Decreased secretions

1. Long term exposure to environmental irritants (such as cigarette smoke, industrial pollutants, and automobile fumes) which can dry and damage nasal mucous membranes. When secretions are reduced, they are usually thicker than normal and produce the false sensation of increased mucus.
2. Structural abnormalities (such as nasal septal irregularities) which alter air currents may then dry surrounding membranes. (Thus, depending on their type, structural problems can increase or decrease secretions.)
3. Age. Mucous membranes commonly shrink and dry with age, causing reduced mucous which is thicker than normal which the elderly perceive as PND.
4. Other less common disorders of the tissues lining the nose and sinuses can alter mucous production or flow.

Swallowing Problems

Swallowing is a complicated process by which food and fluid go from the mouth into the esophagus (tube connecting the throat to the stomach). It requires coordinated nerve and muscle interaction. In the mouth, throat, and esophagus swallowing problems may result in accumulation of solids or liquids in the throat, which can spill into the voice box (larynx) and breathing passages (trachea and bronchi) causing hoarseness, throat clearing, or cough.

Several factors contribute to swallowing problems:

With age, swallowing muscles often lose strength and coordination. Thus, even normal secretions may not pass smoothly into the stomach.

During sleep, swallowing occurs much less frequently, and secretions may accumulate; coughing and vigorous throat clearing are often needed when awakening.

At any age, nervous tension or stress can trigger throat muscle spasms, resulting in a sensation of a lump in the throat. Frequent throat clearing, which usually produces little or no mucus, can make the problem worse by increasing irritation.

Growths or swellings in the food passages

Swallowing dysfunction may be caused by gastroesophageal reflux, which is a return of stomach contents and acid into the esophagus or into the throat. Heartburn, indigestion, and sore throat are common symptoms, which may be aggravated while lying down especially following eating. Hiatal hernia, a pouch-like structure at the junction of the esophagus and stomach, often contributes to the reflux.

may slow or prevent the passage of liquids and/or solids.

Treatment

Before treatment is started, a diagnosis must be made, This requires a detailed ear, nose, and throat exam and possible laboratory, endoscopic, and x-ray studies.