What Causes Severe Cough When Diagnosed With Bronchitis?

Posted on Mon, 22 Aug 2016

Question: I had bronchitis last month with cough and fever. Everything left but the cough. It's going on two months now. First it was producing some small amount of white phlegm now it seems dry with a constant tickle. I saw an ENT and two pulmonologist that didn't do much for me.

Answered by Dr. Rahul Tawde (3 hours later)

Brief Answer:
Following additional suggestions for bronchitis...

Detailed Answer:
Hi my dear,

I have gone through your medical history carefully and understood your concerns.

Bronchitis is caused in majority of cases by virus. In this case, the symptoms will persist for more than 3 or 6 weeks especially when it comes to coughing.

If it is complicated with bacterial infection, then, the symptoms might last longer depending on their severity.

With regards to the treatment, there are multiple approaches :

- antibiotics in case of bacterial infection (Zpack you've already used)
- potent anti-inflammatory like prednisone you already used
- anti-histaminics to stop coughing
- mucolytics that will dissolve the mucus and cleared it out
- antacids: there is increased acidity of the stomach due to bronchitis (inflammation) itself and meds used to treat it. Sometimes, PPIs like Omeprazole can be used once daily for 2 weeks.

As the coughing is persisting, I'd suggest to start taking:

- herbal anti-coughing medicines that can be used for long period without any serious side effect
- use anti-histaminic like Ketotifen or Loratadine for 10 days(prescription needed to be obtained from your local physician)

- increase fluids intake
- take antacids
- consider making some dietary changes: avoid foods like spicy, chilly, oily, fried foods that can precipitate coughing due to hyperacidity of stomach they cause.

I also suggest to run Pulmonary function test and X-ray of the lungs to rule out possible obstruction of respiratory pathways in order to start any specific treatment.

Discuss these further with your doctor.
Hope it helped!
Dr.Sejdini

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

Follow up: Dr. Rahul Tawde (12 minutes later)

I recently had chest xray cleared and sinus xray also normal. In may I had spinometry test normal also

Answered by Dr. Rahul Tawde (2 hours later)

Brief Answer:
Detailed below...

Detailed Answer:
Hi back,

If all these tests resulted normal, then, consider taking antihistaminic and antacids for at least a couple of weeks.

Can discuss about taking steroid shots once a week.

All the best!
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rahul Tawde (6 minutes later)

Why steroid shots? For what? Why is my cough so dry now causes me to choke sometimes. I never had a cough last so long and I don't smoke. If I had a respiratory obstruction like u said would that show on chest xray

Answered by Dr. Rahul Tawde (8 minutes later)

Brief Answer:
Get an upper endoscopy done to rule out stomach hyperacidity problems

Detailed Answer:
Hi back my dear,

Sometimes, the use of steroid shots can help manage inflammation when other meds fail.

If x-ray was clear, respiratory tests (spirometry) were normal, then obstruction or any other respiratory infection is automatically excluded.
So, to me, should look for other reasons like acid reflux or gastritis. Can ask for upper endoscopy to determine/rule it out.

All the best!
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Raju A.T