Chronic Runny Nose and Post-Nasal Drip: Rhinitis, Sinusitis and Treatment Options

A constant runny nose or post-nasal drip can be miserable. Patients often describe needing tissues all day, clearing the throat, coughing, waking with mucus, or feeling that fluid is always running down the back of the nose.

The cause is not always allergy. Chronic nasal drip can be due to allergic rhinitis, non-allergic rhinitis, chronic sinusitis, nasal polyps, medication effects, reflux, environmental triggers or nerve overactivity in the nose.

At Hampshire ENT Clinics, Mr Tim Biggs and Mr Steve Hayes assess patients with chronic rhinitis, post-nasal drip, chronic sinusitis and nasal blockage. The aim is to identify the cause and create a treatment plan that is more precise than simply “try another spray”.

Quick answer: what causes chronic runny nose?

Common causes include allergic rhinitis, non-allergic rhinitis, chronic sinusitis, nasal polyps, irritant exposure, temperature change, medication effects and age-related nasal drip. Treatment depends on the cause and may include saline rinses, steroid sprays, antihistamine sprays, anticholinergic sprays, sinus treatment or posterior nasal nerve procedures in selected patients.

Allergy versus non-allergic rhinitis

Allergic rhinitis is driven by an immune response to allergens such as pollen, house dust mite, animals or mould. Symptoms often include sneezing, itching, watery discharge and eye irritation.

Non-allergic rhinitis can cause similar congestion and runny nose, but triggers may include cold air, eating, alcohol, strong smells, smoke, weather changes or exercise. Itching and eye symptoms may be less prominent.

Distinguishing the two matters because treatment emphasis may differ.

Post-nasal drip and chronic cough

Post-nasal drip can irritate the throat and contribute to chronic cough, throat clearing, hoarseness or a sensation of mucus. Some patients are investigated for chest problems when the upper airway is a major contributor.

The nose, sinuses, throat and larynx work together. A good ENT assessment considers the whole upper airway rather than treating each symptom in isolation.

Could it be sinusitis?

Chronic sinusitis can cause nasal discharge, post-nasal drip, blockage, reduced smell and facial pressure. If symptoms persist for more than 12 weeks or are associated with polyps, recurrent infections or reduced smell, sinus assessment may be needed.

Nasendoscopy and CT scanning can help distinguish rhinitis from sinusitis and identify whether surgery might be useful.

First-line treatments

Treatment often starts with saline rinses and regular intranasal medication. Steroid sprays can reduce inflammation in allergy, rhinitis and sinus disease. Antihistamine sprays can be useful in allergic and some non-allergic rhinitis. Anticholinergic sprays may help watery rhinorrhoea, particularly when dripping is the dominant symptom.

Technique matters. Many sprays fail because they are used intermittently or sprayed directly at the septum rather than toward the outer wall of the nose.

When sprays are not enough

Some patients continue to have troublesome watery nasal drip despite appropriate medical treatment. In selected cases, treatment aimed at the posterior nasal nerve may be considered. This includes procedures such as cryotherapy, sometimes known by device names such as ClariFix.

These treatments aim to reduce overactive nerve signalling that contributes to excessive nasal secretions. Suitability depends on diagnosis, symptom pattern and previous treatment response.

What is ClariFix-style cryotherapy?

Cryotherapy treatment uses controlled cold energy inside the nose to target the posterior nasal nerve region. It is not a treatment for every type of nasal blockage or sinus disease, but it may help selected patients with chronic rhinitis and persistent watery rhinorrhoea.

Patients need assessment first to ensure symptoms are not mainly due to nasal polyps, chronic sinus infection, structural obstruction or another cause.

Why specialist assessment helps

Chronic nasal drip is often treated generically for years. A rhinology assessment can identify whether the problem is allergic, non-allergic, sinus-related, structural or mixed. This allows treatment to be targeted properly.

Mr Tim Biggs and Mr Steve Hayes lead the Hampshire ENT Clinics rhinology service, providing consultant-led care for chronic runny nose, rhinitis, post-nasal drip, sinusitis and nasal obstruction.

When to book an appointment

Consider ENT assessment if your runny nose or post-nasal drip has lasted more than a few months, is affecting sleep or work, has not responded to usual sprays, is associated with chronic cough, reduced smell, nasal blockage, recurrent infections or one-sided symptoms.

Hampshire ENT Clinics provides nasal and sinus assessment across Winchester, Portsmouth, Salisbury and the wider South Coast.

Frequently asked questions

Is a constant runny nose always allergy?

No. Non-allergic rhinitis, sinusitis, medication effects and nerve overactivity can all cause chronic nasal drip.

What is post-nasal drip?

Post-nasal drip is the sensation of mucus running down the back of the nose into the throat. It can cause throat clearing and cough.

Can sinusitis cause post-nasal drip?

Yes. Chronic sinusitis can cause ongoing discharge, post-nasal drip, blockage and reduced smell.

Which nasal spray is best for runny nose?

It depends on the cause. Steroid sprays, antihistamine sprays and anticholinergic sprays all have different roles.

Why do nasal sprays not work for me?

The diagnosis may be wrong, the technique may be poor, the treatment may not have been used long enough, or a different treatment may be needed.

Can eating trigger a runny nose?

Yes. Gustatory rhinitis causes watery nasal drip with eating, particularly spicy or hot foods.

What is non-allergic rhinitis?

It is nasal inflammation or overactivity not driven by a classic allergy. Triggers include temperature change, smells, alcohol, weather and irritants.

What is ClariFix?

ClariFix is a cryotherapy treatment aimed at the posterior nasal nerve region in selected patients with chronic rhinitis and watery nasal drip.

Do I need a CT scan for post-nasal drip?

Not always. CT may be needed if chronic sinusitis, polyps or structural disease is suspected.

Who treats chronic runny nose at Hampshire ENT Clinics?

Mr Tim Biggs and Mr Steve Hayes assess and treat chronic rhinitis, post-nasal drip and sinus-related nasal symptoms.