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What Causes Persistent Throat Congestion And Nasal Drainage?

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Posted on Wed, 9 Mar 2016
Question: I have drainage and congestion in the back of my throat which leads to excessive throat clearings-especially after eating- and is associated with a very bad taste as well as the discharge of a thick yellowish mucus in my throat. I have always assumed this was post nasal drainage from sinusitis but a trip to an ENT resulted in antibiotics, saline washes, Flonase, and no change in symptoms. I have been dealing with these symptoms for years but they are getting worse. Who or what specialty physician would be able to diagnose and treat this condition?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (29 minutes later)
Brief Answer:
Here are some thoughts:

Detailed Answer:
Hello and welcome,

The symptoms you are describing could still be from post nasal drainage (possibly from allergies or irritant rhinitis) but could also be from gastric reflux causing irritation and mucus in your throat.

I would return to the ENT and let him or her know that what was tried didn't help. It's possible that you need a double dose of nasal steroid might help.

The specialists I would consult would be:
1. ENT: I'd suggest going back to the one you just saw and if you don't have confidence in him or her, see a new one.
2. Allergist.

And you can try a short course of Zantac 150 mg twice a day to see if that makes any difference after 2 weeks. You can buy Zantac 150 mg over the counter without prescription. It is a stomach acid reducer.

I am really sorry you are experiencing this and wish you well. Please let me know how you are doing after further evaluation. If this discussion is already closed, and if you have an ongoing subscription, you can write a new question to follow up and put my name at the beginning - then it will be routed to me.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (21 minutes later)
I am currently taking 40 mg pantoprazole 1x for acid reflux and have seen an allergist to confirm allergies to cats and grass that I was already aware of. No action was prescribed by the allergist at the time. Would Zantac be a better choice and should I try doubling the twice a day flonase dosage I'm presently using? Could sleep apnea be a factor? I am freqently awakened at night by a feeling that I'm not breathing...or is this an entirely separate issue?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Some thoughts:

Detailed Answer:
Pantoprazole, which is a proton pump inhibitor, would be much stronger than the Zantac. Although some people actually get reflux from some of these, but you would likely have a sense of that if it were happening as you have a history of reflux and know what it's like.

Touch base with the ENTs office before doubling the dose of Flonase just to confirm your doctor is ok with it, but doubling the dose of a nasal steroid is not uncommon.

I am thinking that the drainage and throat problems are more likely a cause of sleep apnea rather than a result, but it is possible. The person to see for that would be a sleep specialist, and if there is none in your area, then the ENT or a pulmonologist might be able to order and interpret a study. More likely the pulmonologist. But a sleep specialist would be best.

If you find that you cough and clear your throat a lot when eating, a swallow study might be in order.

If you have cats in the house, it would be very important to do everything you possibly can to reduce the dander allergen of course. Some allergists even suggest bathing cats once a week to keep the dander down.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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What Causes Persistent Throat Congestion And Nasal Drainage?

Brief Answer: Here are some thoughts: Detailed Answer: Hello and welcome, The symptoms you are describing could still be from post nasal drainage (possibly from allergies or irritant rhinitis) but could also be from gastric reflux causing irritation and mucus in your throat. I would return to the ENT and let him or her know that what was tried didn't help. It's possible that you need a double dose of nasal steroid might help. The specialists I would consult would be: 1. ENT: I'd suggest going back to the one you just saw and if you don't have confidence in him or her, see a new one. 2. Allergist. And you can try a short course of Zantac 150 mg twice a day to see if that makes any difference after 2 weeks. You can buy Zantac 150 mg over the counter without prescription. It is a stomach acid reducer. I am really sorry you are experiencing this and wish you well. Please let me know how you are doing after further evaluation. If this discussion is already closed, and if you have an ongoing subscription, you can write a new question to follow up and put my name at the beginning - then it will be routed to me.