Suggest Treatment For Cough And Hoarseness Of Voice

Posted on Tue, 13 Oct 2015

Question: Hello! My husband is mid-30's, healthy non-smoker, and about 6-8 months ago presented with what he thought was Eustachian tube irritation (pain, itching, tickling, inflammation-like pain). Gradually it has become worse, now also presents with hoarseness of voice (clamped-down sounding) in the afternoon, and persistent throat and inner-ear-type pain, and a constant feeling of needing to swallow and/or cough. He said it now also feels like his sinuses are reacting as well. Doctors don't seem to really want to "dig in" and we're blowing money on trying to find one that will give him more than a cursory look.

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer:
Acid reflux is the cause.

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Your question has answers in it. The pain in ear and eustachian tube and sinuses involvement and constant urge to swallow like something is stuck at throat and dry cough is not the place to dig in. Pathology in your husband's stomach which is heartburn also called GERD is responsible for all these symptoms.

GERD / acid reflux is notorious for such discomforts and unless taken care of completely recurs with such symptoms of sinuses, eustachian tube clogging and ear pain.

Nutshell nip the evil from the bud. Modify diet and lifestyle. Lose weight, eat small frequent meals, avoid spices, alcohol, stimulants, caffeine, NSAIDs, chocolates and other sweets. Drink plenty of fluids. Delay lying down after last meal for at least 3 hours. Exercise. Reduce fatty and processed food intake. Take some proton pump inhibitors ( acid blockers like nexium or prilosec etc). 98 % of the people respond to just these modifications and symptomatic treatment.

For the ear nose and throat symptoms right now just symptomatic remedies with pain relievers like tylenol and aspirin or saltwater or garlic water gargles would be sufficient.

I hope it helps. Take good care of your husband and yourself and don't forget to close the discussion please.

Regards
Khan

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

Follow up: Dr. Shafi Ullah Khan (2 days later)

My concern with that diagnosis is that ges tried 4 and 6-week rounds of heartburn meds (nexxium, etc) based on the same diagnosis and the symptoms have continued to gradually worsen. Also, the voice loss is in the afternoon, he doesnt sleep on a flat surface, and his pain is always on the same side (right) when he sleeps on his back and left side. The pain never stops. The endoscopy didnt indicate acd damage. i

Answered by Dr. Shafi Ullah Khan (7 hours later)

Brief Answer:
Gastritis/ Acid reflux

Detailed Answer:
Thank you for getting back to me

All the work up including endoscopy are suggestive of gastric discomfort. Some times the symptoms do not respond to the medications alone. it needs more than that. A complete diet and lifestyle modification mentioned above, increasing the dose of antacids, avoiding triggers and losing weight etc is mandatory. In some cases if the symptoms still persist then other options can be considered. Surgical implantation of electromagnetic rings around esophageal sphincter or worst case scenario fundoplication may be considered.

It will take time and effort so hang in there and let your gastro decide what is best for your husband.

I hope it helps,
Regards
Khan

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

Follow up: Dr. Shafi Ullah Khan (2 days later)

Would a swillen lymph node mean anything?

Answered by Dr. Shafi Ullah Khan (3 hours later)

Brief Answer:
Common in GERD, no worries

Detailed Answer:
Thank you for getting back to me

No a swollen lymph node won't mean anything of concern as acid reflux is notorious for sore throat and lymphadenopathy in neck region. So if there is any lymph node swelling you can for sure correlate it to the ongoing GERD problem. Nip the evil from its bud and these collateral damages will be reduced.

I hope it helps.

Regards
Khan

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