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, 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.

However, other researchers argue that mucus dripping down the back of the throat from the nasal cavity is a normal physiologic process that occurs in healthy individuals.[1] Post-nasal drip syndrome as a concept has been challenged due to a lack of an accepted definition, a lack of any pathologic tissue changes and no available biochemical tests. The phrase has been described as a "pseudo-syndrome" (i.e., not a real medical condition) which serves as a catch-all, waste-basket phrase that is unhelpful.[1]

Associated conditions

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] Post-nasal drip can be a cause of laryngeal inflammation and hyperresponsiveness, leading to symptoms of vocal cord dysfunction (VCD).[3][4]


First-generation antihistamine has been suggested as first-line therapy to treat post-nasal drip.[5]


  1. 1 2 Morice, AH (2004). "Post-nasal drip syndrome--a symptom to be sniffed at?". Pulmonary pharmacology & therapeutics. 17 (6): 343–5. doi:10.1016/j.pupt.2004.09.005. PMID 15564073.
  2. 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.
  3. Ibrahim, Wanis H.; Gheriani, Heitham A.; Almohamed, Ahmed A.; Raza, Tasleem (2007-03-01). "Paradoxical vocal cord motion disorder: past, present and future". Postgraduate Medical Journal. 83 (977): 164–172. doi:10.1136/pgmj.2006.052522. ISSN 1469-0756. PMC 2599980Freely accessible. PMID 17344570.
  4. Gimenez; Zafra. "Vocal cord dysfunction: an update". Annals of Allergy, Asthma & Immunology. 106 (4): 267–274.
  5. Irwin, Richard S.; Baumann, Michael H.; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher E.; Brown, Kevin K.; Canning, Brendan J.; Chang, Anne B.; Dicpinigaitis, Peter V.; Eccles, Ron; Glomb, W. Brendle; Goldstein, Larry B.; Graham, LeRoy M.; Hargreave, Frederick E.; Kvale, Paul A.; Lewis, Sandra Zelman; McCool, F. Dennis; McCrory, Douglas C.; Prakash, Udaya B.S.; Pratter, Melvin R.; Rosen, Mark J.; Schulman, Edward; Shannon, John Jay; Hammond, Carol Smith; Tarlo, Susan M. (January 2006). "Diagnosis and Management of Cough Executive Summary". Chest. 129 (1): 1S–23S. doi:10.1378/chest.129.1_suppl.1S.
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