2 years of throat clearing, thick mucus and post nasal drip sensation (allergy/reflux/nerve?)

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Suffering for 2 years with sensation of thick mucus stuck at the back of the nose, which I'm often able to hock up out of my mouth (clear but very "snotty" and like thick glue when it's in a tissue).

Sometimes it gets in my throat and I often clear my throat all day long too. I guess this is post-nasal drip, but not watery or thin (like you apparently get from an allergy), it's very thick and feels awful like a lump or glob that won't move, until I hock it up, but within minutes it's back again...

Tried all reflux and allergy medications (double-dose PPIs, steroid sprays, allergy RAST tests, antihistamines, singulair, antihistamine sprays, nasal irrigation, gastrocopy, multiple nasal/throat endoscopes, sinus CT scans), and they can't identify the problem... All of my symptoms disappear completely, when I eat or lay down with my head to either side (which I find very odd! Equally, if I take pseudoephridrine (oral decongestant), my symptoms go too (but I know that's not a long term option).

Anyone ever dealt with anything similar or know what to suggest next?I've been thinking of self-treating with amitriptyline (10mg at night) and gabapentin (100mg 3x per day), to see if this is a hypersensitivity/nerve issue. I have absolutely no other symptoms and can't live much longer like this, it's completely ruined my life and things are just getting worse sad

Thanks for any help at all.

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  • Posted

    Sounds similar in some ways to my experience. I have the same thick, sticky (but usually clear) mucus that is very hard to dislodge, and in my case it seems to get stuck inside my nose (and possibly sinuses?), and when I get a bad built-up, it does something weird to my sense of smell. I get an unpleasant smell that lingers and distorts normal smells. For me, eating can actually trigger it, and can be ruined by it, as flavour is really as much to do with smell as taste.

    In my case, lying on my side (right in particular) relieves it too - I breathe through my mouth, and after a short while I start to feel a popping sensation inside my nose as the airway presumably clears / opens up, and then the bad smell disappears (but sometimes reappears when I get up again). It's intriguing and maddening in equal measure, as no ENT specialist has been able to tell me what is going on (and I've seen at least a dozen). Nor have I had any firm explanation as to whether the mucus is normal, and if not, what's causing it. The closest I've come is being confirmed with a dust mite allergy, so perhaps that's the cause in my case. I also have a deviated septum and restricted breathing on the left side, so I wonder if it's partly down to that too. I often feel like it's not regarded as particularly important - unfortunately those who've never experienced it (and desensitised medics in particular) can't understand what an impact it can have on quality of life.

    Anyway, in terms of relief, the only things I've found to help (apart from lying on my side) are a nasal rinse with a solution of sea salt and xylitol (< which really seems to make a difference in terms of drawing out the gunk), and a nasal spray called Avamys, which seems to work miles better than any other I've tried (but still doesn't prevent the problem altogether).

    I've had nightly amitriptyline (5-10mg) incidentally, and it hasn't made any difference to the nasal issue.

    Hope some of that helps, and good luck.

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    • Posted

      Hi Larches - many thanks for your detailed inputs. I'm sorry to hear you are suffering with somewhat very similar debilitating symptoms. I agree that docs don't really sympathise with the issues because it's not "serious", or "won't kill you", etc.they certainly don't understand the mental drain such symptoms can have on a person after such a long period of suffering with them...

      Have you ever had your throat or gut explored at all? Do you experience the chronic "fullness" or throat clearing? Just curious to know if you've ever been treated for non-acid reflux because I'm told the thick/sticky mucus is not very common for anything triggered in the nasal area or with allergies (it's usually thin, watery and excessive). Unfortunately I tried an aggressive reflux treatment of a 2 week restricted diet followed by 6 weeks of protonix 2x per day at 40mg (so 80mg per day in total). It didn't do anything for me, but I know that plenty of others have been successfully treated of nasal congestion and post-nasal drip (with thick mucus), with this type of regimen for a couple of months...

      Several of the ENTs I worked with were convinced it was reflux because my sinuses are completely clear with minor- swelling on one side (swelling which apparently would be seen in 90 of 100 normal sinuses on the street). I understand the sinuses are the only other thing that can cause chronic thick mucus regardless of the environment you're in.

      Interestingly, I tried about 6 different nasal steroid sprays over the course of 18 months, and I had some success only with Omnaris. I tried Avamys and that didn't do anything. Unfortunately though, I had to stop with the steroid sprays because they were giving me perioral dermatitis around my nose and eye, which kept spreading and looked gross!! I had to be treated with 3 months of antibiotics to clear that. I even retried the spray again after when it had cleared and low and behold the dermatitis returned in 2 weeks!

