

An anti-reflux diet and lifestyle are essential to beating post-nasal drip, that is, respiratory reflux. This includes a low-fat, low-acid anti-reflux diet, no late eating or night snacking, no fast food, and no carbonated beverages. Dr. Koufman’s Reflux Detox Diet also covers reflux treatment. 

Prevention Tips

• Stay well-hydrated throughout the day
• Maintain a healthy, low-acid diet
• Keep your living space clean and dust-free
• Use air purifiers when possible
• Practice good sleep hygiene

Frequently Asked Questions

Q: What is the main cause of post-nasal drip? A: Respiratory reflux is the primary cause in approximately 90% of cases.

Q: How can I tell if my post-nasal drip is from allergies or reflux? A: Allergy-related postnasal drip typically produces thin, clear mucus, while reflux-related cases result in thicker phlegm accompanied by throat clearing.

Q: Is post-nasal drip dangerous? A: While typically not dangerous, chronic postnasal drip can indicate underlying conditions that may require medical attention.

Q: What other respiratory reflux symptoms can occur alongside post-nasal drip? A: Chronic throat clearing, sinus pressure, hoarseness, sore throat, a lump-in-the-throat sensation, difficulty swallowing, and shortness of breath.  

Q: Who do I see if I want to see a physician for my post-nasal drip? A: An otolaryngologist, an ear, nose, and throat doctor.

Conclusion

Understanding and treating post-nasal drip often requires a comprehensive approach focusing on dietary modifications, lifestyle changes, and proper hydration. While respiratory reflux is the most common cause, other conditions like Sjögren’s Syndrome should be considered when symptoms persist despite treatment.

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