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Suggest Treatment For Chronic Cough
Question: Have had a chronic, lifelong cough that two hiatal hernia operations have not resolved. Helped perhaps, but they are annoying and result in breathlessness. A FEELING of breathlessness is pretty typical throughout the day. I prefer a shallow breath so that my cough doesn't start up. Never feel I have clear breathing and often am plagued by super abundance of mucous clinging to windpipe (?) or deeper? Coughing helps some to loosen and bring up, but always seems to hang in there. Also the hiatal hernia operation from several years back has affected swallowing (not always, but quite a lot). Throat can easily back up with food and/or water and or air and sticks to a painful point where vomiting to clear out is the only way to get relief. With that comes an excess amount of mucous...and sometimes it can result in choking or inhaling. Constant struggle. Local Drs. haven't come up with answers for me. Any suggestions please? XXXX
Brief Answer:
post nasal drip is the most common cause
Detailed Answer:
HI, thanks for using healthcare magic
Chronic cough can be due to different possible causes but the most common causes are: (1) post nasal drip related cough (recently renamed upper airway cough syndrome)
This is the most common cause.
(2)GERD -reflux
(3)asthma
(4)non asthmatic eosinophilic bronchitis- there is a type of white blood cell called eosinophils.
This condition refers to the infiltration of eosinophils into the bronchi (part of the airway).
The airways are also very responsive and there may be some obstruction of the airways.
Because upper airway cough syndrome (post nasal drip) is the most common cause, this is normal addressed first in case this is the cause.
Treatment: (1) topical steroid nasal sprays eg nasonex or flonase or rhinocort along a decongestant and antihistamine
Cough suppressants are not normally used
This can take 2 to 4 weeks for an effect though may take months in some persons
(2) if there is a history of reflux, reflux medications can be used
(3)if there is no response after 2 to 4 weeks, then consider non eosinophilic bronchitis- this can be checked by a sputum (coughed up mucous) test.
When the sputum is sent to the lab, they would see increase in eosinophils.
Treatment involves the use of a course of inhalers, normally improvement in 4 weeks
Summary: (1) post nasal drip (upper airway cough syndrome) is the most common cause so treat first
Treat with nasal steroid sprays, decongestant and antihistamine
(2) non eosinophilic cough syndrome- diagnosed by finding eosinophils in the sputum
If present treat with inhalers, respond in 4 weeks
I hope this helps, feel free to ask any other questions
post nasal drip is the most common cause
Detailed Answer:
HI, thanks for using healthcare magic
Chronic cough can be due to different possible causes but the most common causes are: (1) post nasal drip related cough (recently renamed upper airway cough syndrome)
This is the most common cause.
(2)GERD -reflux
(3)asthma
(4)non asthmatic eosinophilic bronchitis- there is a type of white blood cell called eosinophils.
This condition refers to the infiltration of eosinophils into the bronchi (part of the airway).
The airways are also very responsive and there may be some obstruction of the airways.
Because upper airway cough syndrome (post nasal drip) is the most common cause, this is normal addressed first in case this is the cause.
Treatment: (1) topical steroid nasal sprays eg nasonex or flonase or rhinocort along a decongestant and antihistamine
Cough suppressants are not normally used
This can take 2 to 4 weeks for an effect though may take months in some persons
(2) if there is a history of reflux, reflux medications can be used
(3)if there is no response after 2 to 4 weeks, then consider non eosinophilic bronchitis- this can be checked by a sputum (coughed up mucous) test.
When the sputum is sent to the lab, they would see increase in eosinophils.
Treatment involves the use of a course of inhalers, normally improvement in 4 weeks
Summary: (1) post nasal drip (upper airway cough syndrome) is the most common cause so treat first
Treat with nasal steroid sprays, decongestant and antihistamine
(2) non eosinophilic cough syndrome- diagnosed by finding eosinophils in the sputum
If present treat with inhalers, respond in 4 weeks
I hope this helps, feel free to ask any other questions
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. Chakravarthy Mazumdar
Answered by
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