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Dry cough since many years with clear chest

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I am suffering from dry cough for the past many years. I have done tests that confirms that my chest is clear. There is constant irritation in the throat.I also feel soreness in between throat and nose passage. DOCTORS HAVE TRIED ANTIBIOTIC and anti allergic medicines, but with no effect. At times the cough is so intense that i vomit. Invariably I start coughing when i am in a meeting or in a public place where I am worried that my cough may trouble me and try to control it. Quite a few times I get relief when I take codine bases syrup in the night. My problem persists throughout the year, at times intense and at times mild. I am 65y, active and keeping a good health. Please advise.


Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,

Thank you for your query at DoctorSpring.com. I can understand your problem, and will try to help you the best possible

Let me explain the disease first ->

Sir your problem is Gasto-oesophageal reflux disease (GERD). There may be a associated allergic pharyngitis also.

Gastroesophageal reflux disease (GERD) is a condition in which the contents of the stomach are regurgitated back up into the esophagus.

Lining skin of oesophagus and pharynx is not as strong as of stomach. So this acid reflux caused oedema( swelling) there, So it will cause irritating sensation, foreign body sensation or sticky sensation and will cause dry irritant cough. Reflux increases when we lie down, so your problem increasing in night time.

Treatment ->

Treatment usually involves a combination of medication, weight reduction if necessary, and changes in diet and lifestyle.

Weight loss can greatly reduce symptoms in obese people.

Avoidance of certain foods (such as caffeinated and/or carbonated drinks, chocolate, fatty foods, alcohol, and spicy foods) and stopping smoking can help to prevent reflux.

Eating meals at least one to two hours before lying down or going to bed and elevating the head of the bed a few inches may also help to prevent stomach contents flowing back up into the esophagus.

Proton pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex) are another type of drug, which may be given regularly to cut down the acid production of the stomach and promote the healing of ulcers.

You can start with Tab. Rabeprazole 20 mg half an hour before breakfast once daily for 3 months after consulting your physician.

Rather than codeine(it causes constipation) we can start

Syr. Piriton –CS (Combination of chlorpheniramine maleate and dextromethorphan hydrobromide) 5 ml two times daily for 1 week. This will word as anti allergic and as a cough suppressant.

There is no role of antibiotic, it will make it worse only.

Summary of treatment ->

1. Life style changes

2. Rabeprazole 20 mg half an hour before breakfast once daily for 3 months

Hope this helps. Feel free to ask if you have any further queries.

Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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