Catarrh: constant mucus in the nose and throat
Catarrh is an old word and not a very precise one. It names not a disease of its own but a state: the lining of the nose, the sinuses and the throat swells…
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Medicines commonly prescribed for Catarrh: constant mucus in the nose and throat
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: INJECTABLE, 100 mg/mlActive substance: acetylcysteineManufacturer: Kern Pharma S.L.Prescription requiredDosage form: EFFERVESCENT TABLET, 600 mgActive substance: acetylcysteineManufacturer: Zambon S.A.U.Prescription not requiredDosage form: EFFERVESCENT TABLET, 600 mgActive substance: acetylcysteineManufacturer: Bexal Farmaceutica S.A.Prescription required
Catarrh is an old word and not a very precise one. It names not a disease of its own but a state: the lining of the nose, the sinuses and the throat swells and makes more mucus than is needed. The nose feels blocked, something trickles slowly down the back of the throat, and there is a constant urge to swallow or clear it. Mucus in itself does no harm — it is how the airway washes viruses, dust and everything surplus out. The trouble is not the mucus but whatever set it off. Most often the cause is harmless and settles within a couple of weeks, yet there is a short list of signs that turn stubborn congestion into something else entirely. They are collected below and are worth reading even by someone certain they have an ordinary cold.
What it feels like
The set of sensations is much the same for everyone, even when almost nothing runs from the nose:
- the nose is blocked all the time, or blocks alternately on one side and then the other;
- there is a lump in the throat that will not swallow away;
- mucus trickles noticeably down the back wall of the throat — this is what is called post-nasal drip;
- the throat is scratchy in the morning and wants clearing, the voice goes, the cough is dry and nagging;
- the ears click and crackle and hearing feels muffled, as on a plane;
- the breath smells, and taste and smell are dulled;
- lying down makes everything worse, so the night and the moment of waking are the hardest.
Usually this drags on for a few days or a couple of weeks after a cold and then fades away. If the lump in the throat is there but there is no mucus and no blockage at all, the problem may not lie in the nose: acid coming up from the stomach and tension in the throat muscles behave in much the same way.
Where the mucus comes from
The lining answers a great many different irritants with swelling and extra secretion, and the sensations alone will not tell you which one. The commonest:
- viral infections — colds, flu, sinusitis; the mucus "tail" after them lasts longer than the illness itself;
- allergy: pollen brings seasonal flare-ups, house dust mite and animals a year-round version;
- a reaction of the blood vessels in the lining with no allergy at all — to cold air, spicy food, alcohol, strong smells, a change of temperature;
- dry air: there is no more mucus, but it thickens and clears less easily, so it feels like an excess;
- polyps, a deviated septum, enlarged adenoids in children — anything that mechanically stops the nose clearing itself;
- tobacco smoke and polluted air;
- stomach contents travelling up as far as the throat;
- medicines — decongestant drops used for too long, some blood pressure drugs, hormonal contraceptives; pregnancy belongs here too, blocking the nose with no illness behind it.
What helps at home
The best thing anyone can do unaided is to rinse the nose with a salt solution. It genuinely reduces both blockage and dripping, it is safe, and it is suitable for long-term use. A ready-made solution is sold in pharmacies; a home-made one uses boiled and cooled water — a teaspoon of salt and a pinch of bicarbonate of soda in half a litre. Untreated tap water is not used for this: it is fit to drink, not to put into the nose. Make the solution fresh each time, rinse leaning over the basin, and breathe through the mouth while doing it.
The rest helps more gently but takes some effort:
- humidify the air, especially through the heating season, and air the bedroom;
- drink to thirst — pouring litres of water into yourself achieves nothing, mucus does not thin out because of it;
- sleep on a high pillow so the mucus does not pool in the throat overnight;
- blow the nose gently and one nostril at a time: forceful blowing drives the contents into the sinuses and the ears;
- remove the obvious irritants — smoking, other people's included, aerosols, air fresheners;
- if you suspect house dust mite allergy, start with covers for the mattress and pillow and with washing bedding at a high temperature.
Pharmacy remedies and their pitfalls
Decongestant drops and sprays clear the blockage within minutes, and that is exactly why they are the trap people fall into most often. They are not used for more than five to seven days in a row: the lining adapts, and without the next dose the nose stops breathing altogether. Getting out of that state is harder than getting into it.
Steroid nasal sprays work differently — slowly, with a noticeable effect after one or two weeks of regular use — but they are the right choice where the problem has dragged on: allergy, polyps, chronic inflammation of the sinuses. Aim the spray at the outer wall rather than at the septum, otherwise nosebleeds follow. Antihistamines make sense only when the cause is allergic; on the rest they have no effect. Products that thin mucus help unpredictably. Antibiotics are useless in ordinary catarrh: the overwhelming majority of these cases are viral or not inflammatory at all. Choose the particular product with a doctor or pharmacist, especially if you already take something regularly.
When it is not simply mucus
Some signs turn a blocked nose from a domestic nuisance into something else. There are not many, and they are worth remembering.
- Persistent blockage on one side only, not clearing for weeks — particularly with blood mixed into the discharge, repeated nosebleeds, hearing loss or fullness in one ear, an enlarged gland in the neck, numbness of the cheek or double vision. A tumour of the nasal cavity or the nasopharynx can announce itself this way. It is rare, but a stubbornly one-sided nose is the only early signal, which is why it is always examined.
- Clear watery fluid dripping from one nostril, especially on bending forward, and slightly salty to taste — this is fluid leaking from inside the skull. It is commoner after an injury or nasal surgery, but happens without either.
- A temperature above 38, severe pain in the face, swelling and redness around the eye, the eye pushed forward or moving poorly, double vision, failing sight, severe headache, vomiting, confusion — this is a complication of sinus infection, and it does not wait until morning.
- A sense of smell that stays away for a long time, pus-like or bloody discharge for weeks, and any symptoms lasting longer than three months.
- In a child, one-sided nasal discharge with a bad smell: almost always a foreign body in the nose that has to be removed.
What a doctor can do
The doctor first examines the inside of the nose, if needed with a thin endoscope — the only way to see polyps, a deviated septum and the back of the nose, where nothing is visible from outside. What follows depends on the findings: allergy testing where allergy is suspected, a computed tomography scan of the sinuses for long-lasting symptoms or before surgery, a swab and an examination of the throat if the picture does not add up.
Treatment is aimed not at the mucus but at whatever produced it. Polyps are treated with a steroid spray, and if that fails, surgery is offered — after which the spray still has to continue, or the polyps come back. Allergy is treated with anti-allergy medicines and, where the situation fits, with allergen-specific immunotherapy. A badly deviated septum is straightened surgically, but only once it is proven that the septum is what obstructs the breathing. It is worth being ready for the possibility that in some people no clear cause is found: the aim then is not a permanent cure but symptoms one can live with, and rinsing remains the mainstay.
Online consultation
A remote appointment is well suited to exactly the question that gets in the way most: is this the ordinary tail end of a cold that will pass by itself, or a picture that calls for an ear, nose and throat examination? The doctor asks about the timing, the seasonality, whether the nose is blocked on one side or both, what you have already put into it and for how long — and that is usually enough to separate allergy from the aftermath of an infection and to catch in time the signs that require an endoscopic look. It is also the chance to sort out drops that have stopped working and to set out a clear plan for the coming weeks. The signs in the list above are not handled remotely: they need care in person, and anything involving the eye or the level of consciousness needs it urgently.
This material is for information only and does not replace medical advice.
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