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Persisting cough, stuffy nose, ear popping, taken sudafed and cleratin D. Cure?

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I have a cough for about 3 months that would not go away, for the past month there is added symptoms of stuffy nose and popped ears. I'm taken sudafed and cleratin D to relieve some pressure, and flonese spray for nasal but they all seem temporary. What do I have and how do I get rid of it?
Posted Mon, 30 Apr 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 9 hours later
Hi,

Thank you for your query.

1. You may have developed Rhinitis Medicamentosa due to the combined use of Sudafed and Claritin D, both of which contain pseudoepedrine or related decongestants like phenylepherine. Rebound congestion on prolonged use of systemic decongestatnts leads to the added symptoms of stuffy nose and popped ears.

2. Your cough may now be termed chronic as it has been present for more than four to six weeks. To treat this effectively, I need some more information:

a. Is your cough dry?

b. Does it occur at a particular time of the day, on change of position?

c. Is it related to food intake?

d. Is your cough productive? If yes, what is the color of the phlegm?

e. Has there been any blood tinged sputum?

f. Do you have any chest discomfort, pain in chest or breathlessness?

g. Do you have any exposure to tobacco smoke?

h. Do you have GERD (Gastro-Esophageal Reflux Disease)?

i. Do you have any pre-existing lung disorder such as ashtma?

j. Have you had any investigations such as a Chest X-ray, Blood Tests or sputum examination?

k. Do you have a post nasal drip?

3. To get rid of this you will have to discontinue your tablets. This makes the symptoms worse for a couple of weeks while your body adjusts. To relieve this discomfort, you may continue the Flonase nasal spray and and saline nasal washes, regular, steam inhalation and a plain anti-allergic such as plain Claritin (loratidine) if you also have allergic rhinosinusitis due to pollen allergy. However anti-allergics tend to dry the nose too. You may try a combination of an anti-allergic and an anti-leukotriene (montelukast) under medical supervision of your physician.

4. To ease your cough you may require a cough supressant (not an expectorant) for a few days. Cough is a protective reflex and need not be suppressed if it is mild. If it is a result of nasal allergy or a post nasal drip, it will subside.

Awaiting your reply,

Regards.
Above answer was peer-reviewed by
 
Follow-up: Persisting cough, stuffy nose, ear popping, taken sudafed and cleratin D. Cure? 39 hours later
Thank you for the reply, I had this cough for a while now, 3 months. The cough comes and goes, its not always constant. I have yellow phlem when I cough.

a. Is your cough dry?
some times
b. Does it occur at a particular time of the day, on change of position?
11am-8pm
c. Is it related to food intake?
I do not believe so
d. Is your cough productive? If yes, what is the color of the phlegm?
Yes, yellow, very sticky
e. Has there been any blood tinged sputum?
no
f. Do you have any chest discomfort, pain in chest or breathlessness?
no chest discomfort of any kind
g. Do you have any exposure to tobacco smoke?
No exposure
h. Do you have GERD (Gastro-Esophageal Reflux Disease)?
No I do not
i. Do you have any pre-existing lung disorder such as ashtma?
No
j. Have you had any investigations such as a Chest X-ray, Blood Tests or sputum examination?
No
k. Do you have a post nasal drip?
I dont know, Ive looked up the symptoms and I have more than half the list of those symptoms. I think I might have post nasal drip.

Coughing
Wheezing
Constant swallowing
Rhinorrhea, running nose due to mucus flow
Frequent spitting
Tickling in the throat
Constant clearing of throat
Mucus feeling in the back of the throat
Difficulty in breathing
Congestion in the nasal and sinus passages
Masses formed in the crypts of the tonsils that are generally yellow or white (commonly called tonsil stones, or tonsilloliths)
Halitosis (bad breath)
Snorting to clear mucus from the nasal passage that cannot otherwise be cleared by blowing one's nose
Cobblestone appearance of the oropharyngeal mucosa
 
 
Answered by Dr. Sumit Bhatti 20 minutes later
Hi,

Thank you for writing back.

1. You seem to have an allergic problem, with a post nasal drip (11am to 8pm).

2. Discuss the guidelines that I have suggested in the earlier reply with your physicians. Treatment according to the above mentioned principles should make your cough subside. Your Rhinitis Medicamentosa has to treated.

3. Mucolytics may increase your cough on the short term. A cough suppressant containing dextromethorphan will be sufficient. Levocloperastine is a newer cough suppressant with good results.

Hope this suffices.

Wishing you a speedy recovery,

Regards.
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