37:
320:
Because PND is often characterized as a "symptom" rather than a separate condition, the exact incidence is unknown and varies by its etiology. Chronic rhinitis, which includes allergic and non-allergic rhinitis, can affect 30-40% of the population. Non-allergic rhinitis is more common in females than
277:
Treatment options depend on the nature of an individual's post-nasal drip and its cause. Antibiotics may be prescribed if the PND is the result of bacterial sinusitis. In cases where PND is caused by allergic rhinitis or irritant rhinitis, avoidance of allergens or irritating factors such as dander,
221:
is inflammation or infection of the sinus cavities. Acute rhinosinusitis has symptoms lasting less than four weeks, while chronic rhinosinusitis lasts greater than 12 weeks. This persistent irritation can lead to increased mucus production as a result of pro-inflammatory pathways, producing symptoms
251:
Diagnosis of PND depends on both a detailed history and clinical examination to help determine its etiology. The history may begin with feelings of obstructed nasal breathing or "stuffy nose" with or without nasal discharge. If allergic rhinitis is suspected, a family history of allergic conditions
129:
PND may present itself through the constant presence of discomfort in the upper airways. It is classically described as the sensation of a substance "dripping down the throat" and may also present with rhinorrhea, constant throat clearing, and cough, although its symptoms can be very nonspecific.
260:
can be evaluated. Allergic rhinitis classically has more symptoms of sneezing attacks, itchy eyes, and respiratory problems, although it is difficult to distinguish the different types of rhinitis by symptomology alone. Visual inspection can reveal mouth breathing, which is suggestive of nasal
120:
However, some researchers argue that the flow of mucus down the back of the throat from the nasal cavity is a normal physiologic process that occurs in all healthy individuals. Some researchers challenge post-nasal drip as a syndrome and instead view it as a symptom, also taking into account
264:
In the absence of any specific diagnostic tests, it may be difficult to diagnose PND from history of symptoms alone, as the etiology is broad and the symptoms may be very general. As such, suggestive procedures that highlight rhinitis and mucopurulent secretions, such as
293:
Intranasal steroids may also be beneficial in patients who do not respond to antihistamines. In one meta-analysis, intranasal steroids were shown to improve symptoms of non-allergic rhinitis at four weeks better than a placebo. Decongestants such as
239:; specifically, cholinergic neuropeptides are responsible for increasing mucus production. Excess mucus can drain posteriorly into the upper and lower airways, which, along with other physical and chemical irritants, can activate receptors in the
234:
serves to filter and regulate the temperature and humidity of inspired air. The nasal mucosa can produce secretions, or mucus, that provides lubrication and protection for the nasal cavity. This mucus production is activated by the
187:
Non-allergic rhinitis (NAR) is a condition in which there are symptoms of rhinitis, including rhinorrhea and nasal obstruction, but with negative skin and serum allergy testing results. It can be further categorized into:
278:
cigarette smoke, and cleaning supplies may be beneficial. Antihistamines are particularly useful for allergic rhinitis and may be beneficial in some cases of non-allergic rhinitis. First-generation antihistamines such as
1063:
1048:
121:
variation across different societies. Furthermore, this rebuttal is reinforced because of the lack of an accepted definition, pathologic tissue changes, and available biochemical tests.
312:
Other methods, such as drinking warm fluids and using saline nasal irrigation, may be useful for managing symptoms of PND but their exact efficacy is unclear in medical literature.
1137:
290:, a topical antihistamine, is approved for both allergic and non-allergic rhinitis due to its unique anti-inflammatory effects separate from its histamine receptor antagonism.
817:"Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines"
160:(GERD) is often associated with a high prevalence of upper-respiratory symptoms similar to those of PND, such as coughing, throat clearing, hoarseness and change in voice.
230:
The exact mechanism of PND depends on its etiology, but usually involves increased production of mucus from the nasal mucosa. In addition to providing sense of smell, the
164:
causes throat irritation, leading to a sensation of increased mucus in the throat, which is believed to aggravate and, in some cases, cause post-nasal drip.
