Do you feel a constant fullness in your throat, a frequent need to clear your throat, or increased coughing in the mornings? The cause of these complaints may not only be postnasal drip from the nose. Often, this condition is accompanied by reflux (stomach acid reaching the throat).
When postnasal drip and reflux occur together, they can trigger each other, leading to long-lasting throat discomfort, hoarseness, and chronic pharyngitis.
What is Postnasal Drip?
Postnasal drip is the flow of mucus produced in the back of the nose toward the throat.
Normally, the nasal mucosa produces a small amount of clear secretion. This secretion keeps the inside of the nose moist and protects the respiratory tract. However, in conditions such as allergies, infections, sinusitis, or reflux, the amount of mucus increases, its consistency thickens, and it creates a feeling of discomfort in the throat.
How Does Reflux Trigger Postnasal Drip?
Reflux is the backflow of stomach acid into the esophagus and throat area. The acidic content irritates the throat mucosa, increasing mucus production. This intensifies the sensation of postnasal drip, and the person constantly feels the need to clear their throat. Especially if there are symptoms such as increased coughing at night, morning throat dryness, hoarseness, and burning in the throat, laryngopharyngeal reflux (LPR) should be considered.
The Vicious Cycle Between Postnasal Drip and Reflux
Reflux irritates the throat mucosa, mucus increases and postnasal drip occurs. Postnasal drip creates irritation in the throat, reflex coughing and reflux symptoms increase. When this cycle is not broken, edema in the vocal cords, chronic pharyngitis, and permanent hoarseness can develop.
How is the Diagnosis Made?
The diagnosis is made through a detailed ENT examination and endoscopic examination:
With nasal endoscopy, the back of the nose, pharyngeal mucosa, presence of sinusitis or polyps are evaluated. With laryngoscopy, the vocal cords and back of the throat are examined for irritation due to reflux. In necessary cases, pH monitoring and gastroscopy can be performed.
Treatment
Lifestyle Changes for Reflux
- Not lying down for at least 2–3 hours after dinner
- Avoiding acidic, fatty, spicy foods
- Avoiding tea, coffee, cigarettes, and alcohol
- Elevating the head end by 15–20 cm while sleeping
Nose and Throat Care
- Nasal irrigation with isotonic saline 1–2 times a day
- Drinking plenty of water, increasing room humidity
- Using appropriate nasal spray or antihistamine as recommended by a doctor
The chronic habit of throat clearing can become a reflex that develops due to postnasal drip or reflux. If complaints persist for a long time, it is necessary to clarify the cause with an endoscopic examination and, if necessary, plan treatment for both nasal and gastric sources together.
Prof. Dr. Elif Aksoy, Ear Nose and Throat Diseases Specialist
