Open Access Articles- Top Results for Post-nasal drip

Post-nasal drip

Post-nasal drip
Classification and external resources
ICD-10 R09.8
ICD-9 784.91
eMedicine ent/338
NCI Post-nasal drip
Patient UK Post-nasal drip

Post-nasal drip (PND, also termed upper airway cough syndrome, UACS, or post nasal drip syndrome, PNDS) 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.[medical citation needed]

There is a perspective that post-nasal drip is a poorly defined term that has become used by physicians to refer to different clinical entities. [1] For some, post nasal drip is used to refer to chronic cough, while many patients refer to post-nasal drip to a feeling of excess mucus in the back of the nose or throat (nasopharynx). In fact, most patients who have post-nasal drip do not experience coughing. This lack of unity in definition has been a problem for researchers studying cough and various causes of post-nasal drip.

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.[2]


Individuals may be diagnosed as suffering from post-nasal drip if they suffer from the following symptoms:

  • Coughing;
  • Wheezing
  • Constant swallowing, which can lead to an excessive amount of air in the stomach, causing discomfort;
  • Rhinorrhea, running nose due to mucus flow;
  • Frequent spitting;
  • Tickling in the throat;
  • Constant clearing of throat;
  • Rigid burning sensation at back of the throat;
  • Broken or cracking voice;hoarseness
  • Mucus feeling in the back of the throat;
  • Difficulty in breathing;
  • Congestion in the nasal and sinus passages;
  • Chronic sore throat;
  • Masses formed in the crypts of the tonsils that are generally yellow or white (commonly called tonsil stones, or tonsilloliths);
  • Halitosis (bad breath);
  • Snorting to clear mucus from the nasal passage that cannot otherwise be cleared by blowing one's nose;
  • Cobblestone appearance of the oropharyngeal mucosa;
  • Frontal cranial pressure;
  • Fatigue;
  • Nausea;
  • Vomiting.


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.[medical citation needed]


  1. ^ Morice, AH (2004). "Post-nasal drip syndrome--a symptom to be sniffed at?". Pulmonary pharmacology & therapeutics 17 (6): 343–5. PMID 15564073. doi:10.1016/j.pupt.2004.09.005. 
  2. ^ Rosenberg, M (1996). "Clinical assessment of bad breath: current concepts". Journal of the American Dental Association 127 (4): 475–82. PMID 8655868. doi:10.14219/jada.archive.1996.0239. 

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