Can postnasal drip in children be cured?

If children suffer from postnasal drip when they are young, they must be treated actively because they are in a developmental stage and it is easier to treat many diseases. They are likely to recover. If they are not treated, some sequelae will be left, which will have a great impact on their future life and may even follow them for a lifetime. So can postnasal drip in children be cured?

1. Introduction

Postnasal drip syndrome refers to a syndrome in which nasal diseases cause secretions to flow back into the back of the nose and throat, and even flow back into the glottis or trachea, resulting in coughing or allergic rhinitis. The inflammatory secretions in the nose of patients can flow into or be inhaled into the lungs through the posterior nasal aperture and pharynx.

2. Diagnosis

Especially when sleeping in the supine position, inflammatory secretions in the nose flow into the airway unconsciously, which is very likely to be an important reason for allergic rhinitis to develop into asthma (especially nocturnal asthma). Changes in breathing patterns are also one of the factors that lead to the close relationship between allergic rhinitis and asthma. Swelling of the nasal mucosa, hypertrophy of the nasal conchae and retention of secretions can lead to nasal congestion, forcing patients to switch from nasal breathing to mouth breathing. In this way, allergens can bypass the nasal mucosal barrier and directly enter the lower respiratory tract, triggering asthma. Postnasal drip syndrome is the most common cause of chronic cough in adults and the second most common cause of chronic cough in children. Postnasal drip syndrome is easily missed and misdiagnosed in clinical practice. The main reason is that doctors lack knowledge about postnasal drip syndrome and only pay attention to the manifestations of tonsils, pharynx and lungs. They diagnose interstitial pneumonia when seeing the rough and deep texture of chest X-ray, but ignore the patient's medical history and other signs. In fact, postnasal drip syndrome is the most common cause of chronic cough. Patients with chronic cough can be given specific empirical treatment for postnasal drip syndrome before the cause is determined, and the disease can be confirmed based on the efficacy.

3 Clinical manifestations

Typical clinical manifestations of patients with postnasal drip syndrome include:

1. Paroxysmal or persistent cough, mainly during the day and less after falling asleep.

Second, most patients have backflow of nasal secretions, oral mucus adhesion, itchy throat, a foreign body sensation or a "paste sticking to the throat" feeling, and frequent throat clearing. Simply put, due to the discomfort in the throat caused by the backflow of mucus, people will naturally produce a reflex cough.

3. There are symptoms such as itchy nose, nasal congestion, runny nose, and sneezing. 4. Some patients may also have hoarseness, and even talking may induce coughing. 5. Have a history of rhinitis, sinusitis, nasal polyps or chronic pharyngitis.

4 Western medicine treatment

Patients suspected of having postnasal drip should be treated specifically based on the underlying disorder. For postnasal drip syndrome caused by the common cold, non-allergic rhinitis, vasomotor rhinitis, chronic rhinitis, etc., first-generation antihistamines and decongestants are the first choice. Most patients respond within a few days to 2 weeks after initial treatment. Postnasal drip syndrome caused by allergic rhinitis is effectively treated with various antihistamines, with the second-generation antihistamines without sedative effects being the first choice. Nasal inhaled corticosteroids are also the first choice drug for allergic rhinitis. Improving the environment and avoiding allergen stimulation are effective measures to control allergic rhinitis. Allergen immunotherapy may be effective, but the effect takes a long time to take effect. The main treatment for acute sinusitis is the use of antibacterial drugs. When the effect is poor or there is a lot of secretion, nasal inhalation of corticosteroids and decongestants can be used to reduce inflammation. The treatment of chronic sinusitis generally adopts the following initial treatment plan: use antibacterial drugs effective against Gram-positive bacteria, Gram-negative bacteria and anaerobic bacteria for 3 weeks; oral first-generation antihistamines and decongestants for 3 weeks; nasal decongestants for 1 week; nasal inhaled corticosteroids for 3 months. When medical treatment is ineffective, negative pressure drainage, puncture drainage or surgical operation can be performed. Endonasal transsinus surgery is a surgery that conforms to the physiology of the nasal cavity and sinuses. It achieves the purpose of treating chronic sinusitis by reconstructing the ventilation and drainage of the nasal cavity and sinuses and promoting the recovery of the physiological function of the diseased mucosa.