Post nasal drip - any new ideas??

[stapletonsguitar]

I started get PND six years ago. It was really bad at various times and would keep me awake at night as I just couldn’t clear my throat.

I was referred to an ENT specialist a couple of years in and they looked for polyps but couldn’t see any issues (he put a camera up my nose/down my throat) and he suggested it might be allergies. I took anti histamines for months but they made no difference. I had been using otrivine regularly after getting hooked on it after a cold, and I did wonder if that had buggered up my “drainage system” but I came off it and haven’t used it for couple of years now.

After reading about silent reflux being a possible cause I started on omeprazole, but I’ve been taking that for a couple of weeks and it’s made no difference.

Is there anything else it could be?

Silent reflux isn’t necessarily caused by excess acid so omeprazole doesn’t always help. I saw something a few weeks ago on instagram about diaphragmatic breathing to strengthen the lower oesophageal sphincter, this helps to prevent acid or pepsin from moving upwards, which can be the actual cause rather than too much acid. I have been throat clearing for many more years than you, and it was 90% gone within a couple of days of doing this for 10 mins a couple of times a day (you have to keep it up daily going forward). Slow eating and chewing your food well are also recommended.

It could be you don't have enough stomach acid, bizarrely. That's what started it for me. I am hypothyroid so low stomach acid tends to go with that. I started getting post nasal drip and couldn't figure out why until I started taking Betaine HCl with meals to help with digestion, and it went away!

I use neilmed sinus rinse and find that helpful.

Reducing the milky coffees and teas helps me too.

Blimey. Could be all sorts of things. I’ll try the breathing exercises first - I do have a sinus rinse kit and I do use that sometimes (never noticed any improvement though) Thanks ☺️

I don't know about post nasal drip but I have had very good results with nasal rinse for chronic rhinitis and hay fever.
I don't use a kit I use a neti pot (£2 or £3 ) and boiled water with salt and bicarb.
Have you tried a steroid nasal spray?

Yes, when I first went to the GP she prescribed one and it didn’t do anything. I also use one every spring when I get hay fever and the PND doesn’t go away. Interestingly, when I get a bad cold and have a runny nose it goes away 🤷🏼‍♀️😂

I have suffered from PND for a long time but it’s mostly controlled now. Omeprazole did not help me at all. Mine was caused by a mix of allergies and silent reflux. For silent reflux induced PND, I take Gaviscon Advance. If you decide to take it then go with Aniseed flavour as peppermint can make PND worse. Take a dose before sleeping and it should help.
If you occasionally suffer from acidity then take Pepcid instead of omeprazole as that is more for chronic cases.

For allergies, I use Nasonex as prescribed by ENT. I am surprised that your ENT did not prescribe you a steroid spray even if your case has become chronic. You can get it from online pharmacy or GP. I don’t use it every day but when I do use it, I use it for 5 days in a row.

Did the one she prescribed contain bicarb? I found that sterimar didn’t do much for me (just saline) but that the neilmed one with bicarb helped. I think it’s more soothing.

A bit left field but how is your weight? Dh had recurrent problems with reflux, pnd and a persistent cough that all disappeared when he dropped the excess weight. It creeps back up every Christmas, and on summer holidays, and that trio reappear - that’s what gets him back on his healthy eating kick again. He was on omezprazole for reflux but doesn’t need it since he lost weight.

Another angle could be peri menopause. I know a few people who started struggling with allergies in middle age, and responded well to hrt.