Avatar universal

Constant cough, post nasal drip, and swollen sinuses and throat

I have, over the last approximately 15-20 years suffered from swelling of the back of the tongue and the throat, and of the sinus cavities, perpetual unproductive cough, continual sinus drainage down the back of the throat and sometimes to the front of the nose, and overall fatigue and depression as a result. It has gotten so bad that I have had to give up the running and sports in which I used to participate. It is a hindrance to my overall quality of life. I have had several courses of immunotherapy over my life, beginning as a child, and currently. I last suffered asthma when I was 12. I have since taken several spirometry tests and a methacholine challenge test which all proved negative. I have had a bronchoscopy taken which showed nothing, but also had a nasal endoscopy resulting in decision to perform septoplasty. This relieved the stuffy noses I was having, but drainage and cough have worsened. (NOTE: I question whether this is a cause of my increased coughing problems.) Other tests taken have been upper gastrointestinal tract endoscopy (negative), thyroid function tests (showed normal), nasal endoscopy (showed no changes since septoplasty), erythrocyte sedimentation rate (showed normal), and laryngoscopy of vocal cords (showed normal; however it found thickened and boggy nasal turbinates), blood gas test (showed normal). Have found LARGE doses of prednisone help greatly (methylprednisolone, less so), but also cause side effects. Am currently taking Astelin and Rynatan as a steady regimen and Flonase semi-regularly. I am at my wit's end....any other ideas?

41 Responses
251132 tn?1198078822
This is obviously a very frustrating and complicated problem.  It probably involves both the upper and lower airways.  I would consider working with your doctor to methodically try to determine the cause of the various problems.  Then you and your doctor can try to establish a long-term plan to deal with them.  One consideration is a short visit to National Jewish Medical and Research Center in Denver, Colorado.  Every day we see people with what you are describing.  At National Jewish there is a multi-disciplined approach to the diagnosis and management of these problems.  Often it takes such a coordinated approach to diagnose and treat such a complicated problem.
Avatar universal
could you tell me more about the back of your tongue and throat swelling
hugs star
Avatar universal
I don't know for sure if the swelling is due to the drainage or not....or if it is some sort of reduced reaction anaphylaxis. Do you suffer from the same thing? What solutions have you tried?
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I also can relate to your problem my story is some different but outcome the saME. fOR ME IT STARTED WITH A SINUS INFECTION STARTED 2YR AGO NEVER HAD MUCH OF A SINUS PROBLEM TO SPEAK OF TILL THEN.  
Avatar universal
my problem started in 1998 when i had epsteinn barr virus , over the years my throat kept filling up with phlem and sometimes i would have problems swallowing as the years went by i started to get some bizzar symptoms like all of a sudden one day  i opened my mouth to breath out air as i felt i was smothering all of a sudden my ear popped and a squelching sound of air ran down my neck or through some tube, now this started happening on a regular basis i could pop my ears the normal way by holding my nose but i still felt strange until i opened my mouth pushed out air and that squelchy noise would relieve pressure
i find this so hard to  explain
ENT said it was caused by my jaw, now along with that uncomfortable feeling came other weird symptoms like a spikey feeling in back of the throat near tonsils, pulled tight throat that felt like a razor blade was cutting into it  it hurt so bad and tonsils that got white balls inside of them
