Ask Dr. Gott: Chronic cough usually benign
Jan 8, 2011 02:35AM
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Q: I am a 19-year-old female and have had a nonproductive cough for 16 months without any other symptoms other than some slight drainage down the back of my throat. I have kept food and cough diaries and cannot find anything that triggers it. I cough when I sit, stand, laugh, after strenuous exercise and around smoke.
I have been diagnosed with bronchitis, hiatal hernia, asthma and heartburn. none of the medication given for these diagnoses has worked. I’ve been on Symbicort, Spiriva, codeine, Prilosec, Zantac. I had a chest X-ray done in July 2009 without abnormalities.
At my last visit to the pulmonologist, I was told that I have irritated bronchitis and that I would have it for the rest of my life unless it miraculously went away.
Within the past two weeks, I have noticed that I have all of a sudden been getting heartburn. No acid comes up in my throat, and it usually never lasts for more than a few seconds, but it is a new symptom. Doctors have asked me in the past if I have had heartburn, but I never have up until now. Please help me.
a: Chronic cough can have many causes; most are benign. up to 90 percent of all cases are caused by postnasal drip, acid reflux or asthma.
I suggest that you take a look at your environment to determine if there is something that may be causing this. did you get a new pet or move? did you start wearing a new perfume or using a new scented soap or shampoo?
Talk to your physician about a trial course of an allergy medication. Over-the-counter options include Claritin, Zyrtec, Benadryl and various store brands. Prescription options include Nasonex, Flonase, Clarinex and more.
I am hesitant to believe that you have acid reflux or asthma because treatment failed to improve your cough; however, they may still be the culprits. Acid reflux can be helped through changes in diet as well as physical activity. Limit your intake of fatty, greasy, high-acid and spicy foods. Asthma may require daily preventive therapy such as a steroid inhaler in addition to a rescue inhaler for emergencies. your new symptom of heartburn may be related to acid reflux, but it may also simply be the result of your constant coughing.
I urge you to undergo another chest X-ray. your pulmonologist can then compare the two films to determine whether there are changes that might indicate a more insidious cause.
If you are uncomfortable with your current physicians and their assistants, start fresh with another lung specialist or primary-care physician. Express your concerns about the cough, and be sure to bring all your medical records with you. The new physician can offer a new perspective and insight into your situation and may find something that the others missed.
To provide related information, I am sending you a copy of my Health Report “Pulmonary Disease.” other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. be sure to mention the title or print an order form off my website at AskDrGottMD.com.