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Suggest Treatment For Cough And Uneasiness At Throat

Posted on Mon, 15 Dec 2014

Question: I am suffering from cough for a long time. It is not very hard cough just uneasiness at the throat. I have to clear the throat time to time. There are red spots at the back of the throat. Just two days back I went to Sauna where I took a cold bath after hot steam and throat started paining. I am living in Kazakhstan and its very cold here. Now when I am clearing phlegm blood coming. I have sharp pain at the right side of throat. I did CBC test and result was all OK except eosinophil 5.1 slight high (Normal range 0 - 5.00).
I am taking steam and salt gargle. Also taking Foracort 400 inhaler once in a day and one tablet Montair FX.
What do you think from the symptoms? Also how to mitigate it?

Answered by Dr. Krunal Karade (35 minutes later)

Brief Answer:
You are having allergic rhinitis with PND.

Detailed Answer:
Hi,
Thanks for the query.

I have read your query and understand your concern.

After reading your clinical history it appears that you are having allergic rhinitis with post nasal discharge (PND).

If I were your treating Doctor for this case , I would advice you
Antiseptic chlorhexidine Mouth Wash twice daily ,
Plenty of fluids ,
Steam Inhalation twice daily,
Saline nasal spray thrice daily like solspre ,
Antibiotic tab Azithromycin 500mg / day for 5 days &
Combination Steroid nasal spray with antihistamine 2 puff each nostril twice daily like Duonase or Nezalast. You need to continue till allergy subsides .

Gargle with water 20 mins after nasal spray use to remove any spray coming to throat .

You can stop Foracort 400 inhaler & Montair FX .

You can discuss this with your treating doctor.

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.

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

Follow up: Dr. Krunal Karade (42 minutes later)

The conception of PND is not clear to me. My noses are dry. I am not sniffing at all.
This kind of chronic symptoms never happened to me before. It started from the beginning of the year. I am working in Kazakhstan and its very cold now. I almost spent more than 10 years here. But just this year suffering from this problem.

Answered by Dr. Krunal Karade (19 minutes later)

Brief Answer:
Most people with PND do not have any anterior nasal discomforts .

Detailed Answer:
Hi XXXXXXX ,

Thanks for the follow up query.

Most of my patients with PND do not have any anterior nasal troubles.
Normal nasal sinus mucosa secretion increases because of allergy which due to gravity trickle into throat leading into cough & clearing of throat . Cold increase throat discomfort .

Follow complete treatment plan , you will get relief .

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.

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

Follow up: Dr. Krunal Karade (23 minutes later)

Just two last questions,
1. Why the blood coming when I am disposing phlegm. This is most bothering me.
2. Why all of a sudden started feeling pain in the throat?

Also to let you know I have deviated nasal septum. Not very much and never felt uncomfortable to breath.

Answered by Dr. Krunal Karade (6 minutes later)

Brief Answer:
it is due to increase congestion.

Detailed Answer:
Hi XXXXXXX ,

Thanks for the follow up query.

Minimal blood loss in phlegm is commonly due to increased congestion in sinuses .
Infected PND causes throat pain. Antiseptic chlorhexidine Mouth Wash will decrease infection.
If pain is more, use paracetamol 650 mg after food twice daily .

Hope this information helpful to you. If you have any further questions I will be happy to help.
Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Krunal Karade (20 hours later)

Doctor,
I have no sneezing. May be once in two days.
Nose is dry. No blockage at all. All symptoms at back of the throat. Do you still consider it post nasal drip?

Answered by Dr. Krunal Karade (26 minutes later)

Brief Answer:
Mostly PND

Detailed Answer:
There are four main reasons for your cough...
1) Most common is post nasal discharge in 70 % cases
2) Acid reflux
3) Asthma...
4) Infection

There may be combination of the causes.

If you get relief with Saline nasal spray thrice daily & Combination Steroid nasal spray with antihistamine then it is because of PND.
If you get relief with antacid then it is because of acid reflux.
If you have breathlessness with cough & get relief with steroid inhaler then it is because of asthma.
Infection can be present in combination with above three.

Your symptom like clearing of throat, blood in phlegm, throat pain, DNS & raised eosinophil point towards allergic PND.

Hope this information helpful to you. If you have any further questions I will be happy to help.
Regards,

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Krunal Karade (39 minutes later)

Just to tell you I don't have cough. Some times rarely very minor. Not feeling any breathing problem.
I am feeling stomach burning some times but not regularly.
Also as the day proceeds I am suffering from voice hoarseness and continuously clearing throat.

Answered by Dr. Krunal Karade (27 minutes later)

Brief Answer:
Mostly due allergic PND with acid reflux

Detailed Answer:
Voice hoarseness and continuously clearing throat is due allergic PND.
I would advice you ,
follow above treatment plan with antacid syrup, you will get relief .

Thanks.

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. Bhagyalaxmi Nalaparaju