my ears rang buzzed and made me feel so dizzy and sick and they caused me to have panic attackes and sometimes i could not even feel my body,, i dont know whats causing this but i do know it scares the hell out of me
of course i keep thinking of all the yuk things it could be and that scares me more
hugs star
Avatar universal
I can't say I would proceed with the septoplasty without AT LEAST discussing this possibility with your ENT. I have long regretted having this surgery, because it took me from being constantly stuffed up with SOME drainage, to having everything drain into my throat.
Avatar universal
Hey jimdc58, I have also done the surgery and noticed more fluid at the back of my throat.  I sometimes cough it out but most of the times nothing comes out.  It just produces a nasty dry cough that won't go away.  I have a question for you though.  Do you notice any type of wheezing sound when breathing?  I notice a small wheezing sound when breathing.  I'm currently taking the Pulmicort inhaler which is not doing anything for me right now.  I have an appointment to see an Allergist to see if I'm allergic to anything.  My next step is to see a Respirologist if the tests come out negative.  Any suggestions on what helps your cough?  Thanks.
Avatar universal
I wish I had some ideas for you, but, alas, I wouldn't be posting on this website if it weren't for I was looking for ideas as well. I don't have any "wheezing" issues. Have you had a spirometry test done yet to see if you have asthma? Most of my problem comes from the swelling caused from the constant drainage. My tongue feels like it's doubled in size.
Avatar universal
i also have some quiet wheezing sometimes . diagnosed with mild asthma .
Avatar universal
My problem started with an upper resp infection about 18mos ago. I've never had this as an adult & I definately hadn't had the type of fever it came with but I was "shot up" with some type of intrevenous antibiotic & the infection went away. About 2 days later I noticed that when I took a deep breath my throat & chest hurt as if I just came back from a 10 mile jog outside in hot weather in a smoggy city!! Then came the PND, for 30 days it was so bad I coughed until I threw up! Funny how I felt better after I vomited, the PND would stop for about 1hr of full relief! I ended up losing 30 lbs! I learned how to control my coughing so I would'nt throw up & I haven't done so in about 4mos. What's interesting is that I've also had these skin irritations that just won't go away either. When my cough get's better my skin conditions get worse, when my skin conditions get better & almost dissapear my cough gets worse???!! My dermotoligst said it was a yeast infection?! Then I thought I found the answer to what was ailing me. Candida overgrowth! I bought all this stuff off the internet & it was pure snake oil! But then again I was the dummy who didn't get the blood culture test first, that actually came back negative last week for the candida yeast overgrowth. The doctors I've been to & believe me I've been to all the specialists, can't figure out whats going on. They keep pointing the finger back at another doctor. You would think with all the people going through this they would figure out what the deal is by now. I truly believe there's a connection between the skin problems, the PND & coughing. But pawning it off as an allergy, bronchitis, acid reflux, esopheragal reflex, is just bad medicine.
Avatar universal
I've been reading alot in these forums about sinus and throat problems. I have alot similar similar symtoms. I've also noticed that I am dehydrated, too.  Which lead me on a search about chronic-dehydration.  I know this will not fit everyone situation.  But, when I have a feeling of thick phlem in my throat (often after eating) I have notice that I haven't been drinking water.  Just soft-drinks (with caffine).  The way I see it, a puddle of water becomes a thick mudpuddle without much water.  Hence the phlem that you hard to cough up.  It sensation  disappears completely, in a half a day, away after periodically drinking glasses of water.