1130:
175:(AR) is a common condition where exposure to allergens results in the release of inflammatory mediators, such as histamine, that causes sneezing,
1123:
672:
269:, may instead be utilized because of the vague nature of information available to directly attribute specific symptoms to the syndrome.
1016:
859:
Segboer C, Gevorgyan A, Avdeeva K, Chusakul S, Kanjanaumporn J, Aeumjaturapat S, et al. (Cochrane ENT Group) (November 2019).
1499:
799:
648:
286:
are more potent but have greater sedatory effects; later-generation antihistamines may be used to reduce these effects.
298:
can tighten blood vessels of the nasal mucosa and result in a decrease in mucus production. Anticholinergics such as
959:"Is empiric proton pump inhibition in patients with symptoms of extraesophageal gastroesophageal reflux justified?"
161:
157:
98:
1341:
689:
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. (April 2015).
1505:
102:
1524:
137:
Post-nasal drip can be a cause of laryngeal inflammation and hyperresponsiveness, leading to symptoms of
1115:
1441:
179:, itchy eyes, and nasal congestion. The increased rhinorrhea and mucus production can result in PND.
236:
1618:
1519:
1436:
1241:
138:
1110:
89:, and eventually in the throat once it drips down the back of the throat. It can be caused by
1336:
1231:
381:
Sylvester DC, Karkos PD, Vaughan C, Johnston J, Dwivedi RC, Atkinson H, Kortequee S (2012).
1401:
1367:
1278:
1206:
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30 mg taken twice daily regardless of the presence or absence of typical symptoms of GERD.
1532:
8:
1285:
1067:
299:
54:
993:
958:
639:
Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, Lesperance MM (2014).
305:
One study has found that symptoms of postnasal drainage improved after 8 to 16 weeks of
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obstruction, or a horizontal crease across the nose (caused by the "allergic salute").
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Irritant and occupational rhinitis (including tobacco smoke, cleaning supplies, etc.)
201:
172:
49:
724:
600:
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can help reduce secretions by blocking parasympathetic effects on the nasal mucosa.
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as well as a personal history of other associated conditions such as food allergy,
1096:
833:
816:
30:
Upper airway cough syndrome, postnasal drainage, UACS, or post nasal drip syndrome
1579:
1571:
1483:
1406:
1295:
925:
434:"Treatment of Unexplained Chronic Cough: CHEST Guideline and Expert Panel Report"
432:
Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS (January 2016).
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82:
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1002:
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592:
551:
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467:
418:
362:
341:
Morice AH (2004). "Post-nasal drip syndrome--a symptom to be sniffed at?".
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231:
449:
399:
383:"Chronic cough, reflux, postnasal drip syndrome, and the otolaryngologist"
1546:
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1145:
791:
110:
1040:
1552:
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1473:
1431:
1391:
530:
Gimenez LM, Zafra H (April 2011). "Vocal cord dysfunction: an update".
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86:
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1300:
1258:
1091:
957:
Fossmark, Reidar; Ness-Jensen, Eivind; Sørdal, Øystein (2023-09-06).
738:
McCallion P, De Soyza A (December 2017). "Cough and bronchiectasis".
688:
218:
114:
94:
36:
1458:
1446:
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1310:
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1211:
1186:
950:
90:
483:"Paradoxical vocal cord motion disorder: past, present and future"
1411:
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There are multiple causes of PND, which can be acute or chronic.
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253:
380:
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781:
78:
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Ibrahim WH, Gheriani HA, Almohamed AA, Raza T (March 2007).
480:
431:
956:
638:
1017:"Banishing Sinus Infection Misery? - Andrew Weil, M.D."
691:"Clinical practice guideline (update): adult sinusitis"
861:"Intranasal corticosteroids for non-allergic rhinitis"
1030:
969:(1). Springer Science and Business Media LLC: 303.
101:(GERD), or by a disorder of swallowing (such as an
243:that results in a protective physiological cough.
85:. The excess mucus accumulates in the back of the
737:
1610:
779:
684:
682:
641:Cummings Otolaryngology: Head & Neck Surgery
134:, defined as a cough persisting beyond 8 weeks.
