Suggest Treatment For Chronic Cough With Aching Lungs

Posted on Thu, 2 Apr 2015

Question: Hi-I have a chronic cough with aching lungs. It is almost always non-productive. All of my blood work is normal and I have tested negative for XXXXXXX Proteinase 3 antibody, CRP. I have had this now for four months. My current dr advised it is due to my acid reflux problems and has me on Prilosec. It has been 5 days and no change. The aching feeling in my lungs is non-stop: from when I wake up to when I go to bed. The cough comes and goes...any ideas please?

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Get done chest x ray and PFT.

Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Chronic cough can be due to
1. Lung infection
2. Bronchitis
3. Asthma
4. Pulmonary fibrosis
5. GERD ( gastroesophageal reflux disease ).
So better to consult pulmonologist and get done
1. Clinical examination of respiratory system.
2. Chest x ray
3. PFT ( pulmonary function test )
4. CT thorax if required.
Chest x ray and CT thorax are needed to rule out lung infection and pulmonary fibrosis.
PFT is needed to rule out asthma and bronchitis.
If all these investigations are normal then GERD can be the cause.
It is due to laxity of gastroesophageal sphincter.
Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms.
Along with antacids, you need to follow these lifestyle modifications for better symptomatic relief.
1. Avoid hot and spicy food.
2. Avoid stress and tension.
3. Avoid large meals, instead take frequent small meals.
4. Go for walk after meals.
5. Keep 2 - 3 pillows under head in bed to prevent reflux.
7. Avoid alcohol and smoking if you have these habits.
8. Loose weight if you are obese.
So better to consult pulmonologist and first rule out lung related pathology.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (46 minutes later)

Dear Doctor-Thank you for your reply. I failed to mention I did have a chest x-ray. This was normal. I also did a PFT (I blew into a device). This ended with me breaking into a coughing fit. I have not had a CT Thorax. I have stopped drinking (one week now) and have started a serious low carbohydrate diet to lose weight.

As I write this, my bronchi are aching and I have a brief non-productive cough.
If it were due to GERD wouldn't the Prilosec (omeprazole) I've been taking for 5 days have started to mitigate these symptoms?

Answered by Dr. Drkaushal85 (53 minutes later)

Brief Answer:
You might be having bronchitis.

Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
Since you had bout of coughing after PFT menueur, possibility of bronchitis is high.
So let me know
1. Are you smoker?
2. Have ypu checked your respiratory system by doctor theough stethoscope for any abnormal lung sound?
3. Do you have shortness of breath after exertion?
If your cough is due to GERD, then it will take atleast 15-20 days to show relief, after starting omeprazole. And along with antacid, you need to strictly follow lifestyle modifications, suggested in previous answer.
So please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (39 minutes later)

Dear Doctor Bhavsar-I have never smoked. Yes the doctor checked with a stethoscope. I don't really have a shortness of breath after exertion. The doctor checked my oxygen level and it was at 95%.

It is good to know that the relief will take longer than 5 days. It is uncomfortable, but I will deal with it. I will continue with the lifestyle changes...I am also getting headaches from the coughing. Any further ideas please? if not, no worries.

Thank You,
A. XXXXXXX

Answered by Dr. Drkaushal85 (27 minutes later)

Brief Answer:
This may be due to withdrawal symptom.

Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
For your headache, this might be due to withdrawal symptom.
I want to know
1. Did you drink daily?
2. How much quantity you drink regularly?
If you were taking regular daily alcohol then sudden stoppage of this can cause withdrawal symptoms and headache is commonest withdrawal symptom.
So please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar