Relationship between Post Nasal Drip (PND) and Inflammatory Bowel Disease (IBD): A New Concept on Gastrointestinal Disease Management in Persian Medicine.

Dear Editor-in-Chief

Inflammatory bowel disease (IBD) incidence and prevalence are increasing in different regions around the world and due to the lack of a definitive cause and treatment for this disease (1); all existing theories should be evaluated. For example, a remarkable relationship is defined between abnormal postnasal discharge (PND), and gastrointestinal ulcer In Persian medicine (PM).

There is a broad concept in PM that special substances with head organs origin in different shapes can passage to other organs from known ways like gastrointestinal or respiratory tracts and also from not well-known ways like membranes and nerves sheaths and can cause different problems like gastrointestinal ulcer and lung diseases like asthma; One of the most important shapes is PND (2, 3).

In this system of medicine, one of the major causes of the loss of the mucus layer and ulceration is passing of this discharge that can hurt the intestine between 7 to 40 days (4).

Moreover, in allopathic medicine, one causes of PND is sinusitis and one kind of disease with intestinal ulcers is IBD that has side effects in other organs in addition to gastrointestinal effects.

Some previous studies have shown high prevalence of sinusitis in IBD patients and have noticed to the role of sinusitis treatment in improvement of ulcerative colitis (5, 6). In these studies, some pathogens like Staphylococcus enterotoxin B (SEB) are known as causes of illness that swallowed with the PND, would increase the permeability of intestine mucosa, and finally could lead to the intestinal ulcer (7).

Another interesting point is that Jorjani (1042–1136 A.D.) and Avicenna (Ibn Sīnā: 980–1037 A.D.)-two Persia’s renowned physicians-, believed that seasonal changes could be impress PND prevalence and consequently intestinal ulcers prevalence. Although, they also emphasized this variation could be changed in different years or places (2, 8). But some recent studies carried out prevalence of ulcerative colitis in different seasons, ignored this important principle and got some dissimilar result (9,10). It could be related to variety in geographic condition and also changing seasonal pattern in different years.

In Persian medicine, treatment of PND is very important for prevention of some diseases like intestinal ulcer and if patients show PND and intestinal ulcer (IBD) in the same time, treating PND is considered besides intestinal ulcer treatment (11). In the other hand in this opinion if brain and other head organs like sinuses be weak and sick they make more excreta and it makes good environment for Production of pathogens, so It seems if they become stronger, it would prevent from production of waste so for this condition PM uses from natural and herbal medicine which can strengthen members of the head and also has antibiotic properties and wound healing effect (12).

To sum up, it seems Persian Medicine could offer various strategies for some confusing conditions and more research about the mentioned points could lead us to improve both diseases treating.