POST NASAL DRIP OVERVIEW
What Causes Post Nasal Drip ?
Your body continually makes mucous throughout the day. It is specifically made by the glands and cells lining the sinus passages. Its function is to trap tiny particles such as dust etc and stop them filtering into our breathing system. That is why it is sticky and thick. Although mucous normally is swallowed, occasionally it causes a sensation of dripping from the back of the nose. This sensation is called Post nasal drip (PND). This feeling can be caused by thickened mucous secretions or even excessive mucous, or even by throat or muscle disorders.

The secret to clearing post nasal drip up in a healthy way is to thin the nasal secretions to allow them to drain more readily, whilst actively looking at the cause of the excess secretions. When you produce to much mucous you will also cause swelling of the sinus lining, as well as bleeding, polyps and irritation. Excess mucous production or Post Nasal Drip (PND) will directly affect your breath as it is high in proteins and is an excellent food source for anaerobic bacteria. Excess mucous, once settled on your nasal and throat lining, can irritate, causing a sore throat, and the belief that you may be coming down with a cold.
Post nasal drip will cause bad breath
When we see patients at our Australian Breath Clinic with bad breath, the most common link in all chronic cases is that of Post Nasal Drip (PND) and excess mucus. This has led us to many discussions with ENT surgeons and the development of Fess Isotonic Nasal Sprays . These sprays includes a natural nasal irrigation and natural decongestant which will cleanse and thin the excess mucus from the nasal and sinus passages.

The sinus cavities are air filled spaces in the bones of the face and skull. When a virus or allergy penetrates the nose, we produce extra mucus to try and clear the irritant or infection away, but the tiny cilia hairs often become damaged as they attempt to move this mucus away, thereby impairing Mucocilliary flow. This means that extra mucus cannot be cleared and clogs up in the nose and nasal cavities. The narrow nasal passages of the nose become blocked with tissue swelling and thick mucus, resulting in congestion and even sinus pain and infection.

• Increase fluid intake to 6 to 8 glasses of water daily.
• Stop intake of caffeine.
• Avoid diuretics (under medical advice).
• Avoid stress.
• Use an isotonic buffered saline nasal wash.
• Use an isotonic buffered nasal decongestant with antibacterial properties.
• Use a Rinoflow machine to deliver the saline wash to the sinus cavities.

POST NASAL DRIP CAUSES
Post Nasal Drip Explanation
Post Nasal Drip is best understood as a flow of mucus from the nasal and sinus areas. This mucus then travels down the oro pharynx, where it can collect at the back of the throat and tongue. Most often it is caused or exacerbated by some form of chronic irritation or sickness or allergy. The situation can be made worse by dry mouth, mouth breathing, or medications.

Mucus is made by cells of the nasal lining and sinus lining. Sinuses are air filled spaces situated in our skull. The main sinuses are :

Frontal sinus in the forehead
Ethmoid sinus between our eyes
Maxillary sinus in our cheek bones
Sphenoid sinus at the back of the nose

The purpose of the mucus is to trap introduced particles and irritants and pass them harmlessly from the body. Unfortunately, this process can sometimes go haywire and we can produce too much mucus. This causes an overflow or "post nasal drip". Listed below are the post nasal drip triggers.

Post Nasal Drip Triggers ?

• Inhaled Irritants; This is the most common cause of post nasal drip. As explained previously the function of mucous is to trap dust and  other irritant particles in the mucous created in the upper sinuses and therefore stop them spreading into our main breathing area. When there is a lot of dust or if the body is sensitive to these particles, this can cause an allergic reaction or rhinitis. This is a swelling of the nasal and sinus linings, and is extremely common especially in today's world of smog and dust.
• Dairy Products; Such foods as dairy, milk, cheese, yoghurt, and soy products, can cause mucous to thicken dramatically. This can then inhibit proper drainage.
• Allergies to foods; Allergies to such things as wheat, eggs, milk or nuts. These will once again thicken mucous, and inhibit proper drainage.
• Illnesses; Such as flu, colds, bronchitis, ear infections and tonsillitis are the main culprits in post nasal drip and excess mucous. If you are an asthma sufferer, not only can the excess mucous trigger asthma attacks but it can make breathing through the nasal passages difficult causing the asthmatic to breath through the mouth instead. This is very bad for asthma sufferers, as mouth breathing means that you have not warmed or humidified the air taken into the lungs, and this in turn can also trigger an asthma attack. Also an asthma attack can be triggered because mouth breathing means you have not filtered the air of impurities, as this is the function of the nasal and sinus cavities.

POST NASAL DRIP SYMPTOMS
Symptoms of Post Nasal Drip can be many and varied. In fact a lot of patients that visit us at The Australian Bad Breath Clinic for bad breath do not even realize that they have this problem. We have summarised the most common symptoms below.

• Needing to clear your throat;  This is probably the most common symptom of post nasal drip. When the mucous drains from the sinuses it will commonly collect at the top of the throat area. This can cause a hoarseness of the voice and the need to continually clear your throat.

• Constantly swallowing or feel that you have something trapped in the back of your throat.This would most likely be due to excess mucous and PND. Also if you feel like you have a lump in your throat, then once again this is most likely mucous collection. Patients describe it as a mucous plug.

• Continual sore throats that do not develop into illness. Post nasal drip can cause the cilia (tiny nasal hairs) to stop functioning properly. This causes a collection of crusty mucous on the nasal and throat lining. this in turn will cause inflammation and irritation. This clinically presents as a sore throat. Often medical doctors prescribe antibiotics for this condition in the belief that the person is coming down with a cold or sickness. But in fact this can make the problem worse. Once the antibiotics are stopped, most bacteria will return to normal levels, however we find the anaerobic bacteria will grow in greater numbers, as they are opportunistic in nature. This can take a PND problem and actually cause a significant bad breath problem.

• Small white or yellow crystals lodged in your tonsils. If you have excess mucous this will cause an increase of anaerobic bacteria. These bacteria feed on the mucous as it is high in protein. They then make condensed sulphur granules called TONSILLOLITHS which are laid down in the back of the throat. Every time your tongue touches the back of the throat when you swallow, it will carry these Tonsilloliths into the crypts or folds of the tonsils. If you have ever picked these out with a Q tip you will notice the foul smell that they have. Tonsilloliths are not only a sign of post nasal problems, but also a sign of bad breath.

• Nasal and Sinus Congestion; If you are finding it hard to breathe through your nose, or if you are a mouth breather, then in general you will find that excess mucous or PND is causing your nasal congestion.

POST NASAL DRIP TREATMENT
It is important to determine which of the causes mentioned before is the culprit for the post nasal drip and to remove it. Next it is essential to flush the excess mucous from the nasal passages and throat area. Mucous left in this area will stagnate and cause infections which worsen the problem. Also old crusty mucous left in the nasal and sinus passages stops the intended proper drainage of the sinus cavities.  Once these areas are cleaned, it is important to maintain the area.

Do not use "over the counter" medicines that contain drying agents as this will worsen the problem by making the mucous crust harder to clear. This means, do not use any antihistamines such as Claratyne or Teldane, medicines such as Codral Cold tablets or any preparations that contain pseudoephedrine. Such preparations not only will dry the area, but can increase blood pressure which can be dangerous for some people. Also avoid "over the counter" nasal sprays as these can cause a rebound affect making the problem worse when you stop them. BreezeCare recommends the Sinoclear range of nasal washes. They have no rebound effects and are safe for use during pregnancy and breast feeding.

If you would like to try the Fess products, we have three different sprays that contains unique nasal medicines to help cleans  the nasal passages. These sprays will not only help post nasal drip but they also are a great help in removing the crusty mucous that adds to bad breath.

Nasal Irrigation on a daily basis works on the tiny hairs in the nasal passages to make them work harder and remove mucous collection from the nasal passages. Fess sprays are developed by ENT surgeons in Australia. They are commonly recommended after sinus surgery or for long term sufferers of allergies, sinusitis and rhinitis. We have found it a great benefit in cases where other sprays are not sufficient alone to flush the nasal passages. 

Finally visit your Doctor. If your PND is a long standing problem, we recommend that you visit your GP for further advice. Many times you can undergo desensitising injections against the allergens that are causing your problem. Your medical practitioner can help to diagnose the cause of your post nasal drip. Many times your GP will refer you on to a medical specialist.