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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic Persistent Cough. Chest X-ray, CT Scan, Allergy Tests Normal. Causes For Cough?

I have a cough that dosn t go away. It gets worse when I work out. I have been to the doctors, they checked for: 1. Pulmonary Specialist checked for bronchitis pulmonary function test 2. My doctor blood test chest x ray chest crt scan 2. A specialist also checked for allergens I was told that they found nothing that would cause the caughing. What could it be?
Tue, 16 Apr 2013
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Pulmonologist 's  Response
Hi glennaknight,

Thanks for coming to HCM.

chronic cough as per definition is cough more than eight weeks. The possible causes can be:

1)Cough variant asthma which can be ruled out by bronchial provocation test,

2)Eosinophilic bronchitis where pulmonary function test is normal but there is raised sputum eosinophil and can be readily made out by sputum microscopy.

3) 10% of hypertensive patients who are on ACE inhibitors group of drugs like ramipril, enalapril etc. Cough subsides on discontinuation of drug.

4)Chronic sinusitis, pharyngitis, rhinitis via a mechanism called post nasal drip, where the secretion trickle down in trachea and cause cough.

5) Gastroesophageal reflux disease (GERD) by trickling of refluxed acid into the trachea and causing inflammation.

6) Parasitic infection of the lung like tropical pulmonary eosinophilia in filariasis. But here blood eosinophilia is there and you said blood test is normal, so ruled out.

7) Any chronic disease like bronchictasis, tuberculosis, cancers etc but these are readily catched on CT scan.



In your case, you must have provided your history in these context and gone for respective examinations. I can understand your concern. Many a times cough is so irritating and exhausting. Meet pulmonologist with proper history concerning the above points to reach a specific diagnosis..



Best wishes
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

You have not stated your age, gender, personal habits, family history or co-morbidities...

Exercise induced asthma is a prime possibility
Anxiety is next in the list
Some drugs (like ACEI used in hypertension) are notorious for this.
Reflux from hiatus hernia / Sinusitis and post nasal drip - and so on could do this.. .

Take care
Wishing speedy recovery
God bless
Good luck
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Chronic Persistent Cough. Chest X-ray, CT Scan, Allergy Tests Normal. Causes For Cough?

Hi glennaknight, Thanks for coming to HCM. chronic cough as per definition is cough more than eight weeks. The possible causes can be: 1)Cough variant asthma which can be ruled out by bronchial provocation test, 2)Eosinophilic bronchitis where pulmonary function test is normal but there is raised sputum eosinophil and can be readily made out by sputum microscopy. 3) 10% of hypertensive patients who are on ACE inhibitors group of drugs like ramipril, enalapril etc. Cough subsides on discontinuation of drug. 4)Chronic sinusitis, pharyngitis, rhinitis via a mechanism called post nasal drip, where the secretion trickle down in trachea and cause cough. 5) Gastroesophageal reflux disease (GERD) by trickling of refluxed acid into the trachea and causing inflammation. 6) Parasitic infection of the lung like tropical pulmonary eosinophilia in filariasis. But here blood eosinophilia is there and you said blood test is normal, so ruled out. 7) Any chronic disease like bronchictasis, tuberculosis, cancers etc but these are readily catched on CT scan. In your case, you must have provided your history in these context and gone for respective examinations. I can understand your concern. Many a times cough is so irritating and exhausting. Meet pulmonologist with proper history concerning the above points to reach a specific diagnosis.. Best wishes