From the Guidelines
Yes, postnasal drip is often related to allergic rhinitis, as it is one of the key symptoms of the condition, along with nasal congestion, rhinorrhea, sneezing, and nasal itching, as noted in the clinical practice guideline: allergic rhinitis 1.
Key Points to Consider
- The connection between postnasal drip and allergic rhinitis is well-established, with postnasal drip being a common symptom of the condition, resulting from the increased mucus production in response to allergens 1.
- The diagnosis of allergic rhinitis can be confirmed based on a history of symptoms after exposure to known allergens, which correlates with specific IgE testing, and symptoms such as pruritus and sneezing are much more common in allergic than nonallergic rhinitis 1.
- Treatment options for postnasal drip related to allergic rhinitis include antihistamines, nasal corticosteroid sprays, saline nasal rinses, and decongestants, with the goal of reducing inflammation and mucus production, and identifying and avoiding specific allergens is crucial for long-term management 1.
Treatment Options
- Antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) at standard doses of 10mg, 10mg, and 180mg daily respectively can help alleviate symptoms of allergic rhinitis, including postnasal drip 1.
- Nasal corticosteroid sprays such as fluticasone (Flonase) or triamcinolone (Nasacort), used as 1-2 sprays per nostril daily, can reduce inflammation and mucus production, and are often recommended as first-line treatment for allergic rhinitis 1.
- Saline nasal rinses using a neti pot or squeeze bottle can help flush out allergens and thin mucus, providing relief from postnasal drip and other symptoms of allergic rhinitis 1.
Importance of Diagnosis and Management
- Recognizing the connection between allergic rhinitis and postnasal drip is essential for proper diagnosis and management, as untreated allergic rhinitis can lead to complications such as sinusitis, otitis media, and sleep-disordered breathing 1.
- A comprehensive diagnosis and treatment plan should include an assessment for asthma, atopic eczema, and other comorbidities, as well as education on avoiding specific allergens and managing symptoms, to improve quality of life and reduce morbidity and mortality associated with allergic rhinitis 1.
From the FDA Drug Label
The trials evaluated the patient-rated TNSS (nasal obstruction, postnasal drip, rhinorrhea) in patients treated for 28 days of doubleblind therapy and in 1 of the 3 trials for 6 months of open-label treatment Two of these trials demonstrated that patients treated with Fluticasone Propionate Nasal Spray, USP, at a dosage of 100 mcg twice daily exhibited statistically significant decreases in TNSS compared with patients treated with vehicle.
Postnasal drip (PND) is a symptom that is related to allergic rhinitis, as well as nonallergic rhinitis. The drug label mentions that the trials evaluated the patient-rated TNSS which includes postnasal drip, nasal obstruction, and rhinorrhea in patients with perennial nonallergic rhinitis and allergic rhinitis.
- The studies demonstrated a decrease in nasal symptoms, including postnasal drip, in patients treated with Fluticasone Propionate Nasal Spray, USP.
- However, the label does not provide a direct causal relationship between postnasal drip and allergic rhinitis. 2
From the Research
Relationship between Postnasal Drip and Allergic Rhinitis
- Postnasal drip (PND) is a common symptom of allergic rhinitis, as indicated in studies 3, 4.
- Allergic rhinitis is characterized by symptoms such as sneezing, nasal itching, nasal congestion, postnasal drip, and rhinorrhea 3.
- The presence of postnasal drip is often associated with other symptoms of allergic rhinitis, including nasal congestion and rhinorrhea 4, 5.
Symptoms and Diagnosis
- Patients with allergic rhinitis typically present with symptoms of nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 4.
- The diagnosis of allergic rhinitis is based on the presence of these symptoms, as well as the results of physical examinations and tests for specific IgE aeroallergens 4.
- Postnasal drip can also be a symptom of nonallergic rhinitis, which is characterized by nasal congestion and postnasal drainage without the presence of allergens 4.
Treatment and Management
- Treatment for allergic rhinitis typically involves avoiding inciting allergens and using medications such as second-generation H1 antihistamines, intranasal antihistamines, and intranasal corticosteroids 4.
- Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe allergic rhinitis and nasal congestion 5.
- Postnasal drip can be managed with conservative treatments, including decongestant pharmacotherapy, antiallergy measures, and nasal dilation devices 6.