Postnasal drip and postnasal drip-related cough

Yu, Jason L.; Becker, Samuel S.

doi:10.1097/moo.0000000000000226

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…The postnasal drip is likely to be the most important factor linking the nasal aspiration to an improvement of respiratory symptoms. A pharmacological treatment of upper airway inflammation may improve bronchial hyper-responsiveness and cough [ 15 – 19 ]. Our results suggest that - especially in children older than 24 months - even the simple mechanical removal of nasal mucus may improve symptoms of the lower airways and reduce the need of salbutamol.…”

Section: Discussionmentioning

confidence: 99%

The impact of nasal aspiration with an automatic device on upper and lower respiratory symptoms in wheezing children: a pilot case-control study

Pizzulli¹,

Perna

Bennewiz³

et al. 2018

Ital J Pediatr

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BackgroundThe impact of proper aspiration of nasal secretions during upper respiratory infection on the frequency and severity of symptoms of lower airways has never been investigated. The study was aimed at testing if cleaning the nasal cavities of children with recurrent wheezing using an automatic nasal aspirator improves the upper and lower respiratory symptoms during the cold season.MethodsParents of wheezing children (age 3-72 mo.) answered questionnaires and learned using a nebulizer equipped (cases) or not equipped (controls) with an automatic nasal aspirator (DuoBaby, OMRON, Japan). During a 90-days monitoring period parents filled an electronic diary (BreathMonitor, TPS, Rome, Italy) on their child’s symptoms of the upper and lower airways.ResultsEighty-nine/91 patients (43 cases, 46 controls) completed the study. Less days with upper (25.0% vs 46.4%, p = 0.004) or lower (21.8% vs 32.8%, p = 0.022) airways symptoms and less days with salbutamol inhalation (12.2% vs 16.9%, p < 0.001) were reported by cases than by controls. The episodes of upper respiratory symptoms were shorter [4.3 days (95%CI:3.8–4.9) vs 5.7 days (95%CI:5.0–6.4), p = 0.007] but not less frequent [2.3 (95%CI: 1.8–2.8) vs 2.6 (95%CI:2.2–3.0), p = 0.122] among cases than among controls. Similarly, the episodes of lower respiratory symptoms tended to be shorter [3.8 days, (95%CI: 3.4–4.2) vs 4.4 days, (95%CI: 4.4–6.0), p = 0.067] but not less frequent [1.9 (95%CI:1.5–2.3) vs 2.1 (95%CI:1.7–2.4), p = 0.240] among the group using the nasal aspirator.ConclusionsIn our pilot study, the use of an automatic nasal aspirator in children with a history of recurrent wheezing was associated with an improved respiratory health during the cold season.Electronic supplementary materialThe online version of this article (10.1186/s13052-018-0489-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The impact of nasal aspiration with an automatic device on upper and lower respiratory symptoms in wheezing children: a pilot case-control study

Pizzulli¹,

Perna

Bennewiz³

et al. 2018

Ital J Pediatr

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“…Another limitation is the question of whether there were some other causes in the patients with PND‐induced cough. The cough from PND may be related to an airway sensory hypersensitivity rather than actual irritation from inflamed nasal secretions 28 . The issues of PND are further complicated by the fact that gastro‐esophageal reflux disease can often co‐exist with or mimic PND 29 .…”

Section: Discussionmentioning

confidence: 99%

“…The cough from PND may be related to an airway sensory hypersensitivity rather than actual irritation from inflamed nasal secretions. 28 The issues of PND are further complicated by the fact that gastro-esophageal reflux disease can often co-exist with or mimic PND. 29 We diagnosed PND-induced cough based on a sensation of nasal drip in the throat, but further research is required to define the phenotype of this cough.…”

Section: Discussionmentioning

confidence: 99%

Characteristic appearance of the oropharynx in patients with postnasal drip (PND)‐induced cough

