Management

Management

The main step in management is to determine the cause of post nasal drip and then to initiate treatment that is directed at this underlying condition (1).

In patients without an obvious cause, empiric therapy for PNDS should be started (1).

Treatment options include

• avoidance of the offending antigens
• washing with mild alkaline solutions containing borate such as Dobell’s solution (1)
• non-sedative antihistamine e.g loratadine
• oral decongestant agents - can only be used short-term because of risk of rhinitis medicamentosa
• nasal corticosteroids
• antibiotics if indicated

If a pathological process is not recognized, the patient may have to be counselled with regard to accepting the problem (1).

Reference:

• (1) Sanu A, Eccles R. Postnasal drip syndrome. Two hundred years of controversy between UK and USA. Rhinology. 2008;46(2):86-91
• (2) Pratter MR. Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):63S-71S.