How to get rid of constant postnasal drip?

Question

Hello doctor,

I am 34 years old and have been experiencing postnasal drip for the past month. I took Azithromycin, Levocetirizine, and Montelukast tablets and used steam inhalation, but the drip seems to have worsened and the mucus has thickened. I consulted an ENT, who prescribed Fluticasone Propionate and Azelastine spray, Ambroxol and Loratadine combination tablets, and Esomeprazole, but there has been no improvement in seven days. The doctor then prescribed Acetylcysteine 600 mg. The mucus is expelled through coughing, and I constantly need to clear my throat. I noticed white mucus dripping at the back of my throat.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand that you are experiencing constant post-nasal drip. Are there any other symptoms bothering you, such as a lump sensation in the throat, nasal blockage, runny nasal discharge, or facial fullness? Have you had this problem before this month?

The treatment prescribed by your ENT seems appropriate for the symptoms you have described. However, are you using the spray correctly? The combination of antihistamines, mucolytics, and nasal spray should help reduce post-nasal drip unless there is an underlying issue in the sinuses causing excessive mucus.

Please provide more details about your symptoms. Continue taking the same medications for now. Take a picture of the back of your throat with your mouth open to show the mucus drip and send it to us. Confirm whether you are using the spray correctly. If you are following the instructions properly and this is your only symptom, we may need to perform a nasal endoscopy and a CT (computed tomography) scan of the sinuses. Do you have any allergies? Do you smoke? Is your workplace exposed to dust, smoke, or pollution?

Looking forward to your response in order to help you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

The sensation of something stuck in your throat, along with your symptoms and the treatment you have tried, explains the situation well. Recurrent postnasal drip can cause reflux and a sensation of a lump in the throat, which can be aggravated by stomach acidity. Additionally, you should not have stopped Alaspan AM (Loratadine and Ambroxol) and the nasal spray. The spray should be used for at least four to six weeks, unlike Otrivin (Xylometazoline) nasal drops, which can be used as needed. Please follow these guidelines:

Take Alaspan AM (Ambroxol and Loratadine), one tablet in the evening daily for 15 days.
Take Raciper Plus (Esomeprazole and Levosulpiride), one tablet, before breakfast for 15 days.
Use Nazomac-AF (Azelastine and Fluticasone) nasal spray, two puffs in each nostril twice daily after meals for 15 days.

Directions for using the spray: Inhale deeply and hold your breath. Then, spray two puffs in each nostril. Hold your breath for 10 to 15 seconds before exhaling. This ensures that the medication stays in the nose. If you spray and then inhale, the medication will go into your throat, where it is less effective.

Avoid oily and spicy foods, do not lie down immediately after a meal, and drink plenty of water. Also, avoid exposure to smoke and dust. Please let me know if you need further support. Contact me before stopping the medications, as you may need milder medications for another week. Do not stop the medications abruptly.

If necessary during this course, I will advise if a nasal endoscopy or CT (computed tomography) scan is needed.

I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.

Thank you.