Post-nasal drip
Excess mucus from nasal mucosa drips down the throat.
Post-nasal drip (PND), also known as upper airway cough syndrome (UACS) or idiopathically as catarrh, occurs when excessive mucus produced by the nasal mucosa accumulates in the back of the nose and eventually drips down the throat. It is a common condition associated with chronic cough and can be caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or swallowing disorders, among other factors. Some researchers argue that the flow of mucus down the back of the throat is a normal physiologic process, and they challenge the classification of post-nasal drip as a syndrome, viewing it instead as a symptom, noting the lack of an accepted definition, pathologic tissue changes, and biochemical tests.
- field
- Medicine
- known_for
- Excessive mucus production causing throat discomfort and chronic cough
- causes
- Rhinitis, sinusitis, GERD, swallowing disorders, allergies, cold, flu, medication side effects
- symptoms
- Sensation of dripping in throat, rhinorrhea, throat clearing, cough
- treatment
- Antibiotics, antihistamines, intranasal steroids, decongestants, anticholinergics, saline irrigation
Lore & Background
Post-nasal drip is characterized by the constant presence of discomfort in the upper airways, classically described as a sensation of a substance dripping down the throat. It may also present with rhinorrhea, constant throat clearing, and cough, though symptoms can be very nonspecific. It is one of the most common causes of chronic cough, defined as a cough persisting beyond eight weeks, and can lead to laryngeal inflammation and hyperresponsiveness, contributing to vocal cord dysfunction.
Reader's Guide
The condition has multiple causes, both acute and chronic. Gastroesophageal reflux disease (GERD) is often associated with upper-respiratory symptoms similar to those of PND, such as coughing, throat clearing, hoarseness, and voice changes, with reflux causing throat irritation that aggravates or causes post-nasal drip. Allergic rhinitis, triggered by allergens, releases histamine and other inflammatory mediators, leading to sneezing, rhinorrhea, itchy eyes, and nasal congestion, which can result in PND. Non-allergic rhinitis, including hormonal, medication-induced, atrophic, and irritant forms, also produces symptoms without positive allergy tests. Rhinosinusitis, inflammation or infection of the sinus cavities, can cause persistent irritation and increased mucus production. Diagnosis relies on detailed history and clinical examination, often using nasoendoscopy to visualize mucopurulent secretions. Treatment varies by cause, including antibiotics for bacterial sinusitis, avoidance of allergens, antihistamines, intranasal steroids, decongestants, anticholinergics, and in some cases, proton pump inhibitors like lansoprazole. Saline nasal irrigation and warm fluids may help manage symptoms, though their efficacy is unclear.
Did You Know?
- Some researchers argue that mucus flow down the back of the throat is a normal physiologic process in all healthy individuals.
- Post-nasal drip is one of the most common causes of chronic cough, defined as a cough persisting beyond eight weeks.
- Non-allergic rhinitis, a cause of PND, is more common in females than in males.
- One study found that symptoms of postnasal drainage improved after 8 to 16 weeks of lansoprazole 30 mg taken twice daily, regardless of typical GERD symptoms.
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