Q I heard there are several causes of post-nasal drip. How can I tell whether mine is from rhinitis or from reflux?
A Post-nasal drip caused by rhinitis or sinusitis is usually worse during the day and changes with the season or environment, while reflux-related drip tends to worsen after meals, at night, and when lying down. In many cases the two overlap.
Detailed Answer
The key points for distinguishing the causes are as follows. Allergic rhinitis: accompanied by sneezing, clear runny nose, and nasal congestion, worsening in certain seasons or environments (dust, pollen). Chronic sinusitis: thick yellow secretions, accompanied by facial pressure and reduced sense of smell. Gastroesophageal reflux (LPR): worse after meals, with throat burning, hoarseness, and chronic cough, especially severe in the morning. Dryness and irritation: worse in winter with heater use, smoking, or in strongly air-conditioned environments. When the cause is unclear, nasal endoscopy or upper endoscopy may be needed, and a combined type involving two overlapping causes is also common.
Korean Medicine Clinic Perspective
Korean medicine looks at the body's response pattern rather than the cause itself. Clear, cold secretions are classified as Lung qi deficiency or cold-phlegm (han-dam), while thick, yellow secretions are classified as Lung heat or heat-phlegm (yeol-dam). This pattern differentiation is central to choosing the herbal decoction, so even for the same post-nasal drip, the prescription differs.
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