Post-nasal drip
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| Post-nasal drip Classification and external resources |
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| ICD-9 | 784.91 |
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| eMedicine | ent/338 |
Post-nasal drip (PND) occurs when excessive mucus is produced by the sinuses. The excess mucus accumulates in the throat or back of the nose. It can be caused by rhinitis, sinusitis, or laryngopharyngeal acid reflux. It can be enhanced or sometimes even caused by allergies, whether in spring, fall or early summer.
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[edit] Terminology
The term PND is considered obsolete by some sources and is now referred to as "Chronic Upper Airway Cough Syndrome".[1] However, the term "post-nasal drip" is still used in modern medical literature[2][3], though some do not consider the term to be well-defined.[4]
[edit] Associated conditions
PND may be, in some cases, a contributing cause for halitosis - bad breath arising from the posterior tongue dorsum. [5]
[edit] Symptoms
An individual may be diagnosed as suffering from post-nasal drip if they suffer from the following symptoms.
- Swallowing constantly
- Spitting (mucus) constantly
- Tickling in the throat
- Constant clearing of throat
- Mucus feeling in the back of the throat
- Difficulty in breathing
- Congestion in the nasal and sinus passages
- Chronic sore throat
- Crystals found in the tonsils that are generally yellow or white (commonly called tonsil stones, or tonsilloliths)
- Bad breath
- Coughing
- Feeling nauseated due to accumulation of mucus in stomach
- Vomiting due to excessive mucus in stomach
- Cobblestone appearance of the oropharyngeal mucosa[6]
[edit] Treatment
A person seeking treatment for post-nasal drip should see an otolaryngologist or family physician. For minor relief, drinking plenty of fluids, particularly hot water, can help.
Treatment may include antibiotics, nasal irrigation, or minor surgery.
Some people use bulb syringes, squirt bottles, and neti pots for nasal irrigation. Others use pulsating irrigation devices that deliver an intermittant pulsing saline rinse to remove bacteria, purulent material, and help restore ciliary function.
Many published medical reports indicate pulsatile lavage is more effective at cleansing and removing bacteria than non-pulsating nasal wash products like bulb syringes, neti pots and squeeze bottles, which rely simply on gravity and conventional flow. [7] [8] [9]
A pulsating nasal irrigation device delivers a controlled flow with pressure control that may be adjusted for individual comfort. Medical reports support that positive pressure irrigation retains a larger volume of solution and irrigates the sinuses more consistently than other methods. [10]
Other treatments, for the allergy aspect of the disorder, include the usage of antihistamines and/or decongestants to treat the most common effects. Steroids may also be prescribed for short-term usage, as extended use may cause harmful side effects.
A recent study has also shown that physiotherapy of the nasopharynx has been successfully employed to achieve a quick and effective treatment of symptoms [11].
[edit] External links
[edit] References
- ^ Pratter MR (2006). "Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines". Chest 129 (1 Suppl): 63S–71S. doi:. PMID 16428694.
- ^ Chao TK, Liu CM, Huang WH (2007). "Significance of blood-tinged post-nasal drip in paranasal sinus disease". The Journal of Laryngology & Otology: 1–4. doi:. PMID 17888198.
- ^ O'Hara J, Jones NS (2006). ""Post-nasal drip syndrome": most patients with purulent nasal secretions do not complain of chronic cough". Rhinology 44 (4): 270–3. PMID 17216744.
- ^ Morice AH (2004). "Post-nasal drip syndrome--a symptom to be sniffed at?". Pulmonary pharmacology & therapeutics 17 (6): 343–5. doi:. PMID 15564073.
- ^ Rosenberg M (1996). "Clinical assessment of bad breath: current concepts". Journal of the American Dental Association (1939) 127 (4): 475–82. PMID 8655868.
- ^ Chronic Cough RG. Retrieved on 2007-11-02.
- ^ Brown, LL; Shelton HT, Bornside GH, Cohn I Jr (1978 Feb). "Evaluation of wound irrigation by pulsatile jet and conventional methods" (abstract). Ann Surg. 187 ((2)): 170-73. PMID 343735.
- ^ Anglen, J; Apostoles S, Christensen G, Gainor B. R (1994 Oct). "The efficacy of various irrigation solutions and methods in removing slime-producing staphylococcus" (abstract). J Orthop Trauma 8 ((2)): 390-6. doi:. PMID 7996321.
- ^ Svoboda, SJ; Bice TG, Gooden HA, Brooks DE, Thomas DB, Wenke JC (2006 Oct). "Comparison of bulb syringe and pulsed lavage irrigation." (abstract). J Bone Joint Surg Am 88 ((10)): 2167-74. doi:. PMID 17015593.
- ^ Olson, DE; Rasgon BM, Hilsinger, RL Jr. (2002 Aug). "Radiographic comparison of three methods for nasal saline irrigation" (abstract). Laryngoscope. 112 ((8 Pt 1)): 1394-98. doi:. PMID 12172251.
- ^ Cegla UH, Jost H-J, Harten A (2003). "Changes in postnasal drip, dry cough, airway resistance and bronchial hyperreactivity in asthmatic patients as result of oscillating pep (RC-Cornet-N) treatment of the nasopharyngeal cavity". Atemwegs- und Lungenkrankheiten 29 (9): 428–36.
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