Drainage in Throat

What drainage in the throat is

Glands in the nose and sinuses make 1 to 2 liters of mucus a day. Normally you swallow it without noticing. You become aware of drainage in your throat when there is more mucus than usual, when it becomes thick and sticky, or when the throat becomes more sensitive to it.

People describe it as:

• a constant need to clear the throat or swallow
• a feeling of mucus "stuck" at the back of the throat
• a tickly cough, often worse lying down or first thing in the morning
• a raw or scratchy throat, worse in the morning
• bad breath or nausea from swallowed mucus

This page focuses on throat drainage and the throat symptoms it causes. For the nasal side, see post-nasal drip.

Why drainage makes your throat sore or swollen

Mucus that constantly bathes the back of the throat irritates the lining. The tissue reacts by becoming red and inflamed, and small bumps of lymph tissue on the back wall of the throat can swell, giving a "cobblestone" look. That is why throat drainage can make the throat feel swollen, tight or full, especially in the morning after mucus has collected overnight.

Usually this swelling is mild and you can still swallow and breathe normally. If the throat feels so swollen that swallowing saliva or breathing is difficult, it is not ordinary drainage and needs emergency care.

Causes of drainage in the throat

Infections

• Common cold: the most frequent cause. Drainage is worst in days 3 to 7 and clears within 10 days.
• Sinusitis: thick yellow-green drainage with facial pressure, a blocked nose and reduced smell, lasting more than 10 days or worsening after a cold. Drainage lasting more than 12 weeks suggests chronic sinusitis.

Allergies

Allergic rhinitis produces thin, clear mucus with sneezing, itchy eyes and nose, triggered by pollen, dust mites, pets or mold.

Non-allergic rhinitis

Some people's noses overreact to cold air, smoke, perfume, alcohol, spicy food or weather changes. Pregnancy, aging and some medicines (blood pressure pills, birth control) also increase nasal drainage. Overuse of decongestant sprays for more than 3 days causes rebound congestion.

Acid reflux

Reflux, including "silent" laryngopharyngeal reflux, irritates the throat and makes it produce thick mucus. It feels like drainage even though it is not coming from the nose. Clues are heartburn, a sour taste, hoarseness and symptoms after meals or at night.

Other causes

• Dry indoor air, especially in winter heating
• Thick mucus from dehydration
• Swallowing problems, which make normal mucus feel noticeable
• Rarely, a nasal polyp, a deviated septum or a foreign body (especially one-sided discharge in children)

Telling the causes apart

How doctors diagnose the cause

Diagnosis is mainly from your history and examination of the nose and throat. A doctor may look inside the nose with a small scope, suggest a trial of allergy or reflux treatment, or arrange allergy testing. A CT scan of the sinuses is only needed for chronic sinusitis that is not improving or before surgery. Throat drainage is one of the commonest causes of a chronic cough, which doctors call upper airway cough syndrome.

How to stop drainage in the throat

Home remedies

• Saline nasal rinse once or twice a day, using distilled, sterile or previously boiled water. It washes out mucus and allergens.
• Drink plenty of fluids to thin the mucus.
• Humidify dry air or breathe steam from a shower.
• Sleep with your head raised on an extra pillow to stop mucus pooling overnight.
• Gargle warm salt water for a sore throat.
• Avoid smoke and strong fumes.

Medicines

• Steroid nasal sprays (fluticasone, budesonide, mometasone) for allergies and chronic rhinitis. They take a few days to work and are used daily.
• Antihistamines: non-drowsy ones for allergies. Older, sedating antihistamines dry secretions more and are sometimes used for cold-related drip, but cause drowsiness.
• Decongestants: sprays for no more than 3 days. Oral decongestants are not suitable with high blood pressure, heart disease or glaucoma.
• Ipratropium nasal spray (prescription) for very watery drainage.
• Reflux treatment: avoiding late meals, alcohol and trigger foods, raising the head of the bed, and acid-reducing medicine if advised.

Antibiotics only help if a bacterial sinus infection is diagnosed.

Frequently asked questions

Can drainage in the throat cause the throat to swell?

Yes, mildly. Constant mucus irritates the throat lining, which becomes red and swollen and can feel tight or full. You should still be able to swallow and breathe normally. Swelling that makes breathing or swallowing difficult is not caused by simple drainage and needs emergency care.

Why is throat drainage worse at night?

When you lie flat, mucus pools at the back of the throat instead of being swallowed, which triggers coughing and throat clearing. Reflux also worsens lying down. Raising your head, avoiding late meals and using a saline rinse before bed can help.

How long does drainage in the throat last?

With a cold, it usually clears within 10 days. Drainage from allergies lasts as long as the exposure. Drainage that lasts more than 3 weeks, or more than 10 days with facial pain, should be checked for sinusitis, allergy or reflux.

What color should throat drainage be?

Clear or white mucus is normal and common with allergies and early colds. Yellow or green mucus is common during a cold and does not by itself mean a bacterial infection. Blood-streaked mucus, or mucus from one side only, should be checked by a doctor.

Is drainage in the throat contagious?

The drainage itself is not, but the cause may be. Colds and other viral infections spread easily for the first few days. Drainage from allergies, reflux or non-allergic rhinitis is not contagious.