If this is a factor in alot of our daily lives, thank about this.
Is it the medication we take for minor problems, twice daily.  Or might it be the extra amount of water we clense our bodies with.  Just a thought...
Avatar universal
I sure read alot about the same types of symptoms throughout these threads.  Excess mucus seems to be the main constant.  I have very simular symptoms: constant throat clearing because of mucus, hacking to remove it, it never really goes away, not reflux related, sticky post nasal drip, etc.  I have seen many Dr.'s.  I was tested for allergies to no avail. I saw a nose/throat specialist, no answers other than a possible cyst in my sinus.  I've tried nasal sprays, antibiotics, nasal washes, antacids, reflux meds, diet changes, fiber cleansing, deep tongue scraping(helps somewhat temporarily), herbs, vitamins, threelac, etc.  The best I can figure through all of my research is that it may be yeast related or a result of an acidic body. With that said, no answers in how to rid this disgusting and consuming problem. With so many people suffering from this problem there has to be someone out there with a answer or treatment. Hopefully there is help out there.  I am getting sick of spitting as is my girlfriend.
Avatar universal
I had sinus surgery on July 27th.  Two weeks afterwards, I too have way more drainage than I did prior to the surgery.  I am now on augmentin (after the initial Ketek) and I can tell after 5 days, it is not doing much.  I am sorry I had the surgery too, and I waited two years before deciding to finally go through with it. If my ENT figures it out, I will share.  It is very depressing.
Avatar universal
Over the past year I experienced a sinus infection that eventually linger and lead to various visits to the doctors office and turned into Rhinitis. I noticed that when I spoke to people they would cover their mouths and I realized that I also had a smell that was present along with it. I was told by various physicians that I had atrophic rhinitis and I was treated for that. I have had every nasal steriod, I've done nasal washes everyday since then, I have been on Amoxicillin through Zyrtec and nothing has changed, the smell is still present.
Last week I went to see another ENT (maybe number 10 in a year) and he could find nothing wrong with my nose yet he could smell the smell yet only when I spoke. I've been searching the net and I see that postnasal drip can cause bad breath and that this could be the smell people around me are smelling yet I am unsure. I brush regularly and I have always maintained good dental hygiene and I am perplexed as to why my physicians didn't consider that. I am still being treated for Atrophic rhinitis and I an unsure what my next step should be. Usually I can't smell it yet when I leave a room after being there a while when I return I smell it. Also when I wake in the morning the room is filled with this horrible smell. People usually smell it all day whenever they come in contact with me which lead me to believe it was my nose. Any help was be great.
Avatar universal
I can't believe how many people have the same symptoms. Sometimes I think I am losing my mind...I have a constant post nasal drip which irritates my throat and I cough ALL the time - it is embarrassing at work and i can't sleep at night - I get depressed and run down.  It usually comes with a lousy sinus headache, earache and upset stomach. I've tried everything...antibiotics (seemed to work short term), flonase, puffers, antihistamines. I went for extensive allergy tests which showed up nothing... My ENT says it is acid reflux and put me on nexium - I thought I was cured - but only lasted 2 weeks and then came back with a vegence...I get so frustrated I don't know what to do - and now even fear going to sleep cause it is so much worse at night...The ENT says my ear aches because it is the same nerve as my esophagus which has damage from acid reflux...the best relief i had was with biaxin - an antibiotic - but you can't take that long term.  If anyone has any tips on getting to sleep I'd appreciate them - sleep deprivation is ruining my life
Avatar universal
I too, have had close to the same problem for years, about as long as I can remember.  I've been to an allergist, ENT, even gastroenterologist, still having the same problems.  I clear my throat so much, it gets on MY nerves, it has to get on everyone else's.  It's worse after I eat, but there are times when I get up and haven't eaten anything and still go through this throat clearing routine for 1-2 hours at a time.  Only place I haven't been to is a lung specialist, but from listening to others, doesn't sound like it would make a difference.  If I don't clear my throat, I have difficulty talking, my voice becomes hoarse.  Sometimes I have phlegm in the back of my throat, sometimes not.  Although I sometimes cough because of it, most of it is throat clearing.  I too feel there must be someone out there that knows what the problem could be if it affects so many people.
Avatar universal
I've been suffering from something ever since I went to the Ukraine in March 2004.  Prior to going on my trip, I had underwent a series of vaccinations.  Upon arriving, I was there for only two days before the symptoms arose.  I had eaten raw mussels, raw pig fat (sala) and a few other local foods.  It was after a night of drinking a lot of Vodka.  When I woke up, I had this pain in the back of my throat, and over a few days it seemed to physically move down further in my throat, and when I swallowed, it would feel a little painful, like it was raw, but the pain also travelled down into my lower esophagus, like a nerve was causing it.

