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Can Post Nasal Drips Cause Persistent Dry Cough?
Question: My husband, 28 yrs old, non smoker has developed a dry cough for the past two weeks. No medical history what so ever. Recently went to urgent care where I requested a chest X-ray. Vitals all clear, chest X-ray showed all organs normal and was “beautiful.” However he still has this cough and there is no phlegm associated with it, again a dry cough, and when he touches the middle part of his throat , or space in between the two clavicles, it brings on the cough, which seems odd to me. I’m trying to convince him to see a doctor for a CBC and just a general physical but what are your thoughts? Also isn’t wheezing, not brought on by physical activity, and isn’t affecting his activity, more annoying than anything. Prescribed promethazine with codeine and he doesn’t like it because it makes him groggy. Do you feel there can be a bigger underlying issue if the chest X-ray was clear and the cough isn’t producing anything ?
Brief Answer:
Possible causes and recommendations given
Detailed Answer:
Hello,
Because your husband does not smoke and being young in age and not having other chronic conditions mentioned, I would say that it is unlikely this cough to be a serious condition.
Having a normal chest X-ray is also reassuring and gives us time to consider other more common and likely conditions.
Most likely causes would be post nasal drip, meaning nose secretions that run at the back of the throat and irritate it, it might happen even if he does not have a runny nose (secretions from the front of the nose).
In this case, regular nasal lavage with nasal saline solutions might help soothe the nasal mucosa and thin the secretions.
Nasal steroids like fluticasone spray might help further reduce the inflammation and reduce the secretions.
It can be applied a few minutes after the nasal saline solution lavage. Sometimes over the counter antihistamines can be tried to reduce the tendency for allergy, Loratadine at night is an option- this is less sedative then promethazine and is better tolerated if taken at night.
Another possible cause would be acid reflux. If he is having acid from the stomach come to the throat and irritate it.
Taking a frequent small amount of food and fluids and also not eating or drinking the last 3 hours before bed is helpful in this case.
Taking Omeprazone before breakfast in the morning can be tried for a few days to reduce acids.
A another likely one is if he had a viral infection of the upper respiratory tract which might be resolved already but the healing of the mucosa might take a bit longer and make them more sensitive and irritable causing the cough to go on longer.
In this case, time is the major healing factor and also nasal saline solutions, and sometimes local steroids (fluticasone spray) might be tried to relieve symptoms.
Menthol lozenges can be tried and also Guaifenessine syrup might be helpful.
If the cough is not improving in a week or is getting worse you will need to see your doctor. Generally cough up to 3 weeks is very usual with common conditions like postviral cough, etc.
So it is recommended to wait 3 weeks if no fever, no fatigue, or short of breath, especially with a normal chest x-ray.
Hope I have answered your query.
Take care
Regards,
Dr Zotaj Antoneta, General & Family Physician
Possible causes and recommendations given
Detailed Answer:
Hello,
Because your husband does not smoke and being young in age and not having other chronic conditions mentioned, I would say that it is unlikely this cough to be a serious condition.
Having a normal chest X-ray is also reassuring and gives us time to consider other more common and likely conditions.
Most likely causes would be post nasal drip, meaning nose secretions that run at the back of the throat and irritate it, it might happen even if he does not have a runny nose (secretions from the front of the nose).
In this case, regular nasal lavage with nasal saline solutions might help soothe the nasal mucosa and thin the secretions.
Nasal steroids like fluticasone spray might help further reduce the inflammation and reduce the secretions.
It can be applied a few minutes after the nasal saline solution lavage. Sometimes over the counter antihistamines can be tried to reduce the tendency for allergy, Loratadine at night is an option- this is less sedative then promethazine and is better tolerated if taken at night.
Another possible cause would be acid reflux. If he is having acid from the stomach come to the throat and irritate it.
Taking a frequent small amount of food and fluids and also not eating or drinking the last 3 hours before bed is helpful in this case.
Taking Omeprazone before breakfast in the morning can be tried for a few days to reduce acids.
A another likely one is if he had a viral infection of the upper respiratory tract which might be resolved already but the healing of the mucosa might take a bit longer and make them more sensitive and irritable causing the cough to go on longer.
In this case, time is the major healing factor and also nasal saline solutions, and sometimes local steroids (fluticasone spray) might be tried to relieve symptoms.
Menthol lozenges can be tried and also Guaifenessine syrup might be helpful.
If the cough is not improving in a week or is getting worse you will need to see your doctor. Generally cough up to 3 weeks is very usual with common conditions like postviral cough, etc.
So it is recommended to wait 3 weeks if no fever, no fatigue, or short of breath, especially with a normal chest x-ray.
Hope I have answered your query.
Take care
Regards,
Dr Zotaj Antoneta, General & Family Physician
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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