Q: I have hadp interrupts sleep a constant drip down my throat for approximately two years. Never had this problem before. I have been to two ENT specialists who did X-rays and scans. I had the problem when I went to them and still had it when they finished. Both stated they could find no problem but the problem persists. My throat gets blocked during sleep and I wake up coughing, trying to swallow.
The medications I take have not changed for almost six years. I take Nexium for acid reflux, Avalide and Calan for blood pressure control. Nothing else.
A: The average individual produces an astonishing two quarts of mucus daily that helps keep the respiratory tract moist and clean. When the body produces more than that amount for prolonged periods, mucus builds up at the back of the throat. Over time it can become thick, possibly infected and a condition known as post nasal drip develops. This leads to an individual constantly clearing his or her throat, halitosis (bad breath), a constant cough, sore throat, and more. The body responds by producing more mucus – just what we don’t need – that further aggravates the problem.
Conditions associated with an increase in drainage can include allergies, cold temperatures, specific foods, having a deviated septum, viruses, hormonal changes and being on specific medications, including those taken for high blood pressure. The simple act of swallowing is insufficient to clear normal secretions. It can be further compromised by stress, gastroesophageal reflux disease (GERD), nerve and muscle disorders such as stroke, and advancing age.
Treatment is commonly directed toward the underlying cause. For example, bacterial post nasal drip may be treated with antibiotics. Over-the-counter or prescription antihistamines and decongestants may help short-term and may be coupled with steroid medication. If specific allergens are to blame, avoidance of the offenders such as pollen, house dust, animal dander and mold will help. With allergies, steroid medications such as Nasonex, Rhinocort, Beconase, Flovent, Veramyst, and others may be prescribed in an effort to reduce symptoms; when over-the-counters fail to react sufficiently, oral steroids traditionally work well. They are best used for short periods of time only and should only be taken under the guidance of a physician.
Allergy remedies are specifically divided into two groups – sedating (Benadryl, Tavist, Chlor-Trimeton) and non-sedating (Claritin, Allegra and Zyrtec) to name a few. All are displayed prominently in pharmacies and department stores and on television so we’re familiar with them; however, we may not consider the sedating affect or potential drug interactions with other medications we may be on. Cigarette smoke and perfumes should be avoided whenever possible. Pollen is seasonal and countless over-the-counter or prescription products are available to lessen symptoms. House dust and animal dander may require meticulous cleaning, particularly in areas at home or work where you spend most of your time while indoors. Consider rugs, draperies and wall hangings that might require specific attention. Mold may be a little more difficult to eradicate but perhaps a dehumidifier can provide relief.
You have not had a change in your blood pressure medication for quite some time. To be considered beyond that, however, is that your body may be going through some hormonal changes that exacerbate your post nasal drip. And, you have reflux that can compromise your swallowing. You might try sleeping on your side rather than your back. From my perspective, you’re at bat in the bottom of the ninth with two strikes against you. Before you end up back on the bench, I recommend you visit your physician first to determine if your medication is to blame. Perhaps other drugs will keep you in check and eliminate the post nasal drip. If not, visit an allergy specialist who can test you and get to the bottom of the issue. Find out what’s causing this annoyance and get back in the game.
Readers who would like related information can order Dr. Gott’s Health Report “Allergies” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