To this day, I still have the same feelings when I swallow.  It feels a little spikey, or that there is ulcerations around my epiglottis.  If I push in on my neck right below my thyroid, it also feels spikey, and induces coughing, something that never happened before.  Also, if I stretch or flex the muscles in my throat, it is painful, and more painful while I turn my head down and side-to-side while doing this.

It's basically a chronic feeling that I've learned to live with, and at times is unnoticeable, but something I think about every day.

I went to my family doctor, they took a series of blood tests, said everything was fine, sent me to an ENT, who put a video line in my nose and down my throat, checked out everything in my throat to my voice box and said everything was ok.  He suggested I get a Barium swallow, which I didn't do, instead I went to a gastrointestinal specialist who performed an upper endoscopy.  They said everything looked fine, and took a couple of biopsies, one from my esophagus and one from my stomach.  The lab said there was some rare forms of helibacter pylori bacteria, and gave me a regimen of Helidac for two weeks.

Going through that routine didn't change anything, and I'm still back to point zero.  I'm planning to go back to the specialist and ask them for another upper endoscopy.

It seems to feel better every morning, after waking up, but gradually returns to itself throughout the day.

It is so frustrating talking to medical professionals, who seem to focus on general rational, not believing it could be anything else.  I think they are trained to not to look for rare things, because 99% of the time it's common.

There is something definitely wrong in my throat and esophagus, and I don't believe it was coincidence that it coincided with my trip to the Ukraine, there is definitely an association.  I never had this feeling prior to going there.

I'm also not ruling out the possibility of kissing and saliva exchange with a girl, the night before when I drank a lot of Vodka, I just don't remember.  Is it possible I drank something that permanently damaged my throat?

I hope someone can help guide me, and tell me what my next steps should be? Who should I visit?  What tests should they perform, both blood and swab, etc.?

After dealing with this for 1.5 years, I'd like to get rid of it if possible, or atleast have an accurate diagnosis, so I'm not constantly trying to self-diagnose.
Avatar universal
crystalgray and everyone else,

I also have the odor coming from my nose when I breath and when I talk.  My situation is alot worse...an odor  is present with every breath.  I was diagnosed with post-nasal drip late last year.  But I beleve I suffered from it alot longer.  I experienced a heavy flow of mucus going down my throat and the coated metalic tasting tongue. After some investigation I believe...the cause was mold that developed after a leak from the bathroom ceiling in my apt.  The leaky problem went serveral months before it was fixed and I was exposed to whatever dripped out of the ceiling at the time.   My symptoms are not as bad now but I "suffer" from the odor that comes from my nose.  When I'm at work...the co-workers in the area that I sit can smell the ordor when I breathe and talk.  To add on to it...when I walk past someone...I notice the hands covering faces to prevent smelling of my nasal odor.  Just like you...I can't smell anything but what I ate during the day...at that moment or my morning breath.  I don't even smell anything in the morning when I wake up or coming back into a room after I leave it.  But I do know it takes alot for me to get up and come into work most days because of it.  I'm very embarrased because of it.  Close friends I asked say that can't smell anything but I see the reactions from the people that I am around.  I'm afriad to go to the barber shop for a haircut, sit on the train when I go to work, stand around a crowd of people, or date...just to name a few.  This is changing my life. I'm seeing my second ENT who still can give me a straight answer as to whether or not the odor will go away.  Did the CT Scan...taking the medication...doing the nasal-irrigation...praying that it still may work to some degree.  From all the research I've done...I can't find anything that will support that the ordor will go away!  ...but I willl still believe that something may work.  If anyone knows alittle somethng that help them...please let me.
Avatar universal
Hi all,

I don't know if this will help you guys out at all, but I may as well give it a go. About a year and a half ago I got extremly sick with flu, found it difficult to breath, had a constant post-nasal drip and even felt like I could have lung cancer or something seriously wrong with my lungs. After having x-rays of my lungs and sinuses taken the doc finally concluded that it was my sinuses. Looking back on the evening I got sick, I remembered I had a bad post-nasal drip that even made me feel nauseus and I couldn't sleep the whole night. This constant drip fell into my lungs which resulted in a build up of phlem and thus a violent cough. After getting somewhat better I decided to visit a homeopath that was recomended by my family who had also had sinus problems. From various tests she concluded that it was due to me having allergies towards smoke, caffeine and other foods as well as cat and dog hair (I had had cats and dogs my whole life and never had an allergy so I was a bit skeptical). Anyways, I took her advice and avoided eating chocolate and caffeine containing products. After a week I felt incredible. I wasn't battling to breath after taking a few steps and all off a sudden had loads of energy again. My nose also cleared up. I then went back to the doc and asked him to do the allergies tests on me (blood and urine) to which they concluded that I wasnt allergic to anything. A few months later I moved to the UK, away from my smoking father and pets. Now everytime I go near my boyfriends cats or someone who is smoking my eyes itch, my nose clogs up and I sneeze like crazy. I have also recently found out that my brother has the same problem after eating choclate or drinking coke, which leads us again to believe it is the caffeine. I have never had a problem with vodka although he seems to get violently sick when ever he drinks it. After visitig the doc he concluded my brother was allergic to vodka. I hope that this information helps someone.
Avatar universal
weight 205
hieght: 5,10

I have had the same symptoms for over 2 years. It all started with this poping in my throat when i would swollow but if I turned my head and swollow then it would not pop? this hardly ever happens now but I have thick clear  sticky mucus draining into my lungs causeing me to wheez and cough I had also heard some distorted buzzing in my ears when driving.

