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Suggest Treatment For Chronic Cough

Posted on Wed, 10 Feb 2016

Question: Hi - I have had a long term chronic cough - which flares. For the past 2 1/2 wks - I am coughing up thick mucousy flem yellow & green (just as in the past), my nose gets stuffy & when I blow it - it is yellow/green. I have had numerous chest xrays - which all say lungs are clear. One doctor said it was just allergies & to use an inhaler once a day - which doesn't effect anything one way or the other...I still cough continually, etc. This started 5 yrs ago & I have been battling it off & on since then. When I lay down, it really gets bad & I have no way of sleeping sitting up. Do I need to see another doctor? Would antibiotics help? Thank you.

Answered by Dr. Saad Sultan (37 minutes later)

Brief Answer:
continue with anti allergy medicine , needs workup

Detailed Answer:
Welcome at HCM...
I am Dr Saad Sultan and will be answering your query. I have read and understood your health concerns.
Are you suffering from asthma? Do you smoke? Do you have any fever? Do you cough while sleeping?
Based upon the history , recurrent cough need to be investigated. It may be an allergy , bronchitis, cough variant asthma etc.
Have you visited pulmonlogist? Have you done your pulmonary function tests.?
If am your attending physician I will examine you and investigate you. I will get yourFull blood count FBC,erythrocyte sedimentation rate ESR and pulmonary function tests.There is need to look at your heart as well. ECG and echocardiography would be relevant to do.After then I will be able to proceed.
Meanwhile stay calm and continue with your medicine. You can add tab. Cetrizine 10mg at night daily.If you are having greenish sputum and fever then one should use antibiotics.
Meet pulmonologist for proper assessment.
Regards
Dr Saad Sultan

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Saad Sultan (8 hours later)

Over the past several years, I have seen a pulmonlogist - did a 3 day sputum - came back as indefinitive. Ears, Nose & Throat - did a sinus exam with camera - stated sinuses looked really good. Have had the ECG - which was fine, no prob. Have had full blood count - everything was within normal ranges. One doctor had me take a Zyrtec once a day - which helped minimally for about 6 hrs - where I then had to take something else.

I have never been diagnosed with "asthma". NO - I do not smoke. I have low grade fever - fluctuates. Yes, I cough whether I am laying down or not - start coughing & wakes me up as I gag on the sputum, have vomited, wretched, etc with the sputum, whether laying down or not. I spit/gag up thick mucousy yellow/green sputum, and when I blow my nose - it also has the yellow/green sputum.

I have asked all those doctors - why can't they stop the drainage down the back of my throat? Where is it coming from? None can answer those questions.

Answered by Dr. Saad Sultan (28 minutes later)

Brief Answer:
continue with anti allergy medicine

Detailed Answer:
Welcome to HCM
I appreciate your follow up..

After reviewing your feedback , it seems to be allergy related issue. Pulmonary function tests ( spirometry) seems appropriate along with CT scan of the chest . This will definitely exclude any lung pathology if present.

Do you have any acid reflux problem? It is also a common cause of cough too.
Stay calm, wear mask , continue with zyrtec 10mg. If I am your attending physician I want you to start with Omeprazole 40mg before breakfast for two weeks to see for response.

Hope it helps

Regards
Dr Saad Sultan

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Saad Sultan (54 minutes later)

Thank you for your response. No - I do not have acid reflux. Question - do I also take the "cetrizine 10 mg" as suggested at night, along with the "omeprazole 40 mg"?

I don't remember a spirometry pulmonary test, nor a CT of the chest.

Thank you again.
Candi XXXXXXX

Answered by Dr. Saad Sultan (11 minutes later)

Brief Answer:
yes , you can use it

Detailed Answer:
Welcome Candi XXXXXXX to HCM.
I appreciate your follow up
Yes you can use Omeprazole before breakfast with cetrizine at night. Do discuss with your attending physician about spirometry and CT chest.
Kindly do close discussion in end.
If you have ever any query feel free to ask any time by mentioning my name. HCM is your home and we all care for you ,

May you get well soon

Regards
Dr Saad Sultan

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee