Q & A

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Sinus Drip and Dry Mouth

Question: Lately, I have been suffering from sinus drip and a dry mouth. I have a leaking in my sinuses which runs down the back of my throat. As a result, my saliva is very thick, which leaves my mouth dry, all day every day. I drink a sufficient amount of water daily to combat this. However, its been to no avail, as my breath stinks all day. Constant brushing does nothing to help my bad breath.

What can I do to improve my symptoms? Please advise.

Thank You.

Answer:

Sinus drip or post-nasal drip syndrome stems from nose and sinus problems and can cause some unpleasant symptoms to occur, such as halitosis, coughing, as well as a blocked or runny nose. To help rid you of this condition, pinpointing the cause of your sinus drip is necessary. Several conditions can cause post-nasal drip, including sinusitis, hay fever, upper airway cough syndrome, and rhinitis.

While self-care and home remedies will not treat your condition, they can help improve and manage your symptoms, no matter the underlying cause. While you are experiencing post-nasal drip syndrome, be sure to stay hydrated. Drink plenty of fluids, which will help thin mucus secretions. Just stay away from caffeine and alcohol, they can dehydrate you and make your symptoms worse. You can also wash out the nasal passages with a neti pot or a saline nasal spray to help thin out mucus, as well as flush out irritants and allergens. Just make sure you don’t use this method too much, as it could have the opposite effects of what you are going for.

If you are still experiencing sinus drip and a dry mouth, I would advise a consultation with an ENT specialist. You could have a sinus infection and or silent acid reflux, and these symptoms will not go away until you get the underlying problem corrected. The treatment methods and medications used will vary depending on the underlying cause of your sinus drip, so make sure you see a doctor if your condition still hasn’t improved.

I hope this clears things up for you.

Scott D. Gold MD

NY Sinus Center

NY Otolaryngology Group

Q & A

Salty Post Nasal Drip with Headaches After Surgery

Question
For nearly 3 years I have been getting salty post nasal drip with headaches. I had a CT scan of my sinuses which showed only mild to moderate mucosal thickening. I had FESS bilateral unicectomies, middle meatal anthrostomies and anterior ethmoidectomies.

I wish I never had the surgery done, the salty drainage is so bad, I’m constantly coughing in tissues and have a constant high-pitched ringing in my ears. I have really bad anxiety and depression since the operation. I feel so ill everyday. I’m 22 year old female and it’s ruining my life.

I think I might have a csf leak. Had beta 2 transferrin test, which came back negative. I coughed the fluid from the back, I dont get any out the front of my nose. My recent CT scan doesn’t show any evidence of a leak. Been tested for allergies and am not allergic to anything.

What can I do? Thank you.

Answer

Thanks for your note.

It is really hard to let you know without a complete examination, and it sounds like you have been cared for appropriately without the results one would really hope for or expect.

I definitely would suggest further evaluation for csf leak or increased intracranial pressure.

Any medications you are taking need to be looked at. At the NY Sinus Center, we would also look whether there is Gastro esophageal reflux as high as your sinuses causing these symptoms, usually by Restek pH monitoring in the nasal cavities.

Unfortunately, very often sinus problems are complex, rather than straightforward, and treatment really requires understanding the cause of one’s problems.

Robert Pincus MD

Co-director NY Sinus Center

Let’s clear things up

Q & A

Post Nasal Drip Problems

Question: I have had post nasal drip problems since May. Every doctor I go to tells me they don’t know what’s wrong and cannont find any relief. I’ve been prescribed Nasonex and Augmentin, but both made the problem worse. I have a sore throat, my tonsils hurt, and my post nasal drip is worsening. Even as I write this email, I’m hocking up mucous to spit out. It won’t stop… If you have any thoughts, please let me know. I will greatly appreciate it.

Answer: As you know, to really give you an accurate diagnosis would require your being seen and evaluated. However, we have found that many patients with continuos post nasal drip problems have a post nasal drip due to acid reflux. We call this “silent reflux” when stomach acid reaches the back of the throat and the nose, causing irritation and post nasal drip even if patients don’t have heart burn. The body then makes mucous in response. You can see more about it under sinus treatment on the nysinuscenter.com website. This can often be diagnosed on examination alone, but at times we recommend pH testing. This is a test in which a thin wire that measures acidity is placed into the back of the nose.

Treatment for silent reflux includes following an antireflux diet (not eating 3 hours before bedtime, limited caffeine, chocolate, alcohol, fatty foods, peppermint and a few others) and 6-12 weeks of antacid therapy (usually 2 OTC prilosec or prevacid 30-60 minutes before breakfast)- Sometimes evaluation of the esophagus is needed to make sure there are no more worrisome problems in patients with silent reflux.

Other evaluations I would suggest, if not done, include nasal endoscopy, culturing any nasal discharge and perhaps imaging the sinuses by CT scan to make sure there is not a persistent sinus infection or other such cause of your symptoms.

If you’re in the NY area, please make an appointment, and I think we should be able to help. If not, please see an ENT doctor who specializes in sinus problems near home and ask about the above possibilties..

R Pincus MD

Associate Professor Otolaryngology

NY Sinus Center

Q & A

Is Post Nasal Drip Curable?

Question: Is there a post nasal drip cure? Can you get antibiotics for it? Aside from sinus infections, what are the other causes for it?

Answer:

The short answer is yes, post nasal drip is curable once one finds the cause. Post nasal drip is one of the more common symptoms people complain about to their Ear Nose and Throat doctor. Much of the time doctors consider this a diagnosis. It is not a diagnosis, but a symptom with many causes. The actual post nasal drip cure starts with understanding the sinuses and the causes of post nasal drip.

We make mucous in the nose and sinus cavities, about a quart a day. It serves as a lubricant, think motor oil, that traps particles in the nose- dust, virus, contaminants, bacteria- and is swept back by cilia into the back of the nose and then down the throat into the stomach. The stomach acid then destroys or inactivates these contaminants. The mucous is usually a thin lubricating layer.

However, sometimes we make the wrong consistency of mucous- think thick old motor oil- and there are multiple causes that should be able to be diagnosed by your ENT or sinus doctor.

One of the more common causes of post nasal drip is gastric reflux. If acid comes up as high as the nose or throat, the membranes make extra mucous, trying to delicate nasal lining tissues from the acid. Patients often feel the need to clear the throat with this.

A sinus infection can cause post nasal drip. In this case the examiner can see pus coming out of the sinus openings, being swept down the throat.

Allergies can cause post nasal drip by making “the wrong kind of mucous”. Typically with allergic nasal conditions one may make excess watery- or at other times overly thick- mucous that one feels in the throat.

Mucous can become thick from drying and cause a post nasal drip. This can occur with dry air- such as heated air in cold weather or often from drying medication such as a diuretic (water pill).

Any individual can have one or more of these problems simultaneously. Appropriate treatment, when aimed at the cause or causes, should be able to help alleviate your post nasal drip.

Robert Pincus MD
NY Sinus Center

postnasal drip Archives - The New York Otolaryngology Group

Sinus Drip and Dry Mouth

Salty Post Nasal Drip with Headaches After Surgery

Post Nasal Drip Problems

Is Post Nasal Drip Curable?