Chronic Rhinitis and Post-Nasal Drip

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Quick GuideSinus Infection (Sinusitis) Symptoms and Treatment Options

Sinus Infection (Sinusitis) Symptoms and Treatment Options

What are other options for the treatment of rhinitis and post-nasal drip?

Treatment can also be directed towards specific causes of rhinitis and post-nasal drip as outlined below.

Treatment of infection

The most common nasal infection is a viral infection known as "the common cold." The virus causes swelling of the nasal membranes and production of thick clear mucus. Symptoms usually last several days. If "a cold" goes on for many days and is associated with yellow or green drainage, it may have become secondarily infected by bacteria. Very few patients with a common cold from a virus will go on to have acute bacterial rhinosinusitis from sinus blockage and impaired sinus function. Sinus blockage can lead to acute sinusitis (less than 4 weeks in duration) or chronic sinusitis (lasting 12 weeks with continuous symptoms), which can be characterized by nasal congestion, thick mucus, and facial or dental pain. From 4 to 12 weeks, the symptoms are classified as subacute sinusitis or recurrent acute sinusitis.

Symptomatic treatment often involves pain relief, decongestants, mucous thinning medications, saline rinses, and anti-histamine therapy.

Reflux Medications

For rhinitis that is a result of acid reflux disease, antacids (Maalox, Mylanta) can help to neutralize acid contents, whereas other medications such as cimetidine (Tagamet), famotidine (Pepcid), omeprazole (Prilosec), esomeprazole (Nexium)] can decrease stomach acid production. Non-pharmacological treatments include avoiding late evening meals and snacks and elimination of alcohol and caffeine. Elevating the head of the bed may help decrease reflux during sleep.

Surgery

Structural problems with the nose and sinuses may ultimately require surgical correction to cure them. This should be done only after more conservative measures have been tried and failed. Septal deviation, septal spurs, septal perforation, enlargement of the turbinates, and nasal/sinus polyps can lead to pooling of or overproduction of secretions, blockage of the normal pathways leading to chronic sinusitis, and chronic irritation. The surgery is performed by an ear-nose-throat doctor (otolaryngologist). Surgery can also enhance the delivery of nasal medications and rinses into the nasal cavities.

REFERENCES:

American Academy of Otolaryngology - Head and Neck Surgery. "Post-Nasal Drip." Oct 16, 2015
<http://www.entnet.org/content/post-nasal-drip>

CDC. "Is Rinsing Safe?" Sep 4. 2014
<http://www.entnet.org/content/post-nasal-drip>

Peden, D. MD. "An Overview of Rhinitis."
<http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm.>

Price D, Bond C, Bouchard J, Costa R, Keenan J, Levy ML, Orru M, Ryan D, Walker S, Watson M.; International Primary Care Respiratory Group (IPCRG) Guidelines: management of allergic rhinitis; Prim Care Respir J. 2006 Feb;15(1):58-70. Epub 2005 Dec 27.

Dion GR, Weitzel EK, McMains KC. Current approaches to diagnosis and management of rhinitis. South Med J. 2013 Sep;106(9):526-31 Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011 Dec 17;378(9809):2112-22. Levy ML, Fletcher M, Price DB, Hausen T, Halbert RJ, Yawn BP; International Primary Care Respiratory Group (IPCRG) Guidelines: diagnosis of respiratory diseases in primary care; Prim Care Respir J. 2006 Feb;15(1):20-34. Epub 2005 Dec 27.

Halbert RJ, Isonaka S.; International Primary Care Respiratory Group (IPCRG) Guidelines: integrating diagnostic guidelines for managing chronic respiratory diseases in primary care; Prim Care Respir J. 2006 Feb;15(1):13-9. Epub 2006 Jan 18.

Medically Reviewed by a Doctor on 10/22/2015

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