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What Is The Cause And Treatment For Dry Cough?

Posted on Tue, 5 Aug 2014

Question: Dear Dr. Karade,

I asked you recently concerning my dry cough. Details are as follows:
History: 4 weeks dry cough, when trying to speak. More irritation when trying to make high-pitch sounds instead of lower tone sounds. Taken PPIs (Pariet) for three weeks, not sure if improvement from 3 weeks ago but improvement from one-two weeks ago likely.
ENT doctor has looked through nose and said it was dry and unlikely any post-nasal discharge.

I would like to show a picture of the throat from taken on the 23rd of XXXXXXX 2014. Does it appear to show any vocal chord inflammation or any signs of GERD affecting the throat? Could I ask what do each of the four smaller pictures show?
Does the fact that higher pitch sounds (such as the 'eee' that the ENT doctors ask for) cause the cough much more than lower pitch sounds mean anything?

Thanks and regards.

Answered by Dr. Krunal Karade (2 hours later)

Brief Answer:
Vocal cords appear normal.

Detailed Answer:
Hi XXXXXXX ,
Thanks for the query.
I have seen your throat photos.
Vocal cords appear normal. Minimal GERD & Post nasal drip seen. 1st photo show Vocal cord in closed position with little mucus , 2nd photo show Vocal cord in open position appear normal , 3rd photo just above epiglottis showing posterior pharyngeal wall with post nasal drip & posterior part of tongue & 4th photo show nasal cavity with bigger middle turbinate due to allergy.
Cough is common while performing larynx endoscopy.
I would like to know your profession & history of excess voice use. Also like to know whether you have use steam inhalation , Saline nasal spray & anti allergy medication .
To get complete relief from dry cough , I would advice you plenty of fluids ,steam inhalation , Saline nasal spray & anti allergy medication along with GERD treatment.
Hope this information helpful to you, take care and have a nice day.
Regards.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (17 hours later)

Thanks Dr. Karade,

I understand that the pictures do show some nasal drip, allergy and GERD but they are not serious. I will also speak with doctor about saline nasal sprays and anti-allergy medication.

I don't have a history of excess voice use but this cough mainly appears when using high-pitched voice sounds such as 'eeee' and also appears when not doing the procedure.

Thanks
Regards.

Answered by Dr. Krunal Karade (2 hours later)

Brief Answer:
High pitched voice stimulate cough reflex.

Detailed Answer:
In your case high pitched voice stimulate cough reflex due to dryness common in Upper airway cough syndrome (UACS) ( previously referred to as postnasal drip syndrome ) or GERD . Other causes smoking or antihypertensive ACE inhibitor or asthma . I am considering you are non smoker, non hypertensive & non asthmatic.
UACS ( most common 87% of patients ) show no specific finding & the diagnosis is made based on response to antiallergy & sprays.
I would advice you plenty of fluids , steam inhalation , Saline nasal spray , anti allergy medication along with GERD treatment & see response .
Hope this information helpful to you, take care and have a nice day.
Wish you good health.
Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Krunal Karade (21 hours later)

Thanks Dr. Karade,

Now I understand that the high-pitched voice my stimulate the cough reflex and not necessarily indicate vocal chord involvement or irritation.

I will consult an ENT further and see how to manage the issue and will bring up your suggestions.

Thanks very much,
Regards.

Answered by Dr. Krunal Karade (4 hours later)

Brief Answer:
I will be happy to help .

Detailed Answer:
I will be happy to help .
Wish you good health .
Take care and have a nice day.

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. Vinay Bhardwaj