Postnasal Drip
Postnasal Drip
13 Tips to Turn It Off
As far as you're concerned, whoever put the word "drip" after post-nasal has some wry sense of humor. "Rampant waterfall" seems more fitting to you.
Just where does all this fluid come from anyway? Well let's begin at the beginning. In the course of a single day, 2,500 gallons of air pass through an adult nose. No matter how cold and dry that air is, your nose has to make sure the air is heated to 98.6 degrees and is 100 percent humidified by the time it completes the 8-inch journey to your lungs. If the air isn't properly moist and warm, it will injure lung tissue.
Proper humidification depends mostly on glands in the lining of your nasal and sinus cavities. Each day, those glands crank out about 2 quarts of fluid to lubricate the mucous membranes in your sinuses, nose, mouth, and throat.
"Normally, those secretions flow down the back of the nose and throat, swept by the cilia," explains Gilbert Levitt, M.D., a Puget Sound, Washington, otolaryngologist and clinical instructor of otolaryngology at the University of Washington School of Medicine. Cilia are threadlike cells that wave back and forth over some of the surface tissue. They help keep the nasal passageways clear of particulate matter.
From time to time, and especially in the winter, the mucus dries out. It begins to get "gloopy" or gluelike. That slows down the cilia. A virus can stop the cilia altogether. When the cilia stop waving, secretions pool in the back of the nose. The consistency thickens and suddenly you're aware of postnasal drip.
How can you get the mucus back to its ordinary, watery self without completely drying your upper respiratory tract?
Here's what our experts advise.
Blow your nose regularly. Ths may be so obvious that you overlook it, says Jerald Principato, M.D., an otolaryngologist in private practice in Bethesda, Maryland, and associate clinical professor of otolaryngology at George Washington University School of Medicine. The simple act of blowing eliminates some excessive postnasal drainage from the front of the nose.
But don't be overzealous. Cotton swabs and even tissues should never be placed inside the nose, he says.
Flush with saltwater. Salt, water, and an infant-sized aspirator are all you need to wash away that mucus-clogged feeling—and the bad breath that often accompanies it.
Here's Dr. Principato's recipe. Dissolve 1/2 teaspoon of salt in 8 ounces of warm water. (Make that 1/3 teaspoon if you have high blood pressure.) Draw the water into the aspirator and put the tip of it in your nostril. Hold your nose straight back and the aspirator at a right angle to your face, parallel to the roof of your mouth. And then breathe in to "suck" the water into your nostril.
It may feel uncomfortable at first, but you'll find it gets easier with practice. Do the other nostril and spit the water back into the sink. You may need to do this a few times before you feel relief. When you're finished. blow your nose to remove the water discharge.
Dr. Principato suggests that you irrigate the nostrils three times a day for five days when needed.
Gargle with saltwater. Use the same solution: 1/2 teaspoon of salt (or 1/3 teaspoon for hypertensives) in 8 ounces of warm water. This, says Dr. Principato, will help clear the throat and voice box problems created by excessive postnasal drainage.
Curb that curry craving. Maybe you're crazy for the taste of lamb curry, or a red-hot Mexican chili. But if you have a postnasal drip problem, you might want to pass for now. "Irritants in foods such as hot peppers and spices like curries can cause chronic nasal problems," says Dr. Principato.
Forgo the milk. You might want to try this to see if it helps, suggests John A. Henderson, M.D., an otolaryngologist and allergist in private practice in San Diego, California, and assistant clinical professor of surgery at the University of California, San Diego, School of Medicine. Some food experts believe that dairy products like milk and ice cream stimulate excess mucus production. Others aren't sure. "Cow's milk is a totally different substance than human milk," says Dr. Henderson. "The problem is that it's full of sugar, and this sugar, called lactose, feeds the bacteria and molds in our throats and intestinal tracts." Overgrowth of these organisms can adversely affect the immune system.
Relax. Stress is a major cause of chronic nasal disease, says Dr. Principato. Why? The job of warming and maintaining a proper lining for the nose falls to the parasympathetic nervous system, "which is heavily influenced by stress," he says. Stress can drive the process too hard, causing the nasal lining to produce more mucus than it needs.
If you find that your postnasal drip is worse when you're under stress, relaxation techniques like progressive muscle relaxation or meditation can help you feel better all around.
