Nasal Congestion: Description, signs, and remedies
Postnasal drip, often referred to as catarrh, is a common condition characterised by the buildup of mucus in the back of the nose, throat, or sinuses. This article explores the potential causes and various treatment options available for chronic postnasal drip.
Causes of postnasal drip can be diverse, ranging from changes in weather and eating spicy food to more complex conditions such as hay fever or allergic rhinitis, nonallergic rhinitis, viruses, sinus infection, nasal polyps, gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD), hormone changes during pregnancy, certain medications, and having something stuck in the nose in children.
For those suffering from chronic postnasal drip, long-term treatment options are available. These interventions can be divided into medical and procedural approaches.
Nasal steroid sprays, such as Beconase and Nasacort, are commonly used to reduce inflammation in the nasal passages. They help decrease mucus production and improve symptoms of chronic postnasal drip. Oral corticosteroids may also be prescribed for short courses to reduce severe inflammation, especially when nasal steroids alone are inadequate.
Antihistamines and decongestants, like Claritin and Zyrtec, help control allergic triggers of postnasal drip by reducing mucus production and nasal congestion. Regular saline nasal rinses are another effective measure for clearing mucus and allergens, improving airflow, and reducing symptoms.
For severe cases, especially those involving nasal polyps or chronic rhinosinusitis with nasal polyps (CRwNP), injectable biologics like dupilumab (Dupixent), mepolizumab (Nucala), or omalizumab (Xolair) can be used to lower inflammation effectively and reduce symptom burden.
Minimally invasive procedures, such as surgery, drug-eluting stents, and ClariFix® treatment, may be recommended for anatomical problems or refractory cases. Surgery, such as polypectomy or endoscopic sinus surgery, can remove nasal polyps or correct structural issues causing persistent drainage and congestion. Drug-eluting stents can release steroids locally and reduce inflammation long term, while ClariFix® is a newer, minimally invasive office procedure that targets chronic rhinitis and postnasal drip symptoms.
Immunotherapy, in the form of allergy shots or drops, may be used in cases where allergies significantly contribute to postnasal drip, aiming to desensitize the immune system to allergens over time.
In summary, managing chronic postnasal drip or catarrh involves a combination of anti-inflammatory medications, allergy treatments, nasal hygiene measures, biologics for severe inflammation, and possibly surgery or minimally invasive interventions for anatomical problems or refractory cases. Treatment plans are often tailored based on underlying causes and severity, and collaboration with an ENT specialist is recommended for persistent or complicated cases.
Over-the-counter treatments for catarrh include nasal irrigation, oral decongestants, mucus-thinning medications, antihistamines, pain relievers, home treatments like drinking plenty of water, using an indoor humidifier, inhaling steam, gargling with warm salt water, using a saltwater solution to clean the inside of the nostrils, and sleeping on propped-up pillows.
If catarrh is accompanied by an unexplained high fever, wheezing, shortness of breath, blood in the mucus, or foul-smelling mucus, it may indicate an infection or condition requiring prompt medical treatment. Chronic catarrh that persists for several months or more, or catarrh that interferes with everyday life, should be evaluated by a doctor.
During a consultation, a doctor may use a small hand-held torch to look inside a person's nose or throat. Other symptoms may include coughing, difficulty swallowing, sore throat, blocked or stuffy nose, headache, facial pain, loss of taste or smell, difficulty sleeping, and fever.
It's important to note that while this article provides an overview of common treatments for chronic postnasal drip, individual treatment plans should be discussed with a healthcare professional.
[1] American Academy of Otolaryngology—Head and Neck Surgery. (2020). Chronic sinusitis. Retrieved from https://www.entnet.org/content/chronic-sinusitis [2] American Rhinologic Society. (2019). Chronic rhinosinusitis. Retrieved from https://www.enthealth.org/conditions/chronic-rhinosinusitis [3] National Health Service. (2021). Postnasal drip. Retrieved from https://www.nhs.uk/conditions/post-nasal-drip/ [4] Mayo Clinic. (2021). Postnasal drip. Retrieved from https://www.mayoclinic.org/diseases-conditions/postnasal-drip/symptoms-causes/syc-20377243 [5] ClariFix®. (n.d.). ClariFix® for chronic rhinitis. Retrieved from https://www.clarifix.com/indications-and-use/chronic-rhinitis/
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