WordNet

the topmost one of two
piece of leather or synthetic material that forms the part of a shoe or boot above the sole that encases the foot; "Uppers come in many styles"
higher in place or position; "the upper bunk"; "in the upper center of the picture"; "the upper stories"
superior in rank or accomplishment; "the upper half of the class"
a sudden noisy expulsion of air from the lungs that clears the air passages; a common symptom of upper respiratory infection or bronchitis or pneumonia or tuberculosis (同)coughing
exhale abruptly, as when one has a chest cold or congestion; "The smoker coughs all day"
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"

PrepTutorEJDIC

(場所・位置が)『上のほうの』,上部の / 『上級の』,上位の / 奥地の,上流の / 靴の甲皮(こうがわ)(かかとより上の部分) / 覚醒剤（これの反意語はdowner：鎮静剤）
〈C〉『せき』,せき払 / 《a ~》よくせきの出る病気 / 『せきをする』,せき払いする / せきのような音を出す / …'を'せきをして吐き出す《+『up』(『out』)+『名,』+『名』+『up』(『out』)》
(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
〈C〉航空路 / 〈C〉(鉱山などの)通風路 / 《複数形》航空会社

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/06 16:43:36」(JST)

wiki en

Post-nasal drip (PND, also termed upper airway cough syndrome, UACS, or post nasal drip syndrome, PNDS) occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the throat or back of the nose. It is caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing (such as an esophageal motility disorder). It is frequently caused by an allergy, which may be seasonal or persistent throughout the year.^{[medical citation needed]}

However, other researchers argue that mucus dripping down the back of the throat from the nasal cavity is a normal physiologic process that occurs in healthy individuals.^[1] Post-nasal drip syndrome as a concept has been challenged due to a lack of an accepted definition, a lack of any pathologic tissue changes and no available biochemical tests. The phrase has been described as a "pseudo-syndrome" (i.e. not a real medical condition) which serves as a catch-all, waste-basket phrase that is unhelpful.^[1]

Associated conditions

PND is suggested to be a cause of extra-oral halitosis, especially when a sinus infection is also present. Acid reflux or heartburn is believed to aggravate and in some cases cause post-nasal drip.^[2]

Symptoms

Individuals may be diagnosed as suffering from post-nasal drip if they suffer from the following symptoms:

Coughing;
Wheezing
Constant swallowing, which can lead to an excessive amount of air in the stomach, causing discomfort;
Rhinorrhea, running nose due to mucus flow;
Frequent spitting;
Tickling in the throat;
Constant clearing of throat;
Rigid burning sensation at back of the throat;
Broken or cracking voice;hoarseness
Mucus feeling in the back of the throat;
Difficulty in breathing;
Congestion in the nasal and sinus passages;
Chronic sore throat;
Masses formed in the crypts of the tonsils that are generally yellow or white (commonly called tonsil stones, or tonsilloliths);
Halitosis (bad breath);
Snorting to clear mucus from the nasal passage that cannot otherwise be cleared by blowing one's nose;
Cobblestone appearance of the oropharyngeal mucosa;
Frontal cranial pressure;
Fatigue;
Nausea;
Vomiting.

Treatment

First and foremost, as the causes are manifold, a removal of those causes should be targeted. Treatment may include antibiotics, decongestants, nasal irrigation, sinus massage, acid control medication, allergy medication, and minor surgery. Bulb syringes, squirt bottles, pulsatile nasal irrigators or neti pots are often used for nasal irrigation. Allergy medications include antihistamines, decongestants, nasal steroids alone or in combination. Allergy injections may be used for long-term relief when allergy is the cause. Oral steroids may be prescribed for short-term use in some situations.

According to the evidence-based cough guidelines published by the American College of Chest Physicians in the January 2006 issue of Chest, a first-generation antihistamine should be employed as first-line therapy to treat post-nasal drip.^{[medical citation needed]}

References

^ ^a ^b Morice, AH (2004). "Post-nasal drip syndrome--a symptom to be sniffed at?". Pulmonary pharmacology & therapeutics 17 (6): 343–5. doi:10.1016/j.pupt.2004.09.005. PMID 15564073.
^ Rosenberg, M (1996). "Clinical assessment of bad breath: current concepts". Journal of the American Dental Association 127 (4): 475–82. doi:10.14219/jada.archive.1996.0239. PMID 8655868.

