Something Is Dripping, Dear

And I don't think it's the faucet in the bathroom.

When the nose runs, the throat suffers from excess swallowing, and the cough reflex is frequent, allergy may be the cause. Or, perhaps not, since all that drizzles is not hay fever.

Springtime and early summer make up a major portion of the allergy year. During the " To Your Health" segments of the evening news, allergists are quoted giving their opinions about why things are "so much worse this year." One of the reasons is, "When it's so dry, the pollens blow around more." Another is the statement, "When it has been such a wet year, there is more pollen, so allergies are worse." Thus it appears there is an explanation built to fit every situation, even those which are diametrically opposed.

Don't be quick to criticize the allergists - they are on target with both statements. For their patients, a perfect season would be slightly humid, not too hot, with calm winds. We aren't aware of a place where these conditions prevail. Maybe an island in the Mediterranean would offer such a climate.

There is a built-in human air cleansing and moistening system. It is the constantly flowing "blanket" of light, clear, mucus whose course is backward through the nose and down the throat. Except for post-radiation patients, all of us have this flowing stream, and we are not aware of it as long as the flow isn't excessive or (beg your pardon) thick and sticky. We simply swallow it along with the saliva that joins up from our mouths. Therefore, EVERYONE, including Tom Cruise, Cindy Crawford, and Ralph Nader, has a post-nasal drip! (or PND)

In two circumstances, PND becomes symptomatic. The first is when the volume gets turned up on high (perhaps, but not always, due to an allergy). The second is when the fluid changes from thin and watery to thick and viscous (think of going from chocolate milk to chocolate syrup and you get the idea). This is rarely due to an allergy, and is the result of a combination of things, at times including infection and exposure to atmospheric irritants. If you want to stop the PND it is necessary to know the origin, since treatment improperly used for one cause may worsen the other.

Specifically, if allergy is the problem, antihistamines will usually diminish the volume of secretions. (They will most certainly help with the sneezing and itchy eyes.) Less volume means less to drip back down there and make you swallow and swallow and ---. This is a good thing if not overdone. Nasal cortisone sprays will work this way to a lesser degree.

When PND is not of allergic origin, treating it with antihistamines will have undesirable results, the main one of which is a thicker, stickier mucus. This is much harder to tolerate, and may lead to more nasal congestion. Non-allergic PND can be relieved by non-drug methods, such as breathing cleaner and well-humidified air. (To prove this, next time it happens to you, get in the shower and see how much better you feel.) If you can afford the doctor visit and the drug's cost, a trial of one of the nasal cortisone sprays might give some relief. Clear liquids, like chicken soup and tea or lemonade, enhance the liquidity of the mucus "blanket", and make it easier to tolerate the flow, so to speak.

PND of infectious origin, specifically that due to colds, should not be treated with antihistamines. After all, we want you to get rid of what's there, not keep it in your head somewhere. When it is associated with a troublesome cough, the same rules apply. Seldom does anyone with basically health lungs develop a truly significant problem as a result of PND.

There is a notch group. These patients fall into a space where neither allergy nor atmospheric irritants can explain their symptoms. The condition has been called "vaso-motor" rhinitis, and it's chronic and hard to treat. Breathing in clean humidified air will help, but not cure this problem, and your doctor will almost always give the cortisone spray a trial. (For best results see above re' "Mediterranean island", then go there.)

The life-long victim of PND needs to find a mate who can tolerate the morning throat clearing ritual characteristic of the condition. Those opposed to pre-marital cohabitation may not learn of this until it is too late, usually a few years post-honeymoon. Then it gets messy, with dividing stuff up, and assigning custody of various things, like children.

(There are a few recorded cases where the criminal justice system has become involved: "I'm sorry, your honor, but I just had to do it. I couldn't stand the harking and borking one more day!")