There’s nothing discreet about post-nasal drip.

It’s that persistent tickle at the back of your throat, the constant clearing every five minutes, that annoying cough that refuses to give up—particularly at night. Some find it like mucus that drips down the back of the nose. Others mention that it’s like a lump they can’t swallow. Either way, it’s disturbing. It’s draining. And most of all—it’s relentless.

In our practice at Fort Worth ENT & Sinus, we encounter patients daily who’ve endured post-nasal drip for weeks, even months. When they come into our office, many have already undergone several courses of antibiotics for post-nasal drip with little or no relief.

That’s where the confusion starts. Although post-nasal drip may be caused by infection, for most of the time it’s not. And if it’s not, antibiotics won’t work. Let’s break down what’s happening—and when medication is part of the solution.

What Is Post-Nasal Drip?

Post-nasal drip is a symptom, not an illness. It occurs when excess mucus accumulates in the nasal passages or sinuses and starts flowing down the throat rather than out of the nose.

And that excess may result from several conditions:

• Viral upper respiratory infections
• Bacterial sinus infection after antibiotics
• Allergies (seasonal or environmental)
• Non-allergic rhinitis (due to irritants such as smoke, perfume, changes in the weather)
• Chronic sinusitis
• Gastroesophageal reflux (GERD)
• Medications side effects (such as antihypertensives or birth control)

Post-nasal drip is your body reacting to something—but the “something” can be very variable. So the treatment must be variable, as well.

Why Do So Many People Get Antibiotics?

Let’s be real—antibiotics tend to get doled out as a blanket solution. A patient comes in with congestion, cough, and sore throat. A provider writes them a quick script of antibiotics, just in case.

And sometimes, that works—if there is a bacterial sinus infection. But most of the time, post-nasal drip isn’t bacterial at all.

And when antibiotics for post nasal drip are used improperly, they cause issues:

• They won’t treat the true cause of the drip
• They may have side effects such as stomach discomfort, diarrhea, or yeast infections
• They make bacteria resistant to antibiotics, which is an increasing concern of public health

It’s not merely that antibiotics are overprescribed. They take your attention away from doing the deeper work of figuring out what’s really going on in your sinuses, airways, or immune system.

When Might Antibiotics Be the Answer?

Of course, there are situations where antibiotics are the correct choice, particularly if:

You have thick, yellow-green nasal discharge that’s lasted more than 10 days

• You have facial pressure, swelling, or a fever
• Your symptoms improved, then worsened (“double sickening”)
• Imaging or scope exams show evidence of bacterial sinusitis
• In these situations, a correctly prescribed course of antibiotics can eliminate the infection and alleviate the mucus production leading to the drip.

But again, we don’t treat symptoms, we treat bacteria. So, unless there’s obvious infection, we first seek other causes.

What’s Most Often Causing Your Post-Nasal Drip?

The majority of post-nasal drip cases we see fall into one of the following categories:

1. Allergic Rhinitis

This is probably the biggest culprit. Pollen, dust mites, and pet dander trigger inflammation in the nasal passages and sinuses, leading to overproduction of mucus. This might be your underlying issue if you have sneezing, itchy eyes, or seasonal flares.

Treatment typically includes:

• Antihistamines
• Nasal corticosteroid sprays
• Allergy testing & long-term management

2. Non-Allergic Rhinitis

Sometimes it’s not allergies—irritants like perfumes, smoke, cleaning supplies, or sudden temperature changes. The nose doesn’t like surprises.

Treatment may involve:

• Nasal saline rinses
• Avoidance of triggers
• In some cases, anti-inflammatory sprays

3. Silent Reflux (LPR)

Some patients are shocked to learn their drip is actually coming from below. Stomach acid or digestive enzymes creeping up the throat at night can irritate the upper airway and mimic post-nasal symptoms.

In these cases, we explore:

• Diet and lifestyle modifications
• Acid suppression therapy (temporarily)
• Sleep posture changes

4. Chronic Sinusitis

This is a longer-term problem. If you’ve had nasal congestion, drip, or pressure for months, with or without infections, you may have chronic inflammation or structural issues.

We often recommend:

• In-office CT scan to evaluate sinus anatomy
• Possible balloon sinuplasty or nasal valve correction
• Long-term treatment plan, not just antibiotics

What You Can Try at Home First

If you’re in the early stages of post-nasal drip and trying to manage symptoms on your own, here are some options we frequently recommend:

• Saline irrigation (e.g., neti pot or sinus rinse bottles)
• Hydration—mucus thickens when you’re dehydrated
• Humidifiers—especially during dry winter months
• Nasal steroid sprays like fluticasone (Flonase), used consistently
• Antihistamines if allergies are suspected (but beware of drying effects)
• Elevating your head during sleep to prevent mucus pooling

Suppose these provide relief—great. If not, and your symptoms drag on for weeks or months, it’s time to come in.

Why It’s Not “Just a Nuisance”

We get to hear this a lot:

“I mean… it’s not painful. It’s just annoying.”

 “It’s probably nothing serious. I feel silly even coming in.”

But if post-nasal drip is affecting your life, it counts.

It’s not just a tickle. It’s why you find yourself constantly throat-clearing in meetings. It’s why your spouse elbows you at night when you begin your low, annoying cough in bed. It’s why you’re drinking water all day long just to communicate plainly. It takes its toll over time—mentally, emotionally, and physically.

We don’t minimize that.

We listen to your concerns—not only because we’re in the business of treating sickness, but also because we’re enhancing quality of life. Something as “small” as post-nasal drip can significantly impact your concentration, sleep, self-assurance, and overall well-being. You should be able to feel heard, understood, and assisted.

That’s why we don’t cut visits short, do the testing when it’s called for, and dig beneath the surface.

Because if something’s interrupting your life day after day—even if it’s not high drama—it’s worth fixing.

Final Thought: Let’s Stop the Guesswork

Let’s stop guessing if you’ve been cycling through antibiotics, cough drops, nasal sprays, and home remedies without long-term relief.

Fort Worth ENT‘s goal is simple: get to the root of the problem and help you breathe, sleep, and speak comfortably again, without unnecessary medication and delay.