This is the crazy thing we just built a new house and i had to get state farm to come by for a health test.
everything came back good! accept my colestoral was in the 200's

so I make this doctors appointment 2 months later he runs my blood everything is good excpet my red blood count was  a little high! he ran another test a few days later and it dropped to normal. I had the copd test and my breathing was above normal they said i could have exersied indused asthma.

I asked the doctor to do a sinus  CT to see if this was comming from my sinuses.
they showed a devated septum with some blockage so he put me on a nasal steroid ,albutoral inhaler, singular.and a 2 week augmentan antibiotics hope I spelled that right..

I have to tell you when I go to bed at night I wheez deep down into my stomache and have to use this inhaler every 4 to six hours. I have had asthma attacks out side and during the winter when it is cold I started a new job in a night club about the same time this started  2 years ago and wondering if I am alergic to smoke..

I am about 20 pounds over weight I have borderline high blood pressure that I just started taking 20 mg benicar to see if this can be fixed by loosing weight and eating right. I also drink allot of caffine and wonder if this could be causeing my drainage of mucus.

anyway this sucks and if any doctors here on this board have any advice please leave a post.
Avatar universal
okay here's someone else with the same problem - PDN and coughing, frequent sinus infections... etc.

My own observations lead me to a few theories.

1. There is definitly some allergy reaction going on. I cannot stay in the say room as our dishwasher, washing machine or drier. I think something in the detergents get me going. We've tried different powerders and some are better than others. All I can do at the moment is be out of the house when these things are running.

an allergist recommended shots for a pollen allergy, but I doubt that help with detergents (not to mention costing a lot).

2. I noticed that drinking too little water definitely makes the mucus stikier and harder to cough out. This is important when taking antihistamines etc that dry it up to start with. Defeineitly need more water then.

Last time i i had a sinus infection I get some pseudoephedrine from the doc - dries up the drip nicely.

I have tried all sorts of steroid nasal sprays and antihistamines and have only found one that really helps so far - telnase. can't remember what's in it - a combo of stuff I think.
Avatar universal

I have also a bad nasal odor. It's been 5 years, went to specialist and they can't do nothing. Getting worse and worse every day. Anyone that has a solution, please share it with us.
Avatar universal
I also have the cough, PND, and sinus issues, plus I generally wheeze at night like some sort of broken accordion left out in the wind.  I do notice that it gets worse when I am not drinking water, so I suspect that while dehydration might not be the *cause,* it surely contributes to the level of difficulty (I know there's another word but I can't think of it right now).

So I'm going to slurp through several liters of water tonight.
Avatar universal
Hi Everybody

I have been following these discussion for a while, and it looks like we all got a similar problem.

My problem started in February of this year when I had a severe Throat Infection ( My throat felt like somebody stuck a hot candle underneath it, it was that painful).  After the doctor gave to me some amoxycilin, the severe burning throat ( it was more than sore) went away, but since that time I have gone everyday with a blocked nose, and occasional irritated throat (not as painful when I had the infection).  After many doctor Visits, they diagnosised Allegeric Rhinitis and Post Nasal drip, and gave to me Beclonase Nasal spray, which help for a while but in the long run causes my nose to block more.  I found that using saline nasal sprays (presentative free) frequently through out the day, helps with your nose and  throat. Drinking plenty of fluids (hot water can be beneficial) and sucking sweets(candies, which prevents your throat and muscous from drying, can also help. i believe the sore throat is caused by the stuck muscous on your throat drying. If I look at my throat with a flashlight, I can see thin, frothy muscous running down my throat (I sometime feel like I got a piece of rope stuck on my throat), and when I spit it up, it is clear and frothy.

I have some questions for all of you with this condition:

1.  After my throat infection, I have become more attentive about my throat and I have noticed that I am tending to swallow more (and I make a noise after I swallow, which can be very loud, is this the same for everybody?)
2.  Because I am Swallowing more, more air is entrained in the stomach, which causes me to belch a little  more, but what I have noticed is that more flatulence is generated (up to 40 times a day), and a rumbling intestine , which is audible.  Has anybody else develop these symptoms? What can be done about it?

I appreciate your help.



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