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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Persisting Cough, X-ray Normal, Taking Medicines, Not Much Improvement. Advice?

Suffering from persisting cough now almost for 2 months. Xray report normal without any problem. Doctors suggested- 1. Omancortil 20 mg once a day. 2. Benz Pearl cap 100mg thrice a day 3. Airtec FB twice a day through inhaller Taken above medicine for 15 days. Not much improvement. Severaty of problem varies from time to time.
Mon, 29 Oct 2012
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Allergist and Immunologist,  's  Response
Hello Santosh,
A dry cough persisting for 2 months has several causes and a normal CXR does not exclude pulmonary pathologies completely. CXR is not a sensitive test and HRCT is suggested if there has been any past exposure to TB. Also the QuantiFERON or TB-SPOT blood test can help us know if there is a suggestion of latent TB
All these tests if normal, along with sputum smears or c/s (6 weeks), require exclusion of allergies and house dust mite allergy is high on the cards.
Steroids are not the answer and have long term complications, therefore an allergy test to exclude common allergies is important.
Long acting antihistamines along with nasal sprays is the first line.
Immunotherapy offers long term benefit.
Thanks.
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Pulmonologist,  Dr. Shashi Dangwal's  Response
Your cough appears to be allergic nature, hence you have been prescribed with omnacortil. It seems you have taken enough omnacortil and you should switch over to inhaler medicines like seroflo/foracort and duolin MDIs. Take a tablet of montair lc. Do you have excessive acid secretions. If so that has to be taken care of with PPIs like omez or pan 40. If you have a post nasal drip, consult an ENT. Avoid dust and smoke and any thing that you are known to be allergic to. These will help you and soon you should be alright.
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Pulmonologist,  Dr. Arnab Maji's  Response
Hi
Thanks for your query
First of all you must be aware of the reasons for getting a normal chest x-ray in the presence of cough. They are -
1. upper airway cough syndrome,
2. asthma
3. chronic rhinosinusitis
4. gastro-esophageal reflux disorder
5. endobronchial TB
6. endobronchial growth
7. non-eosinophilic bronchitis
So your physician need to exclude all those. Better you consult a pulmonologist and give him detailed history and get yourself locally examined in details and proper treatment of that i think will cure your cough. Discuss these issues with your pulmonologist.
Thank you.
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Persisting Cough, X-ray Normal, Taking Medicines, Not Much Improvement. Advice?

Hello Santosh, A dry cough persisting for 2 months has several causes and a normal CXR does not exclude pulmonary pathologies completely. CXR is not a sensitive test and HRCT is suggested if there has been any past exposure to TB. Also the QuantiFERON or TB-SPOT blood test can help us know if there is a suggestion of latent TB All these tests if normal, along with sputum smears or c/s (6 weeks), require exclusion of allergies and house dust mite allergy is high on the cards. Steroids are not the answer and have long term complications, therefore an allergy test to exclude common allergies is important. Long acting antihistamines along with nasal sprays is the first line. Immunotherapy offers long term benefit. Thanks.