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Respiratory Disorders (Expert Forum)
Post-Nasal cough?
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis
Post-Nasal cough?
by melbrn, Aug 10, 2004 12:00AM
I have had bad post-nasal drip most of my life and a cough to go along with it. I notice now that the cough almost sounds like a smoker's cough sometimes, goes along with a tightness in the chest. Other times I am fine, although the drip goes on!
I have been using a steroid nasal spray, but it doesn't seem to help that much. What's out there to dry up that drip outside of just becoming an antihistamine junkie??
I have been using a steroid nasal spray, but it doesn't seem to help that much. What's out there to dry up that drip outside of just becoming an antihistamine junkie??
Doctor's Answer
by National Jewish, Aug 12, 2004 12:00AM
, Aug 12, 2004 12:00AM
From what you have described, you may or may not have asthma. This is usually diagnosed with a pulmonary function test with a reversibility challenge. It is possible that all of the coughing comes from the upper airways. If you have difficulty with antihistamines, it is possible to try inhaled nasal steroids on a regular basis to control the inflammation or even a trial with a leukotriene antagonist. You might also consider working with a Board Certified Allergist to identify the causes of the problem.
Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat. There could be several reasons for this drainage. One reason is an allergy. A second reason is a non-allergic, non-infectious inflammation in the sinuses that can linger after a cold. A third reason is chronic sinusitis. Postnasal drip can cause breathing difficulty as a result of irritation of the throat and lungs. You may experience the postnasal drip as a constant feeling of mucus at the back of your throat. Typically this is worse at night when you lay down to sleep. Generally this irritation feels the worst when you wake up and gets better as the day goes on. The mucus may "sit" there, especially when it is thick, and become dark in color and really smell bad. It may not move with coughing or snorting. The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily. Clearing your throat can irritate your throat and make it sore. When you feel the need to clear your throat, sip some water to clear the mucus. An antihistamine, like the Clarinex® (loratadine), can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier. A combination antihistamine-decongestant will do both. Check with your doctor to see if Claritin-D® (loratadine/pseudoephedrine), a combination antihistamine-decongestant, would help you more. Often an antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis. Singulair® (montelukast sodium) helps when the irritation is due to allergies. A nasal wash helps remove mucus and germs from your nose and sinuses. This can temporarily decrease the postnasal drip and lessen breathing difficulty. It is most helpful when done daily before using any nasal spray. A prescription antihistamine nasal spray, like Astelin® (azelastine), helps when the postnasal drip is due to allergies. When the postnasal drip is thin and watery Atrovent® Nasal Spray (ipratropium bromide) may help to dry this up. A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses. This may prevent the postnasal drip and breathing difficulty. A nasal steroid spray does not provide immediate relief of symptoms. It may require several weeks of routine use to become effective. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the Atrovent® Nasal Spray (ipratropium bromide), and the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you. It is possible for a nasal steroid spray, like Beconase® (beclomethasone dipropionate), to create a hole in the septum of your nose. To prevent this possible side effect direct the spray away from the center of your nose. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat. There could be several reasons for this drainage. One reason is an allergy. A second reason is a non-allergic, non-infectious inflammation in the sinuses that can linger after a cold. A third reason is chronic sinusitis. Postnasal drip can cause breathing difficulty as a result of irritation of the throat and lungs. You may experience the postnasal drip as a constant feeling of mucus at the back of your throat. Typically this is worse at night when you lay down to sleep. Generally this irritation feels the worst when you wake up and gets better as the day goes on. The mucus may "sit" there, especially when it is thick, and become dark in color and really smell bad. It may not move with coughing or snorting. The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily. Clearing your throat can irritate your throat and make it sore. When you feel the need to clear your throat, sip some water to clear the mucus. An antihistamine, like the Clarinex® (loratadine), can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier. A combination antihistamine-decongestant will do both. Check with your doctor to see if Claritin-D® (loratadine/pseudoephedrine), a combination antihistamine-decongestant, would help you more. Often an antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis. Singulair® (montelukast sodium) helps when the irritation is due to allergies. A nasal wash helps remove mucus and germs from your nose and sinuses. This can temporarily decrease the postnasal drip and lessen breathing difficulty. It is most helpful when done daily before using any nasal spray. A prescription antihistamine nasal spray, like Astelin® (azelastine), helps when the postnasal drip is due to allergies. When the postnasal drip is thin and watery Atrovent® Nasal Spray (ipratropium bromide) may help to dry this up. A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses. This may prevent the postnasal drip and breathing difficulty. A nasal steroid spray does not provide immediate relief of symptoms. It may require several weeks of routine use to become effective. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the Atrovent® Nasal Spray (ipratropium bromide), and the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you. It is possible for a nasal steroid spray, like Beconase® (beclomethasone dipropionate), to create a hole in the septum of your nose. To prevent this possible side effect direct the spray away from the center of your nose. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique. Share this information with your doctor to see if you would benefit from this daily treatment.
See:
http://www.nationaljewish.org/medfacts/allergic_rhinitis.html
Allergic and Non-Allergic Rhinitis
Excerpt:
"What medications are used to treat rhinitis?
The goal of medical treatment is to reduce symptoms and use medications with few or no side effects.
Inhaled steroids
are often used to decrease symptoms by decreasing swelling in the nose. Commonly available preparations include:
Beconase AQ®, Vancenase DS AQ®, (beclomethasone)
Nasacort® (triamcinolone)
Nasarel® (flunisolide)
Flonase® (fluticasone)
Rhinocort® (budesonide)
Nasonex® (mometasone)
Nasalcrom®
(cromolyn sodium) This nonprescription nasal spray reduces milder symptoms of nasal discharge and sneezing. This is also a preventive medication and does not relieve symptoms immediately.
Astelin®
(azelastine) This prescription medication may benefit those with allergic and non-allergic (vasomotor) rhinitis.
Atrovent®
(ipatroprium bromide) This prescription medication occasionally benefits those with non-allergic rhinitis.
Nasal Wash
A salt water nasal wash is helpful in removing mucus from the nose. The salt water nasal wash is often done before using nasal medications. It temporarily reduces symptoms of nasal congestion and postnasal drainage.
Oral Corticosteroids
These prescription tablet/syrup preparations are very effective in treating and preventing symptoms of rhinitis. However, the side effects of oral steroids, especially with long-term use, limit their use. Your doctor may prescribe a short course (three to seven days) for more severe symptoms. It is important to note that the corticosteroids used in respiratory treatment are not the same as the anabolic steroids used by athletes."
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