From the Guidelines
Yes, post-nasal drip can cause chronic sore throat. Post-nasal drip occurs when excess mucus from the sinuses drips down the back of the throat, irritating the tissues and causing inflammation, as described in the diagnosis of postnasal drip syndrome (PNDS) 1. This constant irritation can lead to a persistent sore throat that may be worse in the morning or after lying down.
Key Points to Consider
- The diagnosis of PNDS-induced cough is best determined by considering a combination of criteria, including symptoms, physical examination, radiographic findings, and, ultimately, the response to specific therapy 1.
- To manage this condition, consider the following:
- Saline nasal rinses once or twice daily to flush out mucus and irritants
- Over-the-counter antihistamines like loratadine (10mg daily) or cetirizine (10mg daily) if allergies are contributing to the mucus production
- Nasal steroid sprays such as fluticasone (1-2 sprays per nostril daily) to reduce inflammation and mucus production
- Stay well-hydrated with 6-8 glasses of water daily to thin mucus secretions
- Using a humidifier at night can moisten dry air that may worsen throat irritation
- Elevating the head of your bed by 4-6 inches can prevent mucus from pooling in the throat while sleeping
Next Steps
If symptoms persist beyond 2-3 weeks despite these measures, consult a healthcare provider as you may need prescription medications or further evaluation to rule out other causes of chronic sore throat, as the improvement or resolution of cough in response to specific treatment is the pivotal factor in confirming the diagnosis of PNDS as a cause of cough 1.
From the Research
Postnasal Drip and Chronic Sore Throat
- Postnasal drip is a common complaint in primary care and ear-nose-throat offices, and is often associated with chronic cough and sore throat 2.
- Allergic rhinitis, which can cause postnasal drip, is associated with symptoms of nasal congestion, sneezing, and itching of the eyes, nose, and throat, and can contribute to chronic sore throat 3.
- Studies have shown that postnasal drip may be related to an airway sensory hypersensitivity rather than actual irritation from inflamed nasal secretions, which can lead to chronic sore throat 2.
- Treatment of postnasal drip and chronic cough with temperature-controlled radiofrequency neurolysis has been shown to significantly improve symptoms of postnasal drip and chronic cough, which can contribute to chronic sore throat 4.
Symptoms and Treatment
- Symptoms of postnasal drip include nasal congestion, rhinorrhea, and sore throat, and can be treated with second-generation H1 antihistamines, intranasal antihistamines, and intranasal corticosteroids 3, 5.
- Treatment of allergic rhinitis, which can cause postnasal drip, should be selected based on the severity and frequency of symptoms and patient preference 3.
- Postnasal drip and chronic cough contribute to the symptomatology of chronic rhinitis and are significantly improved after treatment with temperature-controlled radiofrequency neurolysis of the posterior nasal nerve 4.
Correlation with Other Symptoms
- Postnasal drip and chronic cough have been shown to have a weak to moderate correlation with other symptoms of chronic rhinitis, such as rhinorrhea, congestion, itching, and sneezing 4.
- The inclusion of postnasal drip and chronic cough symptoms in a chronic rhinitis assessment instrument could provide important additional information for the characterization of the disease state and outcomes after therapeutic treatment 4.