Why have my colds started to turn into months of post-nasal drip?
August 22, 2017 7:35 AM   Subscribe

For the past two years, I have been getting colds that turn into months of thick, sticky mucus dripping down my throat from the back of my nose. For all of my lifelong nasal problems, this one is new. A complicating factor is that I moved across the country to an infamously polluted West Coast city in the midst of the first of these episodes, although later experience shows that they are not limited to my new place of residence.

Please help me figure out any details or patterns that I’m missing. Have you ever experienced anything similar? Two weeks ago, while visiting family in VA, I caught a cold. The main symptoms abated after a week, at which point I still had a cough producing yellow phlegm and was blowing the same material out of my nose. Another five days or so, and that went away. Now I am left with an exceedingly annoying sensation of occasional post-nasal drip. This can occur at any time/place, but it seems to be exacerbated by eating or drinking anything (even a glass of water), taking a shower, or engaging in any kind of physical activity. When it happens, I become aware of a feeling of congestion behind my nose (my nasopharynx?), after which this stuff starts to slide down my throat. It is often so thick and sticky that I am unable to swallow it without washing it down with several gulps of water. It starts during or immediately after these activities, and abates after about 15 minutes. It seems to be at its worst when I do any of these things in the morning, although some days are worse than others in terms of the volume of mucus. When I bring it up, it is clear.

None of this would seem particularly noteworthy to me were it not for the fact that this has started to happen after my colds very abruptly. Two years ago, around this time of year, I caught a cold, which turned into months of the same post-nasal drip. I was then in the midst of a move from the Northeast to California, so when the symptoms persisted in CA, I thought I was allergic to something local. They got better over the course of several months, although the various medications I tried (Claritin, Allegra, Flonase, Mucinex) didn’t seem to do anything, and Sudafed with pseudoephedrine seems to dry things up for the most part but doesn’t seem like a viable long-term solution.

I have been to my doctor several times about this. At first he thought it might be lingering infection and recommended sinus rinsing and Flonase. This didn’t help much in the short term, but over the course of months, the drip went away. When I went to my doctor after the second time this happened (about a year after the firs time), he said it sounded like allergies, prescribed a new nasal spray (Dymista), recommended sinus rinsing, and gave me a referral to an allergist. The allergist confirmed that my nose looked allergic and scheduled allergy testing. The results of that show that I am likely allergic to dust mites and several types of grass and tree pollen. This makes sense, as I’ve had some kind of allergies my whole life. At times, I have had almost constant rhinitis, sneezing, and post-nasal drip, but what I am experiencing now seems very different—the persistent post-nasal drip for a month or two following a cold is new. Furthermore, seemingly complicating the idea that it is a dust mite allergy is the fact that I wake up with a totally clear nose and no mucus. It only gets worse when I get up and start moving around (having breakfast, taking a shower, etc.).

When I first got this, I particularly noticed the drip after eating, and googling this symptom led me to read a great deal about laryngopharyngeal reflux (LPR), which in turn led me to reading a bunch of desperate-sounding accounts of people who had tried every medication imaginable and had found no relief. This made me anxious (and this anxiety was no doubt compounded by my cross-country move to a place where I didn’t know anyone and had to begin a stressful new job). Then, one afternoon in CA, maybe a week after my arrival, I suddenly felt a lump in my throat. Soon after that, I started to experience hoarseness. When I told my doctor about this, he said it sounded like reflux and prescribed a single dose of Prilosec daily. After about a week, the lump in my throat and hoarseness went away. Somewhere in the midst of these new, scary symptoms, I lost track of the post-nasal drip, and only noticed that it was lessened, although still present, after a few weeks on the Prilosec. I was on PPIs for six months, after which I stopped abruptly without noticing any worsening or return of symptoms. In particular, the characteristic LPR symptoms have not returned, and I still wonder if that was psychosomatic, given how freaked out I was by the possibility of LPR right before I started experiencing its common symptoms, together with my lack of obvious risk factors (I am thirty years old, thin, reasonably active, rarely eat greasy or spicy foods, rarely drink, almost never eat within a few hours of bed time, and never experience problems while lying down at night). Furthermore, the one thing I am fairly sure about is that the symptoms become much more noticeable following a cold and are either minimally bothersome or entirely absent at other times. In general, I remain unsure whether this was a red herring. My allergist thinks that allergies are a more likely cause of my problem than reflux. She said the eating-related congestion is gustatory rhinitis, although I feel like I might have explained the issue poorly, since all the descriptions of that I’ve read involve thin, runny nasal discharge rather than my thick post-nasal drip. She also said at my last appointment that if nasal rinsing and measures to reduce allergens in my apartment don’t help, then it would be time for allergy shots. My concern is that it might take a long time to know whether those shots are helping or not, and if allergies (or those allergies I was tested for) are not the problem, then the real issue will go unaddressed for a long time.

