Within 5 days of beginning the course determined by the algorithm (FIGURE), 176 patients (47%) who received treatment for presumed postnasal drip
syndrome experienced resolution of their chronic cough.
Although the symptoms related to GERD and postnasal drip
completely resolved on maximal medical treatment with proton pump inhibitors and steroid nasal spray, his cough remained unchanged.
Subjectively, our study clearly demonstrates that laser turbinoplasty decreases the symptoms of postnasal drip
, nasal congestion/obstruction, rhinorrhea, headache, and cough.
A cough associated with throat clearing suggests GERD or postnasal drip
As the saline pulses through the sinuses, it clears mucus, which stops postnasal drip
and cough and quickly moves harmful bacteria out of the nose.
Compared with patients who had other diagnoses, such as postnasal drip
, gastroesophageal reflux, and asthma, these patients had a longer median duration of cough (72 vs.
Cough is the second most common reason for office visits, and a number of studies have shown that the top three causes of common cough are postnasal drip
, asthma, and gastroesophageal reflux.
27) Chronic cough may be triggered by more than one condition (eg, GERD, postnasal drip
, or asthma) in 18% to 93% of patients.
Finally, at 6 months following their most recent surgery, patients with Samter's triad had significantly higher rates of symptom recurrence (nasal obstruction, facial pain, postnasal drip
, and anosmia) and a recurrence of nasal polyps.
It is believed to be due to several different mechanisms: irritation from GERD, postnasal drip
syndrome, in-halation of irritants, or psychiatric conditions such as obsessive-compulsive disorder and depression leading to a conversion reaction.
Evaluation and treatment for postnasal drip
syndrome (PNDS), asthma, and gastroesophageal reflux disease (GERD) should remedy symptoms in the vast majority of patients (grade of recommendation: C, based on case series at referral centers).
Two squirts twice a day of intranasal azelastine spray significantly reduced sneezes, postnasal drip
, nasal congestion, and rhinorrhea in patients with perennial nonallergic rhinitis, according to the two placebo-controlled trials, which were included in information submitted to the FDA.
The prevalence of postnasal drip
and environmental allergies in the two groups was similar.
Patients were included if they met a minimum symptom score based on a severity rating of 6 symptoms (purulent rhinorrhea, congestion, postnasal drip
, headache, facial pain, cough).