Postnasal Drip

When post-nasal drip secretions irritate the mucosa of the pharynx and trachea, a cough reflex occurs. Especially when lying down, secretions flow down toward the airway opening and nighttime cough worsens. Features of post-nasal drip-associated cough: dry, throat-clearing type, a feeling of scratching at the throat, worse in the early morning or right after going to bed, no response to bronchodilators. Causes that need to be differentiated: cough-variant asthma, gastroesophageal reflux, bronchitis, and side effects of ACE inhibitors (blood pressure medication). Because treating post-nasal drip often resolves the cough as well, differentiating post-nasal drip is a priority in the therapeutic approach to chronic cough.