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What Causes Recurrent Cold, Congestion, Throat Pain And Excessive Phlegm In The Throat?

Posted on Wed, 16 May 2018

Question: Hi, My Daughter is getting cold and congestion very frequently with pain in throat and sputum/mucus, what can be reason for same and to whom we should see. Pls advise

Answered by Dr. Drkaushal85 (49 minutes later)

Brief Answer:
Consult pulmonologist and get done PFT.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Recurrent cold, cough, congestion, mucus production in young patient (18 years) should be evaluated for asthma.
So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).
PFT will not only diagnose asthma but it will also tell you about severity of the disease and treatment is based on severity only.
Please let me know
1. Is she having any allergies?
2. Is there any family history of allergy?
3. Since how many years she is having these symptoms?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (7 hours later)

Hello Dr. Pls do find reply as below,

1. Is she having any allergies?
we are in XXXXXXX and high pollution but not known yet if she has allergy to any thing
2. Is there any family history of allergy?
No
3. Since how many years she is having these symptoms?
earlier it used be with change in weather but from last 2 month it quite often

she has cold and mucus/sputum but don't have cough

Rgds

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Is she having breathlessness or wheezing sound at night?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Pollution can also exaggerate ongoing asthma.
So please let me know
1. Is she having breathlessness or wheezing at night?
2. Has she ever undergone PFT?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (25 hours later)

Hello Doctor, Pls do find reply as below

1. Is she having breathlessness or wheezing at night?
No breathlessness as I asked her but noticed some time, but she has cold and her nose is congested so she try to breath trough mouth some time and I could hear mild snoring
during this process when nasal airways are closed and she take breath through mouth, I think she gets pain in throat as cold/congestion always starts with pain in throat

2. Has she ever undergone PFT?
No

Answered by Dr. Drkaushal85 (10 hours later)

Brief Answer:
Get done PFT.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, she is having allergic rhinitis with allergic asthma.
So better to consult pulmonologist and get done PFT.
She will need
1. Intranasal spray containing steroid (fluticasone)
2. Inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
3. Oral combination of antihistamine (levocetrizine or fexofenadine) and anti allergic (montelukast) once a day.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (4 days later)

Hello Dr.
We have consulted ENT in XXXXXXX and she has advised test like Adenoid Xray and CBC with AEC, I am attaching report for same with prescription, Pls look into same and advice finally.
Rgds

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
What about PFT?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I have gone through the reports you have attached.
It is suggestive of adenoid hypertrophy and related symptoms.
So surgical removal is must.
What about NCCT of paranasal sinuses?
What about PFT? I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (16 hours later)

Thanks Dr.
we didn't done PFT and NCCT yet
I have attached Xray Picture also, my question

1. should I go for PFT test also, what it will help to know?, or we can assume that problem is with adenoid?
2. should we go for NCCT test also, as it is exposure to radiation and what it will help?
3. what about low hemoglobin and low AEC and ABC in report, is it allergic also?
4. Pls help to close how to move for further treatment for which treatment, not sure, need advise?
5. since yesterday, she has slight fever at lower side at 97.8/98 and sick feeling of vomiting
Rgds

Answered by Dr. Drkaushal85 (18 hours later)

Brief Answer:
Yes, you should get done PFT.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry for late reply as I was busy.

Answer to your 1st question.

Yes, you should get done PFT.
PFT will tell you if she is having asthma or not. If she is found to have asthma then treatment of asthma might reduce adenoid size.

Answer to your 2nd question.

Yes, NCCT paranasal sinuses is also needed because it will tell you exact size of adenoid. So if surgery is planned then NCCT paranasal sinuses will guide about surgical approach. No need to worry much for single time radiation exposure in CT scan.

Answer to your 3rd question.

No, low AEC is not suggestive of allergy. It is normal thing. Low hemoglobin is mostly due to nutritional anemia (low iron). This can be easily treated by iron supplements (diet and pills).

Answer to your 4rth question.

Get done PFT and NCCT both.
If PFT is normal then adenoid surgery is must.
If PFT is showing asthma then start asthma treatment and see if adenoids are reducing in size or not. If after starting asthma treatment, her symptoms reduce then she may not need surgery.

Answer to your 5th question.

Give her antacid and anti emetic combination (pantoprazole plus domperidone) for vomiting sensations.

Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (4 hours later)

Thanks Dr. for detailed response... very much helpful...

Pls do suggest some iron supplement name for low hemoglobin and pantoprazole plus domperidone... I have given her Razo D...Rgds

Answered by Dr. Drkaushal85 (49 minutes later)

Brief Answer:
Iron supplement is levogen Z tablet.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Iron supplement is Tablet Levogen Z.
It should be taken once a day after lunch for 2-3 months.
Get done repeat hemoglobin levels after 2-3 months.
Razo D is rabeprazole and domperidone combination. It is better than pantoprazole combination.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (1 hour later)

Thanks Dr.

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
Please close the conversation and rate my answer.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's always encouraging for doctors to hear positive feedback from patients.
I am glad that my advice is helping you.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng