Does post-nasal drip cause cough in childhood?

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Clinical Pediatrics

Background:

• The concept of post-nasal drip (PND) as a frequent cause of childhood cough is debated.
• This notion primarily stems from adult medical literature, lacking robust pediatric evidence.
• Definitions and diagnostic criteria for PND are inconsistent, complicating its role in cough etiology.

Purpose of the Study:

• To critically evaluate the evidence supporting post-nasal drip (PND) as a cause of chronic cough in children.
• To challenge the prevailing concept of PND syndrome in pediatric respiratory complaints.
• To propose alternative explanations for cough associated with increased post-nasal secretions in children.

Main Methods:

• Literature review and critical analysis of existing studies on PND and childhood cough.
• Examination of the scientific basis (rheology) and clinical definitions of PND.
• Comparative analysis of diagnostic certainty based on history and physical examination versus underlying pathologies.

Main Results:

• The definition of PND is variable, and its diagnostic specificity in children is low.
• History and physical examination alone are insufficient for diagnosing PND-induced cough.
• The term 'drip' and rheological principles are inconsistent with PND as a direct cause of cough.

Conclusions:

• The concept of post-nasal drip (PND) as a common cause of childhood cough is not well-supported.
• Increased post-nasal secretions in children with cough likely indicate co-existing airway pathologies.
• The concept of PND and PND syndrome should be reconsidered and potentially abandoned in the diagnosis of chronic cough in children.