GERD and postnasal drip: What to know

Excess mucus that lingers at the top of your throat and causes a cough or pain is known as postnasal drip.

Your body has a high natural tolerance for mucus because it naturally produces a lot of it every day. But when a health event like an infection or an underlying condition causes an imbalance, it can lead to discomfort.

GERD is a long-term condition that causes your stomach contents to move back up your esophagus. These contents are often very acidic and can lead to irritation to the throat and airways.

GERD may lead to postnasal drip by triggering excess mucus production in response to irritation of the soft tissues in your throat and sinuses.

In this article, we explain the link between GERD and postnasal drip, as well as treatments a doctor may recommend.

What is postnasal drip?

Postnasal drip happens when the glands in your throat and sinuses, the tubes that connect your nasal passages in your head, are constantly producing mucus. It is a common cause of persistent coughing, among other uncomfortable symptoms like sore throat and congestion.

Your body naturally produces a lot of mucus to help keep your nose, throat, and sinuses moist and clean. Mucus production is also important for preventing infection. It provides an initial barrier to stop bacteria and viruses from entering. But too much can cause problems.

Irritation and inflammation of your sinuses and throat can cause your body to produce excess amounts of mucus. When this happens, the mucus can either run out of your nose, giving you a runny nose, or straight down the back of your throat.

This is called postnasal drip. Some people describe it as feeling like a constant tickle as mucus drains into your throat.

You can develop postnasal drip from a variety of triggers:

• viral infections like the common cold
• sinus infection
• dry air
• cold temperatures
• exposure to substances that irritate your airways, like fumes
• reaction to allergens like pollen or dust mites
• GERD

GERD and postnasal drip

GERD develops as the result of a weakening of your esophageal sphincter. This is the muscle in the space between your esophagus and your stomach. This means that your stomach contents may flow back up your esophagus.

A weakened or relaxed esophageal sphincter can develop as a result of:

• being overweight
• being pregnant
• smoking
• taking certain medications like benzodiazepines and tricyclic antidepressants

More research is needed into exactly how GERD and postnasal drip are linked.

One possibility is that the acidity of the stomach content that can make its way up your esophagus can irritate your throat and sinuses, causing inflammation in the upper respiratory mucosa. This is the thin membrane that lines your respiratory tract, which includes your sinuses and airways.

Inflammation of this membrane hinders the movement of mucus, which can cause a buildup that may lead to postnasal drip.

But there is another possibility. If you’re experiencing acid reflux, you might feel a tickle at the back of your throat that you mistakenly attribute to postnasal drip.

Research also shows that GERD and postnasal drip are both linked with increased sputum (mucus in your lungs) production, so you may be mistaking GERD symptoms for postnasal drip.

Treatments

Treatments for symptoms of postnasal drip and GERD depend on the underlying cause. Determining the right treatment may involve undergoing some tests, such as an upper gastrointestinal (GI) endoscopy.

Medications

If a doctor determines that the cause of postnasal drip symptoms is GERD, they may prescribe the following medications to help manage your symptoms:

• OTC antacids: These reduce the amount of stomach acid. Examples include Pepto-Bismol and Alka-Seltzer.
• Proton pump inhibitors: These are the most potent medications for limiting your stomach acid production to reduce irritation in your respiratory tract. These include dexlansoprazole (Dexilant), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex).
• H2 receptor blockers: These medications are a safe and effective way to reduce stomach acid, and they can help treat Zollinger–Ellison syndrome, which can cause GERD. These include cimetidine (Tagamet), nizatidine (Axid), and famotidine (Pepcid).
• Prokinetics: These medications help strengthen your esophageal sphincter muscle, but they’re only used for treating severe GERD. These medications include metoclopramide (Reglan).

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Lifestyle changes

Adapting certain lifestyle habits can help you manage and reduce your symptoms of GERD like postnasal drip.

These can include:

• maintaining a moderate weight and recommended abdominal fat level can help reduce pressure on your stomach
• avoiding dietary triggers like citrus juice, fatty foods, and carbs
• limiting your intake of fatty foods, which can trigger GERD symptoms
• quitting smoking if you smoke
• elevating your head while sleeping can help reduce heartburn

Postnasal drip treatments

Actionable steps you can consider taking to help manage postnasal drip include over-the-counter (OTC) medications and changes to your daily routine like:

• taking OTC decongestant medications, such as pseudoephedrine (Sudafed)
• taking OTC antihistamine medications, such as diphenhydramine (Benadryl)
• using saline rinses to remove excess mucus and reduce irritation
• remembering to drink lots of water to keep mucus thin
• sleeping with your head elevated to prevent mucus from collecting in your throat

Summary

There may be a link between GERD and postnasal drip.

Researchers suggest that it is due to irritation in your respiratory airways from acidic stomach contents entering your esophagus that causes excess mucus production.

Symptoms of GERD and postnasal drip may also mimic each other, leading to confusion about which is affecting you.

A doctor may prescribe prescription-strength proton pump inhibitors or H2 receptor blockers to manage GERD.

Drinking water and sleeping with an elevated head at night can help you manage postnasal drip and other symptoms caused by GERD.

If your current treatment plan is not working well in addressing your GERD or postnasal drip symptoms, it’s important to talk with a doctor.

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