Post-nasal drip
| Post-nasal drip | |
|---|---|
| Classification and external resources | |
| Specialty | Otorhinolaryngology |
| ICD-10 | R09.8 |
| ICD-9-CM | 784.91 |
| eMedicine | ent/338 |
Post-nasal drip (PND, or post nasal drip syndrome, PNDS, also known as Upper Airways Cough Syndrome, UACS) occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the throat or back of the nose. It is caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing (such as an esophageal motility disorder). It is frequently caused by an allergy, which may be seasonal or persistent throughout the year.
Associated conditions
Post-nasal drip is usually seen as being a pathology of the nose as mucus production is thought to originate there. It is typically seen as a symptom of rhinitis and sinusitis. The exact mechanism by which mucus hyper secretion occurs is not known but it may involve the immune system or the nervous system that regulates mucus production. It is likely that the difficulty with which many patients have expelling the mucus is due to tethering of mucin to the surface of goblet cells or due to an over expression of the gel forming mucin.
PND is suggested to be a cause of extra-oral halitosis, especially when a sinus infection is also present. Acid reflux or heartburn is believed to aggravate and in some cases cause post-nasal drip.[1]
Treatment
First and foremost, as the causes are manifold, a removal of those causes should be targeted. Treatment may include antibiotics, decongestants, nasal irrigation, sinus massage, acid control medication, allergy medication, and minor surgery. Bulb syringes, squirt bottles, pulsatile nasal irrigators or neti pots are often used for nasal irrigation. Allergy medications include antihistamines, decongestants, nasal steroids alone or in combination. Allergy injections may be used for long-term relief when allergy is the cause. Oral steroids may be prescribed for short-term use in some situations.
According to the evidence-based cough guidelines published by the American College of Chest Physicians in the January 2006 issue of Chest, a first-generation antihistamine should be employed as first-line therapy to treat post-nasal drip. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345522/)
References
- ↑ Rosenberg, M (1996). "Clinical assessment of bad breath: current concepts". Journal of the American Dental Association 127 (4): 475–82. doi:10.14219/jada.archive.1996.0239. PMID 8655868.
External links
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