Drink lots of fluids. Keeping the mucous lining moist is essential if the cilia are to do their job. Drinking lots of fluids helps to get at the mucus that's struck in the upper part of the pharynx, says Alvin Katz, M.D., an otolaryngologist in private practice in New York City and surgeon director of the Manhattan Eye, Ear, Nose, and Throat Hospital.
"Herb tea with lemon and honey, or just warm water with lemon is excellent," adds Dr. Levitt. "Help the postnasal drainage to go down instead of fighting it by clearing the throat. Anything in the secretion is destroyed by hydrochloric acid in the stomach, so there's nothing to worry about."
Turn on the humidifier. A good humidifier, one that takes several gallons of water to fill, can help keep your nasal passages moist during the dry winter months. And this can help keep mucus from drying out and getting so thick you notice it.
"Use distilled water to fill the humidifiers and you won't have impurities," says Dr. Katz. Be sure to clean the unit weekly with water mixed with a little bit of white vinegar, he advises. That keeps mold and mildew away.
The Alternate Route
Get Your Neti Ready If you hanker after absolute purity in that schnozzola of yours, do what the yogis do. Use a neti pot daily to flush your nasal passages with saltwater. A neti pot resembles a small teapot with an extended spout. It typically holds several ounces of water. Students of yoga believe that keeping the body's air passageways clean of dried mucus can help increase vitality throughout the system. Proponents also claim that consistent use can keep you free of all sinus problems that arise from nasal obstructions. How do you use a neti pot? Here's the word from a spokesman for the Himalayan International Institute. Fill the pot with warm water and a pinch of salt. use just enough salt to approximate the salt-to-water ratio you find in your own tears. If the solution stings, you're using too much salt. Tip your head sideways over a sink, put the spout in one nostril, and keep pouring until you've used all the fluid in the pot. The fluid should run out the other nostril. Refill the pot, tilt your head to the other side, and irrigate the other nostril. It may require some practice to do this just right. When you're finished, blow your nose freely through both nostrils. You can repeat the process a second time each day if you want. "It really is fun and easy," says the spokesman. "I use it twice a day now, which I've done for over a decade. This takes care of the mucus blockages in the most important portal in your body—the place where you get your air. When that's clogged with mucus, it affects your system dramatically." |
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Don't overuse decongestants. "If nose drops are being used to control postnasal drainage, they're being used inappropriately," says Dr. Principato. They're best used when you have a documented sinus infection, he says. And he echoes other experts when he warns that you should never use nose drops or sprays for more than a few days in a row.
Consider your stomach. What you think is excessive postnasal drip could actually be esophageal reflux, more commonly known as heartburn. "This gives the symptoms of a postnasal drip," says Mark Baldree, M.D., an otolaryngologist in private practice in Phoenix, Arizona, and staff member in the Division of Otolaryngology at St. Joseph's Hospital in Phoenix. "Some of the new antihypertensive medications can cause people to have symptoms of postnasal drip when they actually have heartburn.
Consider your estrogen level. The hormone estrogen affects the mucous lining of the nasal cavity. Some oral contraceptives are high in estrogen. Increasing the amount of estrogen circulating in the body can cause the nasal lining to get more puffy and produce excess mucus.
If you have a postnasal drip problem and take the Pill, discuss this with your gynecologist. He may be able to give you a low-dose prescription.
Skip the antihistamines. "They usually aren't that helpful," says Dr. Baldree. "They don't work that well, and they do make you drowsy. A plain decongestant is better."
PANEL OF ADVISERS
Mark Baldree, M.D., is an otolaryngologist in private practice in Phoenix, Arizona. He is a staff member in the Division of Otolaryngology, Department of Surgery, at St. Joseph's Hospital in Phoenix.
John A. Henderson, M.D., is an otolaryngologist and allergist in private practice in San Diego, California. He is also assistant clinical professor of surgery at the University of California, San Diego, School of Medicine.
Alvin Katz, M.D., is an otolaryngologist in private practice in New York City and surgeon director of the Manhattan Eye, Ear, Nose, and Throat Hospital there. He is past president of the American Rhinologic Society.
Gilbert Levitt, M.D., is an otolaryngologist in practice with Group Health Cooperative in Puget Sound, Washington. He is also clinical instructor of otolaryngology at the University of Washington School of Medicine in Seattle.
Jerold Principato, M.D., is an otolaryngologist in private practice in Bethesda, Maryland. He is an associate clinical professor of otolaryngology in the Department of Surgery at George Washington University School of Medicine in Washington, D.C. He is also an instructor at the American Academy of Otolaryngology.