Tomita

Ikeuchi

Touge

et al. 2021

Clinical Respiratory J

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Introduction Post‐nasal drip (PND)‐induced cough is a common cause of chronic cough. However, there is little known about the characteristic physical findings of this condition. Objectives We investigated views of the pharyngeal wall in patients with PND‐induced cough using a handy endoscopic images. Methods The subjects were 135 consecutive patients referred to our hospital with a sensation of something “dripping down the throat” as one of their symptoms. Physical findings for the oropharynx were examined using Wi‐Fi endoscope camera. The difference in probability of symptoms in patients with acute cough and those with subacute/chronic cough was assessed using a Bayesian Fisher exact test on a 2 × 2 table. Results Among the patients, 105 (78%) complained of cough, 78 (58%) of acute cough, 20 (15%) of subacute cough, and 7 (5%) of chronic cough; and 71 (53%) had coexisting asthma. Using Bayesian inference, a sore or scratchy throat and fever were more common in patients with acute cough than in those with subacute/chronic cough. In endoscopic images of the oropharynx, a reddish curtain sign on the posterior pharyngeal wall behind the palatopharyngeal arch was found in 121 patients (90%). Conclusion Patients with acute PND‐induced cough have a component of acute upper respiratory infection, because of high probability of a sore or scratchy throat and fever as symptom. A reddish curtain sign may be a useful finding for identifying PND‐induced cough in these cases.

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“… 28 This includes sensory fibers of the trigeminal nerve 16 , 29 and superior laryngeal and pharyngolaryngeal branch of the vagus nerve. Pathogenic mechanisms can be mechanical or chemical stimulation of the vagal afferent nerve by postnasal drip, 17 , 30 hematogenous spread of inflammatory mediators, 16 or cough reflex hypersensitivity. 16 As a mechanistic trigger, PND, whether subjectively reported or noted on physical examination, is not a consistent complaint/finding in patients with chronic cough.…”

Section: Upper Airway Cough Syndromementioning

confidence: 99%

WAO-ARIA consensus on chronic cough - Part II: Phenotypes and mechanisms of abnormal cough presentation — Updates in COVID-19

Rouadi

Idriss

Bousquet

et al. 2021

World Allergy Organization Journal

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Background: Chronic cough can be triggered by respiratory and non-respiratory tract illnesses originating mainly from the upper and lower airways, and the GI tract (ie, reflux). Recent findings suggest it can also be a prominent feature in obstructive sleep apnea (OSA), laryngeal hyperresponsiveness, and COVID-19. The classification of chronic cough is constantly updated but lacks clear definition. Epidemiological data on the prevalence of chronic cough are informative but highly variable. The underlying mechanism of chronic cough is a neurogenic inflammation of the cough reflex which becomes hypersensitive, thus the term hypersensitive cough reflex (HCR). A current challenge is to decipher how various infectious and inflammatory airway diseases and esophageal reflux, among others, modulate HCR. Objectives:The World Allergy Organization/Allergic Rhinitis and its Impact on Asthma (WAO/ ARIA) Joint Committee on Chronic Cough reviewed the current literature on classification, epidemiology, presenting features, and mechanistic pathways of chronic cough in airway-and reflux-related cough phenotypes, OSA, and COVID-19. The interplay of cough reflex sensitivity

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Postnasal drip and postnasal drip-related cough

Abstract: The article summarizes the current recommendations on evaluation and management of PND as well as brings to discussion new therapies and hypothesis regarding its pathophysiology.

Cited by 7 publications

References 19 publications

The impact of nasal aspiration with an automatic device on upper and lower respiratory symptoms in wheezing children: a pilot case-control study

The impact of nasal aspiration with an automatic device on upper and lower respiratory symptoms in wheezing children: a pilot case-control study

Characteristic appearance of the oropharynx in patients with postnasal drip (PND)‐induced cough

WAO-ARIA consensus on chronic cough - Part II: Phenotypes and mechanisms of abnormal cough presentation — Updates in COVID-19

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