910:"Anticholinergic drugs in nonallergic rhinitis"
192:Non-allergic rhinitis with eosinophilia (NARES)
775:
773:
771:
769:
564:
336:
334:
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130:PND is one of the most common etiologies for
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195:Hormonal rhinitis (such as during pregnancy)
865:The Cochrane Database of Systematic Reviews
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331:
1138:
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671:: CS1 maint: location missing publisher (
567:"Vocal cord dysfunction: what do we know?"
532:Annals of Allergy, Asthma & Immunology
35:
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832:
740:Pulmonary Pharmacology & Therapeutics
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343:Pulmonary Pharmacology & Therapeutics
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1111:Medline Plus article on Nasal Discharge
814:
387:International Journal of Otolaryngology
1611:
914:The World Allergy Organization Journal
340:
1119:
854:
852:
565:Kenn K, Balkissoon R (January 2011).
124:
117:, and side effects from medications.
695:Otolaryngology–Head and Neck Surgery
643:(Sixth ed.). Philadelphia, PA.
376:
374:
372:
167:
780:Probst R, Grevers G, Iro H (2017).
13:
849:
14:
1635:
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369:
213:
571:The European Respiratory Journal
1009:
901:
808:
315:
209:Idiopathic nonallergic rhinitis
158:Gastroesophageal reflux disease
99:gastroesophageal reflux disease
877:10.1002/14651858.CD010592.pub2
731:
558:
523:
474:
425:
1:
834:10.1378/chest.129.1_suppl.63s
324:
926:10.1097/WOX.0b013e3181b35336
487:Postgraduate Medical Journal
272:
246:
225:
103:esophageal motility disorder
7:
815:Pratter MR (January 2006).
198:Medication-induced rhinitis
71:upper airway cough syndrome
10:
1640:
976:10.1186/s12876-023-02945-7
908:Naclerio R (August 2009).
752:10.1016/j.pupt.2017.04.010
544:10.1016/j.anai.2010.09.004
355:10.1016/j.pupt.2004.09.005
1442:Precordial catch syndrome
1424:
1360:
1342:Cheyne–Stokes respiration
1324:
1266:
1257:
1157:
1082:
1034:
783:Basic Otorhinolaryngology
584:10.1183/09031936.00192809
144:
81:is produced by the nasal
77:), occurs when excessive
48:
43:
34:
26:
21:
708:10.1177/0194599815572097
499:10.1136/pgmj.2006.052522
237:autonomic nervous system
1525:Charcot–Leyden crystals
786:. Georg Thieme Verlag.
538:(4): 267–74, quiz 275.
152:
105:). Other causes can be
1242:Whispered pectoriloquy
139:vocal cord dysfunction
450:10.1378/chest.15-1496
183:Non-allergic rhinitis
1520:Curschmann's spirals
1368:Respiratory distress
1207:Pleural friction rub
963:BMC Gastroenterology
827:(1 Suppl): 63S–71S.
792:10.1055/b-005-148915
701:(2 Suppl): S1–S39.
400:10.1155/2012/564852
300:ipratropium bromide
55:Otorhinolaryngology
1561:pulmonary embolism
1533:chronic bronchitis
1373:Respiratory arrest
1352:Ataxic respiration
1347:Kussmaul breathing
1337:Biot's respiration
1332:Agonal respiration
1228:Elicited findings
1172:Respiratory sounds
1151:respiratory system
1147:Signs and symptoms
1083:External resources
125:Signs and symptoms
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1605:
1420:
1419:
1106:
1105:
801:978-3-13-203472-3
650:978-0-323-27820-1
258:atopic dermatitis
241:respiratory tract
202:Atrophic rhinitis
173:Allergic rhinitis
168:Allergic rhinitis
69:), also known as
60:
59:
16:Medical condition
1631:
1291:Hyperventilation
1264:
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1149:relating to the
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280:chlorpheniramine
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1609:
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1580:pulmonary edema
1572:Westermark sign
1489:Post-nasal drip
1484:Silhouette sign
1416:
1407:Mouth breathing
1356:
1320:
1296:Hypoventilation
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493:(977): 164–72.
