February 11, 2026 | Black & Kletz Allergy
A common complaint among patients is the need to clear their throats frequently in an attempt to get relief from a feeling of “irritation” in their throats. This feeling is often termed “post-nasal drip,” implying excessive secretions from the upper respiratory tract draining down the back of the throat.
All because the feeling of a post-nasal drip is present, there are many other conditions or processes that may result in the sensation of throat irritation. Post-nasal drip is primarily a subjective complaint with no definitive objective diagnostic criteria.
It should be pointed out that a chronic cough is one of the most bothersome symptoms triggered by a post-nasal drip, however, hoarseness, bad breath, and sore throat are other common manifestations of a post-nasal drip.
There are many conditions that predispose an individual to a post-nasal drip and some of them are listed below:
- Allergic rhinitis (Hay fever): The inflamed nasal mucus membranes secrete excessive mucus in patients with allergies.
- Non-allergic rhinitis: Some examples of this condition include gustatory rhinitis (i.e., related to eating where eating any food may trigger a runny nose or post-nasal drip), neurologic rhinitis, and rhinitis caused by other irritants such as smoke, strong scents (e.g., perfumes, cleaning solutions), changes in barometric pressure, changes in temperatures).
- Nasal polyps: The increased surface area of the mucus membranes from excessive tissue growth of the nasal polyp results in oversecretion of mucus.
- Ciliary dyskinesia: Dysfunction or reduced activity of the ciliary (hair-like) structures which promote normal drainage of secretions.
- Cystic fibrosis: A genetically determined condition which causes abundant thick mucus production.
- Heightened body awareness or hypersensitivity
- Upper respiratory tract infections: May cause ciliary damage and thus prolonged symptoms.
- Chronic rhinosinusitis: Typically caused by viral, bacterial, or fungal infections.
- Laryngopharyngeal reflux (LPR): Gastroesophageal reflux disease (GERD)-related disorder usually resulting in a sore throat and/or hoarseness.
Diagnosis:
- Comprehensive history and physical examination
- Allergy skin testing or allergy blood testing
- Rhinoscopy: A direct visualization procedure of the tissues in the nose and the back of the throat that can be done in the office. It is when the physician puts a thin long tube up one’s nose in order to look in the nose, throat, and vocal cords. Rhinoscopy identifies posterior nasal secretions but has a limited sensitivity and specificity. Patient-reported frequency and severity of symptoms do not always correlate with the abnormalities detected by rhinoscopy.
- Fluorescent particle tracking: May show slower mucociliary clearance and more viscous mucus.
Measurement of Symptom Severity:
- The Sinonasal Outcome Test (SNOT) is used to measure symptom severity. It is a subjective 0-5 scale where patients report bothersome symptoms, including postnasal drip.
- Associated symptoms may include nasal congestion, poor sense of smell and taste, facial pressure, and/or difficulty in sleeping
Treatment:
Effective treatments vary by the underlying condition:
- Chronic rhinosinusitis: Functional endoscopic sinus surgery, posterior nasal nerve ablation, etc.
- Allergic rhinitis: Antihistamine (e.g., azelastine, olopatadine), corticosteroid (e.g., fluticasone, mometasone, budesonide), and anticholinergic (e.g., ipratropium bromide) nasal sprays, oral antihistamines (e.g., loratadine, desloratadine, fexofenadine, cetirizine, levocetirizine), and/or allergen immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization, allergy hyposensitization) to environmental allergens. Allergy shots are effective in 80-85% of patients. The average length allergy immunotherapy treatment is typically 3-5 years.
- A humidifier or steam inhalation (as occurs in a hot shower)
- Keeping well-hydrated: Keeps the mucus thinner.
- Sleep on propped up pillows, to keep the mucus from collecting at the back of the throat
- Nasal irrigation: Available over-the-counter saline preparations
- Oral decongestant: Such as pseudoephedrine (e.g., Sudafed)
- Mucolytic agents: Medications that thin out mucus such as Guaifenesin (e.g., Mucinex)
- Gastroesophageal reflux disease (GERD): Lifestyle modifications may help to reduce acid secretion. Proton pump inhibitors (e.g., pantoprazole, omeprazole, esomeprazole, lansoprazole, rabeprazole, dexlansoprazole) may help alleviate symptoms.
- Biologics: Medications such as omalizumab (i.e., Xolair) and dupilumab (i.e., Dupixent) show moderate efficacy.
The board certified allergy doctors at Black & Kletz Allergy have expertise in diagnosing and treating post-nasal drip as well as any other symptom of allergies. We diagnose and treat both children and adults. In addition, we also see patients with a variety of other allergic/immunologic conditions such as asthma, sinus problems, generalized itching (i.e., pruritus), hives (i.e. urticaria), swelling episodes (i.e., angioedema), eczema (i.e., atopic dermatitis), poison ivy, poison oak, poison sumac, contact dermatitis, insect sting allergies, food allergies, medication allergies, eosinophilic esophagitis, hypogammaglobulinemia, and other immune disorders. Black & Kletz Allergy has 3 convenient locations in the Washington, DC metropolitan area. Our office locations are in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. Each office has on-site parking and the Washington, DC and McLean offices are Metro accessible. There is a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line. To make an appointment, please call our office location that is most convenient for you or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. The allergy specialists at Black & Kletz Allergy strive to provide our patients with the highest quality allergy and asthma care in the Washington, DC and Northern Virginia metropolitan area.
