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Getting Cough After Having Curd. Took Dexrabeprazole. Should I Go To ENT?

Posted on Wed, 9 Jan 2013

Question: Hi Doctor,
please pass this to ENT specialist
From past 1 month I am suffering from Dry cough I took homeopathy got some relief but it came back. I observed when I took curd it started. Then I showed to ENT Dr who prescribed me below medicine
1.     Dexrabeprazole 10 mg in morning before food
2.     Magnocef 325 MG( Cefpodexime +Clavulanate Potassium) Antibiotics for 5 days two times a day
3.     Tab Telekast- L 1 time a day
4.     Bricarex A Syp 3 time a day
5.     Immune Forte Tab for 10 days

I have completed the courses of antibiotics but didn’t get any relief and my cough frequency got increased. I need your advice what next I could do as cough is no going to be for 2 months. Yesterday night my cough got increased I had my son Asthalin syp which gave some relief in bringing down the cough as it became intolerable to me. Was taking Asthalin syp right or did a mistake. Please help me

If possible please pass this to ENT specialist

Answered by Dr. Sumit Bhatti (2 hours later)

Hi,

Thank you for writing back.

1. An expectorant cough syrup will exacerbate dry cough. Bricarex A syrup is an expectorant. It also contains a bronchodilator (Terbutaline), hence it is surprising why you felt better with another bronchodilator (Salbutamol).

2. If you had a severe cold and sinusitis leading to a Post Nasal Drip (PND). A PND usually causes cough. Allergy and Acid Reflux which also cause dry cough.

2. Get a chest auscultation and a Chest X-ray done. If these are normal and if you have normal blood tests (no eosinophilia), no fever or breathlessness then you may get a prescription for supportive medication from your physician. If symptoms do not subside, get a Sinus X-ray / plain Scan CT PNS (Para Nasal Sinuses) done.

3. Anti inflammatory, anti-allergic, mucolytic, anti-reflux medication along with a medicated gargle and cough suppressant along with steam inhalation may help.

4. Keep a local physician's informed. Smoking worsens symptoms and delays recovery. Your B12 level is within normal limits, but on the lower side.You may take Vit B12.

5. Use warm clothing and drink warm liquids. Avoid sour, spicy and cold liquids. If this is only a hyper-reactive airway after a viral infection, it will subside in a few weeks.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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

Follow up: Dr. Sumit Bhatti (28 minutes later)

Hi Dr Bhatti,
Thanks for the reply.
1.     I was taking Bricarex A syrup from past 5 days 3 times a day but no relief last night cough became worse so in home I was having my Son Asthalin Syrup which I tried, I don’t know but to me I got bit relief. Is there any problem or may cause side effect leading to Asthma. Please let me know.
2.     I don’t have cold or sinusitis.
3.     X’ray I will try and my blood report I have attached. I not have fever or breathless problem.
4.     I am having the anti allergic tab which I have mention earlier started along with antibiotic along with this I am having betadene gargle and Steam I will start.
5.     I have seen ENT specialist and planning to go for followup. I do not smoke. ENT has prescribed me supplementary for B12 level
6.     The cough originates at the vocal cord and some time I feel irritation like itching nothing else.

Thank you,
XXXXXXX

Answered by Dr. Sumit Bhatti (5 hours later)

Hi,

Thank you for writing back.

1. Take a cough suppressant syrup such as Ascoril-D, Soventus-Dc or Reswas. This should not lead to asthma.

2. If you still have doubt, get Pulmonary (Lung) Function Tests (PFTs) done.

3. Get a Video Laryngoscopy done. You may share the images here. Acid reflux or a PND may be involved.

4. We can discuss the options after the test results.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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

Follow up: Dr. Sumit Bhatti (16 hours later)

Hi Dr Bhatti,

Thanks for the reply Today I went to see my ENT for the followup and he has mentioned a/c Granular Pharyngitis with LPR. May i know what is this.
He told me the infection has come down and only left is post infection after antibiotics. today he changes the medicine which is as below.
T Defcort 6 mg one day for 5 days
T.Phlogam 2 times for 5 days
T Allegra 180mg 1 day for 7 days
T Telekast-L 1 day for 7 days.

May i know all about this is this fine and serious of the infection. Please note in night coughing increase I have intution that i might have allergic to Milk and i do have TSH high which you can see my report but Dr said its fine. Please suggest.

Thank you,
XXXXXXX

Answered by Dr. Sumit Bhatti (6 hours later)

Hi,

Thank you for writing back.

1. As suggested above, Granular Pharyngitis is usually due to a PND (Post Nasal Drip). LPR is Laryngopharyngeal Reflux which is due to Acid Reflux from the stomach into the throat without any heartburn (burning pain in the chest or food pipe) seen in GERD (Gastro-Esophageal Reflux Disease).

2. Ask your physician to prescribe a medicated gargle, a cough suppressant and anti-reflux medication in addition. Steroids (Defcort) may increase gastritis.

3. There is no cause for worry. These are common conditions and will respond to treatment.

4. Cough may increase after lying down due to a PND or Acid Reflux. Allergy to milk may not be the cause.

5. The attached report only shows Vit B12 levels. There is no TSH report attached.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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