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What Causes Recurrent Episodes Of Cold And Cough?
Question: I m suffering from weird cold cough. It is quite surprising that I get this invariable every 6 months. In the last 4 years, I have had around 6 episodes which last from 15 days to 45 days depending on severity. Doctors generally start with paracetamol, then antibiotics, then anti-allergic and only in the end they realize this is not a routine cold but something else. So subsequently last year one doctor suggested seroflo (for bronchitis). The year before that a doctor in London informed me this is acid reflux and therefore put me on PPI. I am not clear whats going on. Today, a doctor tells me that what I m having is a combination of acid reflux and bronchitis as the former is leading to the latter and therefore medicines for both need to be taken in parallel. My questions are as follows:
1. Assuming this is acid reflux leading to bronchital situation, what medicines are best?
2. If this were only bronchitis, then how long should seroflo (zydus manufactured pump inhaler) should be consumed? A doctor tells me that it should be consumed for 2 months even though symptoms are cured. This is absolutely contrary to another doctor who informed me that seroflo should never be taken and in worst cases, restrict to minimal usage. Both these doctors are different from a doctor I met today who informed me that seroflo has a fixed cycle usage of 15 days, so it can be used in mutliple of it or till the time it is cured whichever is later.
3. The irony is that every time I get this kind of problem (cough), it generally starts when I first wake up and I am reasonably sure that this is the "weird" one coming along which won't go away with Paracetamols. In such situations, what medicine should I immediately take so as to not wait and experiment before taking the heavy doses
4. What are the medicines you prescribe? As a precaution and for post mortem repair
Thanks
1. Assuming this is acid reflux leading to bronchital situation, what medicines are best?
2. If this were only bronchitis, then how long should seroflo (zydus manufactured pump inhaler) should be consumed? A doctor tells me that it should be consumed for 2 months even though symptoms are cured. This is absolutely contrary to another doctor who informed me that seroflo should never be taken and in worst cases, restrict to minimal usage. Both these doctors are different from a doctor I met today who informed me that seroflo has a fixed cycle usage of 15 days, so it can be used in mutliple of it or till the time it is cured whichever is later.
3. The irony is that every time I get this kind of problem (cough), it generally starts when I first wake up and I am reasonably sure that this is the "weird" one coming along which won't go away with Paracetamols. In such situations, what medicine should I immediately take so as to not wait and experiment before taking the heavy doses
4. What are the medicines you prescribe? As a precaution and for post mortem repair
Thanks
Brief Answer:
Please go through the following discussions.
Detailed Answer:
Hi
Thanks for your query.
I am trying to answer your questions one by one below -
1. There are many direct and indirect causes by which acid reflux may cause cough especially dry asthmatic cough. Medications for this are proton pump inhibitors like pantoprazole, omeprazole, rabeprazole, esomeprazole which are to be taken twice daily before food for at least 6-7 weeks even after remission along with life-style modifications like small but frequent food intake, avoidance of spicy and fast food, plenty of water intake, avoidance of smoking, alcohol, tea, coffee and head end elevation during sleep.
2. I think you are having asthma rather than bronchitis. You must go for a spirometry testing to confirm and grade your diagnosis along with sputum eosinophil count, total serum IgE level to asses severity and prognosis of your disease.If you started seroflo then the dose of seroflo should be gradually tappered and withdrawn depending upon the response to treatment and obviously under close monitoring of pulmonologist because only he will be the master of your disease and he can rightly prescribe the dosage and duration of that drug. In general if you have no symptoms for 3 months the drug dosage should be decreased gradually and ultimately should be withdrawn. But treatment must be stepped up again in future if symptoms reappear.
3. In your scenario antibiotics have no role until you have symptoms of chest infections like increase in sputum purulence, sputum volume or fever.
4. I recommend you5to start salmeterol plus fluticasone or formeterol plus fluticasone inhaler (250) 2 puffs twice daily along with montelukast-levocetrizine during night time and treatment must be stepped down gradually under the guidance of a pulmonologist.
If you have further queries you can ask me without hesitation.
If you are happy with my response kindly write a review for me.
Thank you.
Regards,
Dr Arnab Maji
Consultant Pulmonologist
Please go through the following discussions.
Detailed Answer:
Hi
Thanks for your query.
I am trying to answer your questions one by one below -
1. There are many direct and indirect causes by which acid reflux may cause cough especially dry asthmatic cough. Medications for this are proton pump inhibitors like pantoprazole, omeprazole, rabeprazole, esomeprazole which are to be taken twice daily before food for at least 6-7 weeks even after remission along with life-style modifications like small but frequent food intake, avoidance of spicy and fast food, plenty of water intake, avoidance of smoking, alcohol, tea, coffee and head end elevation during sleep.
2. I think you are having asthma rather than bronchitis. You must go for a spirometry testing to confirm and grade your diagnosis along with sputum eosinophil count, total serum IgE level to asses severity and prognosis of your disease.If you started seroflo then the dose of seroflo should be gradually tappered and withdrawn depending upon the response to treatment and obviously under close monitoring of pulmonologist because only he will be the master of your disease and he can rightly prescribe the dosage and duration of that drug. In general if you have no symptoms for 3 months the drug dosage should be decreased gradually and ultimately should be withdrawn. But treatment must be stepped up again in future if symptoms reappear.
3. In your scenario antibiotics have no role until you have symptoms of chest infections like increase in sputum purulence, sputum volume or fever.
4. I recommend you5to start salmeterol plus fluticasone or formeterol plus fluticasone inhaler (250) 2 puffs twice daily along with montelukast-levocetrizine during night time and treatment must be stepped down gradually under the guidance of a pulmonologist.
If you have further queries you can ask me without hesitation.
If you are happy with my response kindly write a review for me.
Thank you.
Regards,
Dr Arnab Maji
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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