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Patient Instructions

Nasal discharge is any mucus-like material that comes out of the nose.

Nasal discharge is common, but rarely serious. Drainage from swollen or infected sinuses may be thick or discolored.

Excess mucus may run down the back of your throat (postnasal drip) or cause a cough that is usually worse at night. A sore throat may also result from too much mucus drainage.

The mucus drainage may plug up the eustachian tube between the nose and the ear, causing an ear infection and pain. The mucus drip may also plug the sinus passages, causing sinus infection and pain.

• Bacterial infections
• Colds
• Flu
• Hay fever
• Head injury
• Nasal sprays
• Sinusitis
• Small objects in the nostril (especially in children)

Keep the mucus thin rather than thick and sticky. This helps prevent complications, such as ear and sinus infections, and plugging of your nasal passages. To thin the mucus:

• Drink extra fluids.
• Increase the humidity in the air with a vaporizer or humidifier.
• Use saline nasal sprays.

Antihistamines may reduce the amount of mucus. Be careful, because some antihistamines may make you drowsy. Don't use over-the-counter nasal sprays more often than 3 days on and 3 days off, unless told to by your doctor.

OVERUSE OF ANTIBIOTICS

Many people think that a green or yellow nasal discharge means a bacterial infection, which requires antibiotics. This is NOT true. Colds will often begin with a clear nasal discharge, but after several days it usually turns creamy yellow or green. Colds are caused by viruses, and antibiotics will not help. A green or yellow nasal discharge is not a sign that you need antibiotics.

• Drainage is foul smelling, one-sided, or a color other than white or yellow
• Nasal discharge follows a head injury
• Symptoms last more than 3 weeks
• Syptoms last more than 10 days in a child under 3 years old
• There is fever with nasal discharge

Your doctor may perform a physical examination, including an examination of the ears, nose, and throat.

Your doctor may ask medical history questions, such as:

• Is the discharge thin and watery, or is it thick?
• Is it bloody?
• What color is it?
• How long has the nasal discharge been present?
• Is it present all the time?
• What other symptoms are also present?
• Is your nose stuffy or congested?
• Do you have a cough or headache?
• Do you have a sore throat?
• Do you have a fever?

Tests that may be performed include:

• CT scan of the head
• X-rays of the skull and sinuses

For allergic rhinitis, the health care provider may prescribe antihistamines. Antibiotics should only be prescribed for bacterial infections.

Runny nose; Postnasal drip; Rhinorrhea

Bachert C, Gevaert P, van Cauwenberge P. Nasal polyps and rhinosinusitis. In: Adkinson NF Jr., Yunginger JW, Busse WW, Bochner BS, Holgate ST, eds. Middleton's Allergy: Principles and Practice. 6th ed. Philadelphia, Pa; Mosby Elsevier; 2003: chap 56.

Long SS. Respiratory tract symptom complexes. In: Long SS, Pickering LK, Prober CG. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008: chap: 23.

Orban NT, Saleh H,Durham SR. Allergic and non-allergic rhinitis. In: Adkinson NF Jr., Yunginger JW, Busse WW, Bochner BS, Holgate ST, eds. Middleton's Allergy: Principles and Practice. 6th ed. Philadelphia, Pa; Mosby Elsevier; 2003: chap 55.

Updated by: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.