Bloody postnasal drip: what to know

Postnasal drip is mucus moving from the nose or sinuses towards the throat. Dry air, allergies, frequent nose-blowing, rubbing, or a recent infection can make the lining fragile. Sinusitis or chronic sinusitis may add pressure, congestion, facial pain, and thicker drainage. Acid reflux can irritate the throat but does not usually explain blood from the nose. A small smear on mucus may be from the upper airway; coughing blood from the chest is a separate concern.

Blow your nose gently, drink fluids, and consider a saline nasal rinse or spray if it is suitable for you. Follow the product instructions and use safe water for a rinse. Avoid picking the nose, smoke, and very dry air. Note whether bleeding follows nose-blowing and whether drainage is from one or both sides. Arrange a review if the drip lasts, keeps returning, smells unpleasant, or comes with facial pain, fever, or worsening congestion.

Get urgent help if bleeding is heavy, does not stop with gentle pressure, or causes faintness or breathing difficulty. Seek prompt assessment for swelling around the eye, severe headache, confusion, a stiff neck, or severe facial pain with fever. Blood that is coughed up from the chest, rather than draining from the nose, also needs urgent medical advice.

Does the bleeding appear to start in my nose, sinuses, throat, or chest? Could allergies or sinusitis explain the drainage? Is a nasal examination needed? Which rinse or treatment is appropriate for my symptoms?