What causes chronic cough? How do you treat it? Get the facts about chronic cough and postnasal drip from a Harvard health expert.

Postnasal Drip: A Common Cause of Chronic Cough

You thought it would never end: that tickling in the back of your throat that makes you cough or clear your throat. It’s been going on for several months now. And now you know why: postnasal drip. This is a common diagnosis. It can happen for a number of reasons: allergies, viral infections (including the common cold), sinus infections, irritants in the air (such as fumes or dust). Less common causes include something getting stuck in the nose (usually in young children), pregnancy, and certain medications. Temporary and normal reasons for postnasal drip include certain weather conditions (especially cold and dry air) and spicy foods.

Whatever the cause, the issue is a constant trickle of mucus from the back of the nasal passages irritating the throat, a nagging cough, or other symptoms.

What Can You Do About Postnasal Drip?

Now that you have an official diagnosis, what can you do about it? There are a number of treatment options, including home remedies and over-the-counter medications:

• Humidifying or steam inhalation (as during a hot shower)
• Maintaining hydration (to thin out mucus)
• Sleeping with your head elevated to prevent mucus from pooling in the back of your throat
• Nasal irrigation (available over-the-counter)
• Oral decongestant, such as pseudoephedrine (as in Sudafed) or phenylephrine (as in Sudafed PE or Neo-Synephrine)
• Guaifenesin (like Mucinex), a medication that thins mucus
• Antihistamine, such as:
  • diphenhydramine (as in Benadryl)
  • chlorpheniramine (as in Chlor-Trimeton)
  • loratadine (as in Claritin or Alavert)
  • fexofenadine (Allegra)
  • cetirizine (Zyrtec)
  • levocetirizine (Xyzal)
  • desloratadine (Clarinex)
• Nasal decongestant, such as oxymetazoline (found in Afrin), which constricts blood vessels in the nasal passages, leading to less drainage. These medications should only be used for a day or two; prolonged use can do more harm than good.

Keep in mind that many of these medications are combined in over-the-counter products. For example, there are several formulations of “Sudafed” that contain pseudoephedrine or phenylephrine, as well as additional ingredients including acetaminophen, dextromethorphan, and guaifenesin. While these combinations can be effective, it’s important to read the label and avoid taking too much of any active ingredient.

What About Prescription Treatments?

If these approaches are ineffective, the next best step may be prescription treatment, including:

• Nasal steroid spray (e.g., beclomethasone/Beconase or triamcinolone/Nasacort)
• Ipratropium (Atrovent) nasal spray, which inhibits secretion (such as mucus)
• Other treatment approaches depend on the cause of the postnasal drip.

Antibiotics are usually useless, so they are generally not prescribed for postnasal syndrome (unless the symptoms are caused by a bacterial sinus infection). For allergies, frequent dusting and vacuuming, covering mattresses and pillows, and using a special air filter can help reduce exposure to allergy triggers.

What About Chicken Soup?

If you’ve been told that chicken broth helps with nasal congestion (or other cold or flu symptoms), it’s true! But it doesn’t necessarily have to be chicken broth – any hot liquid can help thin out mucus and maintain hydration.

When Should You See a Doctor?

In most cases, postnasal drip is unpleasant but not dangerous. However, you should see a doctor if you have:

• Unexplained fever
• Blood-tinged mucus
• Wheezing or shortness of breath
• Drainage with a foul odor
• Persistent symptoms despite treatment

The Good and Bad News About Postnasal Syndrome

Postnasal syndrome is one of the most common causes of persistent cough, hoarseness, sore throat, and other unpleasant symptoms. It can be caused by a variety of conditions and can persist for weeks or months. That’s the bad news. The good news is that most causes can be quickly identified, and most will improve with treatment.

Image: Cecilie_Arcurs/Getty Images

Gastroesophageal Reflux Disease (GERD) – Harvard Health

Gastroesophageal reflux disease (GERD) is commonly called heartburn. This digestive disorder most often causes a burning sensation, and sometimes a squeezing feeling, in the middle of the chest.

With GERD, acid and digestive enzymes from the stomach back up into the esophagus. This can irritate the lining of the esophagus and cause symptoms.