What Is The Remedy For The Dry Ticking Cough?

Hi. There are two conditions that can explain your symptoms. One is probably an allergic process given the tickling nature of the cough. Allergy may also have precipitated your sinus disease.The surgery cures the effects of allergy but soes not cure the allergy so I would recommend a 6 -12 week course of oral mast cell stabilisers once in the morning after meals ( You will nee your ENT specialist to prescribed this) In addition to the allergy, the repeated dry coughing without prominent chest symptoms is very suggestive of a condition called LPRD or Laryngopharyngeal Reflux Disease. In this condition small amounts of acid from the stomach create injury and inflammation around the voice box leading to swelling in the interarytenoid region (posterior portion of the voice box). This is what causes the sticking feeling in the throat and the acid irritation leads to dry cough. LPRD is different from GERD or Gastroesophageal Reflux Disease and therefore may not be associated with symptoms of gastritis such as burning chest pain, stomach pain and gas. The Bronchitis must have lead to chronic cough and during coughing the pressure within the abdomen rises leading to the acid being pushed towards the voice box. Repeated coughing also creates interarytenoid injury and swelling by itself and continues the sticking feeling in the throat. So here is the vicious cycle - Allergy, bronchitis and LPRD lead to coughing which leads to voice box injury which leads to more coughing and LPRD and more injury. This is probably the reason for these symptoms to persist for so long. Management of this condition involves breaking this cycle by keeping the allergy, bronchitis and LPRD under control and allowing the voice box to heal (2-3 weeks). This is a challenge because there is more effort required from the patients in the form of lifestyle changes and little support provided by medications. At the least you need an ENT evaluation to follow up with you to review improvement and Pulmonology evaluation to manage the Bronchitis. Antacids and lifestyle changes may need to be followed for 6 months or more for complete cure. Here are some recommended lifestyle modifications 1. Reduce/ avoid spicy and fried food 2. Reducing intake of tea/ coffee/ carbonated drinks 3. Reducing/ stopping smoking and alcohol consumption 4. Reducing stress/ anxiety related to work or family 5. Taking plenty of fluids : 1.8 to 2.5 litres of water per day 6. Maintaining fixed or identical meal timings every day 7. Maintaining fixed or identical sleep timings every day 8. To maintain an upright posture for up to 2 hrs after meals. Avoid lying down immediately after meals. 9. Raise the head end of your bed. Avoid raising the height of the pillow. 10. Voice rest for 48 hrs Patience is not an option here but a necessity. Please do keep me posted on your recovery. Will be happy to follow up and modify medications based on your response since many times doses/durations/choice and combinations of antacids can vary from patient to patient and may need to be tailored for you specifically.