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332:
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296:pseudoephedrine
275:
249:
228:
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63:Post-nasal drip
44:Post-nasal drip
22:Post-nasal drip
17:
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11:
5:
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1619:Nose disorders
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1402:Breath holding
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1035:Classification
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1027:External links
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577:(1): 194–200.
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1598:Golden S sign
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133:
132:chronic cough
122:
118:
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108:
104:
100:
96:
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88:
84:
80:
76:
72:
68:
64:
56:
53:
51:
47:
42:
38:
33:
29:
25:
20:
1586:Kerley lines
1578:
1567:Hampton hump
1559:
1545:
1531:
1512:
1498:
1488:
1237:Pectoriloquy
1222:Death rattle
1217:Bronchophony
1159:Auscultation
1090:
1062:
1047:
1011:
966:
962:
952:
920:(8): 162–5.
917:
913:
903:
868:
864:
824:
820:
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782:
743:
739:
733:
698:
694:
640:
574:
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560:
535:
531:
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490:
486:
476:
444:(1): 27–44.
441:
437:
427:
390:
386:
349:(6): 343–5.
346:
342:
319:
316:Epidemiology
311:
307:lansoprazole
304:
292:
276:
263:
250:
232:nasal cavity
229:
217:
186:
171:
156:
148:
136:
128:
119:
74:
70:
66:
62:
61:
1547:sarcoidosis
1437:In children
1279:Prematurity
1167:Stethoscope
27:Other names
1613:Categories
1553:Kveim test
1539:Reid index
1474:Hemoptysis
1432:Chest pain
1392:Aerophagia
1232:Percussion
393:: 564852.
325:References
321:in males.
288:Azelastine
284:clemastine
177:rhinorrhea
1624:Syndromes
1479:Epistaxis
1387:Trepopnea
1382:Platypnea
1378:Orthopnea
1316:Bradypnea
1306:Tachypnea
1301:Hyperpnea
1259:Breathing
1092:eMedicine
985:1471-230X
746:: 77–83.
667:cite book
659:894112159
273:Treatment
247:Diagnosis
226:Mechanism
95:sinusitis
50:Specialty
1459:Cyanosis
1447:Pleurisy
1397:Asphyxia
1311:Hypopnea
1247:Egophony
1212:Fremitus
1187:Crackles
1003:37674110
994:10483799
944:24228813
895:31677153
843:16428694
760:28602999
725:30043393
717:25832968
601:12436689
593:21205712
552:21457874
517:17344570
468:26426314
419:22577385
363:15564073
222:of PND.
91:rhinitis
1412:Snoring
1325:Pattern
1286:Dyspnea
1197:Stertor
1192:Rhonchi
1177:Stridor
1097:ent/338
935:3650956
886:6824914
508:2599980
459:5831652
410:3332192
107:allergy
1514:asthma
1494:Hiccup
1469:Sputum
1202:Squawk
1182:Wheeze
1073:784.91
1001:
991:
983:
942:
932:
893:
883:
871:(11).
841:
798:
758:
723:
715:
657:
647:
599:
591:
550:
515:
505:
466:
456:
417:
407:
361:
256:, and
254:asthma
162:Reflux
145:Causes
83:mucosa
1464:Cough
1425:Other
1361:Other
1274:Apnea
1058:R09.8
821:Chest
721:S2CID
597:S2CID
438:Chest
79:mucus
1500:COPD
1267:Rate
1068:9-CM
999:PMID
981:ISSN
940:PMID
891:PMID
869:2019
839:PMID
796:ISBN
756:PMID
713:PMID
673:link
655:OCLC
645:ISBN
589:PMID
548:PMID
513:PMID
464:PMID
415:PMID
391:2012
359:PMID
282:and
153:GERD
111:cold
87:nose
75:UACS
1064:ICD
1049:ICD
989:PMC
971:doi
930:PMC
922:doi
881:PMC
873:doi
829:doi
825:129
788:doi
748:doi
703:doi
699:152
579:doi
540:doi
536:106
503:PMC
495:doi
454:PMC
446:doi
442:149
405:PMC
395:doi
351:doi
115:flu
67:PND
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