External links

Medline Plus article on Nasal Discharge

UpToDate Contents

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1. 成人における亜急性および慢性咳嗽の治療 treatment of subacute and chronic cough in adults
2. 成人における亜急性および慢性咳嗽の評価 evaluation of subacute and chronic cough in adults
3. 小児における慢性咳嗽の原因 causes of chronic cough in children
4. 小児における慢性咳嗽に対するアプローチ approach to chronic cough in children
5. ウイルス誘発性の喘鳴および喘息：概要 virus induced wheezing and asthma an overview

English Journal

The Evaluation of children with prolonged cough accompanied by American College of Chest Physicians guidelines.

Karabel M, Kelekçi S, Karabel D, Gürkan MF.SourceDicle University, School of Medicine, Pediatric Pulmonology Unit, Diyarbakır, Turkey.
The clinical respiratory journal.Clin Respir J.2013 Aug 26. doi: 10.1111/crj.12052. [Epub ahead of print]
INTRODUCTION: In children, coughs lasting longer than four weeks are considered to be chronic, with etiological factors varying widely. Objective: This study included children with chronic cough who were followed for one year. All cases were evaluated with the guidance of the American College of Che
PMID 23981451

Laryngeal sensory dysfunction in laryngeal hypersensitivity syndrome.

Vertigan AE, Bone SL, Gibson PG.SourcePriority Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle; Speech Pathology Department; Hunter Medical Research Institute, Newcastle.
Respirology (Carlton, Vic.).Respirology.2013 Aug;18(6):948-56. doi: 10.1111/resp.12103.
BACKGROUND AND OBJECTIVE: Diseases associated with laryngeal dysfunction include chronic refractory cough (CRC), paradoxical vocal fold movement (PVFM), muscle tension dysphonia (MTD) and globus pharyngeus. We hypothesized the presence of a common sensory laryngeal dysfunction, the 'laryngeal hypers
PMID 23617471

A longitudinal study of CPAP therapy for patients with chronic cough and obstructive sleep apnoea.

Sundar KM, Daly SE, Willis AM.SourceDepartment of Medicine, University of Utah, Salt Lake City, UT, USA. krishna.sundar@hsc.utah.edu.
Cough (London, England).Cough.2013 Jul 11;9(1):19. doi: 10.1186/1745-9974-9-19.
BACKGROUND: Chronic cough patients are rendered therapies for gastro-esophageal reflux (GERD), upper airway cough syndrome (UACS) and cough-variant asthma (CVA) with varying benefit. Idiopathic or unexplained cough has emerged as an important clinical entity in both primary care and subspecialty cli
PMID 23845135

Japanese Journal

Measurement of Nasal Nitric Oxide Is Useful for the Diagnosis of Sinusitis-Induced Prolonged Cough

KIM Sang-Heon,JEONG Jin Hyeok,KWAK Hyun Jung,SONG Sung Heon,KIM Tae Hyung,SOHN Jang Won,SHIN Dong Ho,YOON Ho Joo,PARK Sung Soo
Tohoku journal of experimental medicine 223(2), 145-151, 2011-02-01
NAID 10027807004

アスリートと咳（慢性咳嗽を中心に）―最近の研究の動向―

田中繁宏
健康運動科学 1, 1-5, 2010-12-00
… Athletes occasionally have problems in training while having a chronic cough. … Cough is aprotective reflex of the respiratory tract that is mainly used to clear the upper airways. … Diseases causing chronic cough include cancer, tuberculosis,asthma, eosinophilic bronchitis, gastroesophageal reflux disease （GERD）, postnasaldrip syndrome, allergic rhinitis, sinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis,and bronchiectasis. …
NAID 120005265256