How Can Persistent Dry Cough Be Treated?

Posted on Fri, 27 Apr 2018

Question: Hello Doctor,

I have been having persistent dry cough with little or no mucus for last 9-10 weeks. Problem started towards end of September when I was down with severe cough and sore throat. I even had some blood in my cough few times.
At that time I met a doctor and was prescribed following.
-Gramocef CV for 5 days
-Predmet for 10 days with reducing dosages (8mg, 4mg)
-Ambrolite -D
-Montral Tablet

After taking prescribed course, I started feeling better but cough remained.
During next few days, I regularly used to cough few times a day but never in night.

During end October, my cough again flared up with mucus. I underwent few tests.
Chest XRay: Normal
CBC/Haemogram: Normal but Eosinophils was detected as 12%(900 AEC)
This time I was prescribed following treatment.
-Synclar 500 for 5 days
-Defcort for 15 days (18,12,6 mg for 5 days each)
-Mcberry XT
-Montral for 3 months.

It is end of Novemeber now and my cough has again increased. I am at loss of what is being wrong with me as every time it is being diagnosed as Allergic cough?
Please suggest future treatment.

Extra facts
-I stay in XXXXXXX
- i dont have running nose but yes one nostril is a bit stuffy
-No watery/red eyes
-There is hardly any cough at night during sleep

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Get done PFT.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
By your history and description, possibility of bronchitis (inflammation of airways) is more likely.
Chronic cough, hemoptysis (blood in sputum) with normal chest x ray not improving with routine drugs are favoring bronchitis more.
So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).
PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.
You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Please let me know if you had PFT done or not.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (3 hours later)

Thanks Doctor.
Couple of queries
-I am having little or no mucus. Can it also be a sign of bronchitis?
-How does one explain raised count of Eosinophils ? Is it too high or still Ok types?
-Why current steroids like Predmet/Defcort are not improving my cough?

Thanks in advance

Answered by Dr. Drkaushal85 (16 minutes later)

Brief Answer:
Dry cough is also seen in bronchitis.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Dry cough is also seen in bronchitis.
Your eosinophil count is not excessively high.
So no need to worry for allergic reaction.
This kind of slightly higher eosinophil count is also seen with bronchitis.
Oral corticosteroids is useful in Asthma, not in bronchitis.
Inhaled bronchodilators (formoterol or salmeterol) is the mainstay of treatment for bronchitis.
Inhaled corticosteroid (ICS) acts directly on lungs. When given along with bronchodilators, gives excellent effect.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (2 days later)

Thanks Doctor.
I will try to undergo PFT testing ans share results with you.
One last query, I do cough a bit more and my lower throat burns when I speak more. Is it related to bronchitis?

Answered by Dr. Drkaushal85 (23 minutes later)

Brief Answer:
Yes, it is also due to bronchitis.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, these symptoms are also seen in bronchitis.
And I will wait for your reply with PFT.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng