Hi doctor, I am a 25 year old man. It is about 4 years that I am experiencing chronic sputum production which I feel is originated from my nasopharyngeal or oropharyngeal region. It does not pain or itch and the quantity too is less. In the first year of its development it was mostly white in color but sometimes yellow and difficult to remove. Many of my doctors did not take it serious and just adviced me to wash regularly with normal saline. It gets a little bothering sometimes especially in morning after waking up or late at night or after eating some special meals or juices like orange juice which are sweet, but I think it should not be an allergy. It does not go inside my stomach by swallowing my mouth secretions and are very difficult to get out. All my other hematology, biochemistry and hormone profiles have been normal during these 5 years. I am having issue only with the sputum. It was cultured once, but no bacteria was grown. Please help to get rid of that. Thanks for your advice in advance.
Hello. This is post nasal drip. It has a multitude reasons for its evolution and for disturbing all over this long period.  Nasal septal defects like deviated nasal septum (DNS), stones in nose and polyps in nose are some of the reasons. Long-standing Inflammation of sinus mucosa around nose also causes such issues. Chronic tonsil infection, pharynx infection or stones on tonsils may be other causes. 1. Radiologic investigation for anatomy of nose and paranasal sinuses. 2. CT scan is mandatory. 1. You need to consult an otorhinolaryngologist for thorough evaluation. He may need to go for urgent sputum culture and sensitivity testing and an antibiotic accordingly if bacterial infection is the cause. If fungal infection, antifungals are needed then. Viral does not remain so long usually.  2. If anatomic defect is found he may go for a surgical repair.  3. Medication may be decided according to ENT evaluation because in such chronic cases hit and trial method is not acceptable for treatment.