Congestion and post-nasal drip: what to know

The nose normally makes mucus to humidify and protect its lining. When the lining swells during a common cold, allergic rhinitis or sinusitis, mucus may become more noticeable and drain backwards. This can feel like a lump or tickle in the throat and may cause coughing, hoarseness or frequent swallowing. Chronic sinusitis can cause longer-lasting blockage, facial pressure or reduced smell. House dust mite allergy may produce recurring morning congestion and throat irritation, especially in bedrooms.

Reflux, dry air and some medicines can add to throat symptoms. A blocked nose can also worsen mouth breathing at night. Persistent snoring, pauses in breathing or marked daytime sleepiness should raise the possibility of obstructive sleep apnoea rather than being attributed to mucus alone.

Drink regularly, use saline spray or a gentle nasal rinse, and avoid smoke, strong fragrances and known allergens. Keep the bedroom clean and reduce dust exposure if symptoms follow time indoors; wash bedding as directed for the fabric and keep the room well ventilated. Sleep with your head slightly raised if lying down worsens drainage. Allergy medication may help when symptoms include sneezing, itching or watery eyes, but ask a pharmacist about suitability and correct use. Do not use another person’s medicine or continue a decongestant spray beyond its labelled advice.

Arrange an assessment when drainage persists, repeatedly returns, causes facial pain or affects sleep, eating or breathing. Seek prompt advice for fever with worsening facial swelling, severe one-sided pain, foul-smelling discharge, blood that keeps recurring or difficulty swallowing. Get urgent help for breathing difficulty, choking, confusion, swelling of the lips or tongue, or pauses in breathing during sleep. Children who struggle to drink or breathe need timely assessment. A clinician can examine the nose, throat and ears and consider allergy, sinus disease or another cause.

Ask whether the pattern fits allergy, infection, sinus disease or reflux; whether a nasal examination is needed; which rinse or medicine is suitable; and whether snoring or sleepiness warrants a sleep assessment.