Nose

Upper Airway Cough Syndrome

search

Upper Airway Cough Syndrome, UACS, Postnasal Drip Syndrome

  • See Also
  1. Chronic Cough
  2. Chronic Cough Causes
  3. Rhinitis
  • Definitions
  1. Upper Airway Cough Syndrome (previously Postnasal Drip Syndrome)
    1. Chronic Cough due to upper airway cause (often, but not always, due to postnasal drainage)
  • Epidemiology
  1. Most common cause of Chronic Cough in non-smoking adults with intact Immunity and normal Chest XRay
  • Pathophysiology
  1. Cough syndrome associated with upper airway Hypersensitivity to triggers (e.g. postnasal drainage)
  • Causes
  1. Chronic Nonallergic Rhinitis (most common)
  2. Chronic Allergic Rhinitis
  3. Chronic Rhinosinusitis
  • Differential Diagnosis
  1. See Rhinitis Causes
  2. See Chronic Cough Causes
  3. See Chronic Cough Causes in Children
  • Signs
  1. Posterior pharynx drainage or mucus
  2. Throat clearing
  3. Nasal Discharge
  4. Nasal Congestion
  5. Rhinorrhea
  6. Oropharyngeal mucosa with cobblestone appearance
  • Imaging
  1. Consider Sinus XRay or Sinus CT if persistent symptoms refractory to treatment
  • Management
  1. General
    1. Avoid allergens
    2. See Chronic Cough
  2. Treat specific causes
    1. Sinusitis
    2. Allergic Rhinitis
  3. Trial on empiric therapy
    1. See Rhinitis for a full protocol
    2. Consider oral Antihistamine
    3. Consider Intranasal Steroid
    4. Consider intranasal Atrovent
  • References
  1. Sonoda (2024) Am Fam Physician 110(2): 167-73 [PubMed]