How is postnasal drip syndrome diagnosed

What is Postnasal Drip Syndrome

At a postnasal drip syndrome (PNDS) drips fluid from the nasopharynx down into the throat ("postnasal" lat. = coming towards the nose, "drip" English = to drip). This is, so to speak, a runny noseexcept that the secretion does not come out of the nose in the front, but in the back towards the throat. Postnasal drip syndrome is often caused by a stuffy nose and is associated with a runny nose. The PNDS is no independent clinical picture, but a syndrome that can occur in the context of a wide variety of diseases.


Treatment for postnasal drip syndrome depends on the triggering factor. If you have a cold, a decongestant nasal spray can relieve the blocked nose and ensure that the mucus can drain out of the front of the nose. Most common colds are caused by viruses, which is why a antibiotic treatment makes no sense makes. However, a harmless cold often heals on its own within a few days and does not require any explicit treatment. Green nasal secretions can indicate a bacterial infection that may need antibiotic treatment. The doctor can counteract the formation of mucus and dry coughs expectorants prescribe. If an allergy is the cause of the PNDS, antiallergic drugs such as antihistamines or help Glucocorticoids.

Depending on the cause of the disease, surgery may also be necessary to remove constrictions and the resulting nasal congestion. The surgeon will try to be as minimally invasive as possible so as not to leave any scars on the face. During the operation, the paranasal sinuses are opened in an attempt to restore the normal function of the mucous glands. After the operation, patients have to use cortisone-containing nasal sprays for several weeks and regularly rinse the nasal mucosa with sea salt water.

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Home remedies

A number of different home remedies have proven themselves in the treatment of postnasal drip syndrome and can be used to loosen mucus. An efficient method of treating nasal congestion is one Nasal douche or that Gargle with a salt water solution. You can easily prepare the salt water solution yourself by dissolving a teaspoon of salt (preferably sea salt) in 250 ml of warm water.

Another expectorant option is that Inhale with essential oils or herbs (e.g. peppermint, chamomile or lavender) over hot steam.

During the illness, patients should take care: enough liquid to be consumed in the form of warm teas and water. On the other hand, milk should be avoided as it leads to increased mucus production. By drinking the mucous membranes are moistened and the viscous mucus can more easily loosen. In addition, moist air has a similar effect on the mucous membranes. This can be achieved by ventilating the rooms regularly or with the help of an air humidifier.


Homeopathy can be used for postnasal drip syndrome. Which globules or drops are most suitable depends on the cause of the disease and the exact symptoms. Your pharmacist or a homeopath can help find a suitable homeopathic remedy.

Duration of a PNDS

The duration of a postnasal drip syndrome depends not only on the cause of the disease and its course, but also on the therapy used. If the cause of the disease is not treated correctly, a chronic cough or bronchitis and, in the worst case, bronchial asthma can develop. If the symptoms are caused by a cyst or tumor in the sinus area, the PNDS will persist until it is surgically removed.


The cause of postnasal drip syndrome is that the Mucous glands in the nasal mucosa and sinuses of the head produce too much secretion. Normally, the slimy secretion protects the mucous membrane from the penetration of pathogenic viruses and bacteria. The trigger for the excessive mucus production is usually one Inflammation of the lining of the nose (Rhinitis), the paranasal sinuses (Sinusitis) or a combination of these two forms (Rhinosinusitis).

The postnasal drip syndrome can accordingly be a part of a cold, one flu or one Sinus infection occur. But allergies or anatomical misalignments of the nose can also lead to PNDS. Furthermore, some medications and foods or external stimuli such as chemicals or exhaust fumes (including cigarette smoke) can trigger postnasal drip syndrome. Post-nasal drip syndrome can also temporarily occur during pregnancy due to hormonal changes.

As the mucus leaks into the throat, the secretion drains into the lower respiratory tract, where it can lead to infections of the lungs (e.g. bronchitis) and the throat. This phenomenon is known as "floor change" and is typical of PNDS: although the origin of the disease lies in the upper respiratory tract, it leads to an infection of the lower respiratory tract as it progresses.

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These symptoms tell me that I have the disease

The most characteristic symptom of postnasal drip syndrome is the constant flow of mucus from the nose to the throat. Those affected notice that they have to swallow or spit out mucus. Clearing the throat and dry coughing tries to move the mucus from the lower airways back up, which is why a chronic cough is often an accompanying symptom of PNDS. In this case, the cough is a protective mechanism of the body that tries to prevent the slimy secretion from entering the lungs by coughing up. Furthermore, the PNDS causes a Itching in the throat, especially when lying down at night, and can lead to hoarseness and a hoarse voice. Typically, the nose is also blocked and nasal breathing is hindered or even short of breath.

Other symptoms depend on the cause of the postnasal drip syndrome. However, since most of the time there is an allergic or non-allergic inflammation of the nasal mucous membranes, the result is a runny nose, headache, toothache and a restricted ability to smell. The swallowed mucus can also lead to inflammation of the lower airways (acute bronchitis).

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How is PNDS diagnosed?

The doctor (preferably an ENT specialist) makes the diagnosis of postnasal drip syndrome in addition to the patient's medical history by means of a nasal endoscopy (Nasoscopy). He inserts an endoscope with a light source into the nose, examines the mucous membranes and looks for the causes of the nasal congestion. The patient's throat is then inspected to see if there is an excessive flow of mucus.

These examinations are usually sufficient to diagnose PNDS and determine the underlying disease. In rare cases, when the cause of the PNDS cannot be found, the doctor may order a CT or MRI of the head. With these imaging procedures the pharynx and sinuses can be better assessed and possible causes diagnosed. If an allergic event is suspected, the doctor initiates an allergy diagnosis (skin test, laboratory test or provocation test).

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Quality assurance by: Dr. Nicolas Gumpert | Last change: 03.04.2021