I apologize for the long post. To summarize: for one or more months after I get sick, I experience post-nasal drip, particularly following anything that seems to affect my nasal passages (breathing more rapidly, breathing in hot steam, eating or drinking). By way of experiment, I made a cup of herbal tea this morning, and within a couple of minutes of inhaling the steam and taking a few sips, I experienced the all-too-familiar cascade of gunk down my throat. I am now drinking another cup of the same tea, and everything seems fine with my nose and sinuses, so it does not seem like what I am drinking is causing these symptoms continually—more that it starts up immediately and runs its course. I used to think I only experienced this in California, but now I am going through the same thing on the East Coast, where I lived most of my life without this problem. Could it be allergies that get worse after I have been sick? Could this be dust mite allergies even though I do not experience symptoms when I am in bed and then continue to experience them throughout the day? Also, a few more possibly relevant details: doctors have noted many times that I have a deviated septum, and I cannot breathe well through one of my nostrils. When I was younger, I was prone to what were obviously sinus infections (sinus pain and pressure following a cold, and sometimes similarly persistent post-nasal drip). This time, however, there was no obvious sinus pain. Finally, I got an MRI for unrelated reasons a few years ago (just before this all started, actually), and the report noted that I have a mucus retention cyst in my sphenoid sinus. However, my current pcp does not seem concerned by this.
posted by a certain Sysoi Pafnut'evich to Health & Fitness (6 answers total) 7 users marked this as a favorite
Have you or your doctors considered correcting your deviated septum?

I had a septoplasty done a couple of years ago and my post-nasal drip was not only reduced in volume, but also traditional remedies such as a daily rinse around colds are much, much more effective. My ENT suggested that improved airflow and the capacity to actually flush my sinuses kept them from getting irritated so often.
posted by notorious medium at 7:43 AM on August 22, 2017

I am also a person with sinus woes and am wondering if you've been to an ENT for this or just the allergist and regular doc? I have also heard the airflow thing concerning my own deviated septum. I got a turbinate reduction on one side and it helped considerably. I also do this sort of thing (sort of like the valsalva maneuver but different, you don't need tools for it, can use a finger) because I think my issue has to do with narrow eustachian tubes. Also suggest not reading desperate people on the internet stories (that helped me SO much) and yes, considering allergy shots which helped my SO who has a similar sort of set of issues. I don't know what amucus retention cyst is but it does sound like something that is worth talking to a professional about and that might be an ENT and not a regular PCP.
posted by jessamyn at 8:09 AM on August 22, 2017

Try picking up claratin, allegra or other generic OTC allergy pill and using them for a week or two and see if that clears things up. Low risk, low cost, possibly high payoff.
posted by k5.user at 8:13 AM on August 22, 2017 [1 favorite]

Are you still doing the daily Flonase + Prilosec? My experience with both of these medications is that they help my nasal congestion/allergy issues significantly, but you can't stop taking them after your symptoms go away -- they're daily maintenance medications. (The Prilosec box says you can only take it for two weeks without a doctor's okay, but check with your doctor -- mine told me the only reason they say that is to make sure people aren't self-medicating when they actually have throat cancer or something -- once you are checked by a doc to make sure nothing more serious is in play, there is nothing dangerous about taking it for longer than 2 weeks at a stretch.) I also have a backup nasal spray (not Dymista, but another one that's a step up from Flonase) that I use during weeks when the pollen count is high. Basically, the thing I have learned about allergies is that it's not like an infection where you take a medication once and it clears up the problem and then you're done. You really do have to keep taking whatever combination of stuff that works for you pretty much forever, as long as the allergens are existing in your environment.
posted by rainbowbrite at 8:21 AM on August 22, 2017 [2 favorites]

I get this or something similar and it's from a combination of 2 things: my constant year-round allergies, and a medication side effect that causes severe dry mouth/throat/nose. The allergies make the constant snot, and the dryness makes it unbearably thick and sticky and impossible to blow out/cough up, but exertion and hot food/drink (and hot muggy weather to an extent) can loosen it and cause that awful gluelike drip. Taking an otc allergy pill daily mitigates it for the most part but I rarely remember to do so until symptoms become unbearable.
posted by poffin boffin at 12:52 PM on August 22, 2017

I have what sounds like this (along with throat clearing and hoarseness). It's what's known as silent reflux and I've tried everything to fix it. The only thing that works is avoiding whatever your triggers are (for most people, they are things like caffeine, garlic, onions, tomatoes, alcohol, chocolate, in other words, everything good in life.)

Some of these things I can live without but you'll pry coffee from my cold, dead hands, so you have to decide how much you're ok to live with. Oh, and doctors will tell you go on PPIs, and initially, they'll work, and you be happy! Then eventually they'll stop working. Or you'll read the scary list of side effects that come from long term use that the doctors never tell you about. Basically the answer is lifestyle/diet changes, then you won't need medication.
posted by Jubey at 5:27 PM on August 22, 2017

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