      The xylitol option sounds like an interesting addition to the nasal rinse. I'll certainly try that. I'm also still going to self-pursue the option of Amitriptyline in addition to gabapentin (just from all the research I've done, and if I don't try it I'll never know!).

      Another thing to explore is a vitamin deficiency which can be done through a basic blood test. I've read a lot that this can cause immense system responses. Not highly optimistic but what else is there to do!!

      Lastly, I do find it odd that Pseudoephedrine is the only thing that works for me. This is because it apparently dries up my already very thick mucus? I know it also expands the tubes to clear the congestion, but not all of the time my nose is actually blocked, rather it's the sensation of the thick plugged feeling at the back of it somewhere. I too have a deviated septum (just mild), and every doc has said it wouldn't make any difference if I had surgery to it.



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    • Posted

      Hi derekjp,

      Sorry it's taken a while to reply. I'm pretty sure I did have my throat checked out a long time ago and nothing of interest was found, but at one point I was prescribed Omeprazole for acid reflux, which I took for quite a while but it didn't seem to make a great deal of difference to the nasal symptoms. I stopped taking that after getting recurrent water infections - the doctor was adamant it would be nothing to do with the Omeprazole, but I just found it strange that it seemed to coincide with me taking it and I've not had another infection since I stopped taking it.

      I've never tried Omnaris, but I think I'll persist with my low maintenance dose of Avamys as long as it doesn't cause me any other problems (I was a bit concerned at first when using a higher dose as it gave me a peculiar sensation (a bit like pressure), I think around my eye, but that seems to have eased off now).

      I too was told that a septoplasty may well make no difference to my symptoms... although it could ease breathing on the affected side, and I often wonder if that (and obstructed drainage) is part of the problem. However, surgery is never something to be embarked upon lightly, and I've more or less been told several times that it's not a worthwhile gamble (and in fact there's a real, if not huge, risk of worsening things).

      I'm pretty sure I've been checked on the vitamin front. I've had at least a couple of separate multi-purpose blood tests and they were all fine except for the mild dust allergy (so I was advised to wash my bedding more frequently at at 60 degrees which I'm now doing).

      Anyway, you seem to be doing the right thing in doing your own research and trying options systematically, so best of luck with that.

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    • Posted

      My son has put up with all this for over 2 years it’s crazy doctors know nothing they give him all sorts of medication but nothing works he had a operation it did but hi g so he had his aidnoids out for nothing I wish some one could help it’s make school hard he’s withdrawn from lots of things 
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  • Posted

    Derekjp, I googled post nasal drip and mucus and found your post. After reading it, I registered just to tell you I could've written your post. I read it out loud to my husband & he said "Wow...you could've written that yourself!". I too have tried absolutely everything. And like Larches, I also have a deviated septum (right side), and a severe dust mite allergy (received allergy shots for years...can't imagine how worse off I would be if I hadn't.), among other seasonal (as in every season) allergies. I walk around day and night clearing my throat and doing a cough that people always think is a sneeze. I have asthma that only flares up a couple times a year as long as I take my singulair and symbicort. And from what my Dr. tells me that cough is common for asthmatics. I sleep propped up (but always wake up laying down on my left side).

    Also for me the only thing that gives me any kind of relief is pseudoephedrine but I also add guaifenesin (pills, not syrup) to help thin the mucus and when I remember, drink lots of water. I also try to stay away from ice cream.

    I don't know if you have trouble with your sinuses or not but I've been known to say "tell me again why we need these damn sinuses?" My sinuses can become inflamed out of the blue. And the thing is, unlike when I have a cold, they're not congested, and my nose doesn't drip. They are just inflamed & it causes a burning pain &/or sinus pressure headaches. Humidifiers and keeping my sinuses moist does help. But for them to never become inflamed I'd have to have a netipot, or saline spray up my nose 24/7. And I'm sorry but that's just not a good look for me... smile There are also nasal gels that can keep your sinuses moist, but they only work for short periods.

    Anyway, you're not alone. If I find the magic cure I'll let you know, as long as you do the same!


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    • Posted


      This might be applicable to the others in the thread as well. I have similar symptoms and a deviated septum. According to my regular doctor my septum was deviated only slightly, but the symptoms were annoying enough I went to an ENT. He thought my septum was deviated enough that surgery was recommended. On top of the deviated septum my Nasal Valves are collapsed, exacerbating the problems. I have not had the surgery yet, since I am hoping things clear up with a new nasal spray prescription but it is looking more and more like I will go under the knife. 

      The point of the post I guess is to see an ENT, if possible, because what your GP thinks is slight might actually be more deviated than thought.

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