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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Continuous Cough, Constant Tickling In Chest And Phlegm, Episode Of Choking And Clamped Throat, Lungs Seem To Be Clear. Advice?

Hello, I have had a cough for 6 weeks. I have just finished amoxicillan having taken it for 7 days, three times a day, at 500 mg. I still continue to cough, but it is now more aggressive. My doctor says it is from a post nasal drip . He claims that my lungs are clear, although I have this constant tickle in my chest . I was frightened yesterday as I was eating because I suddenly could not breathe. Logically you would have thought I was choking but it seems as though my throat just clamped. Inhaling was a problem. It was quick and as I swallowed I could breathe again. I have also had a constant phlegm that wont move right around my vocal chords and I try hard to clear it. I have never experienced a cough for so long and I am worried. My doctor insists my lungs are clear after two visits. After choking I went to the hospital they kept me waiting for hours. I will revisit my doctor on Monday. I would appreciate any advice. Thank-you.
Tue, 23 Oct 2012
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Allergist and Immunologist 's  Response
Hello,
Constant cough for 6 weeks requires several critical investigations.
1. If you are a smoker, then a ENT consult to exclude throat pathologies
2. Exclude communicable respiratory diseases like TB, especially if you have been in contact with someone with infection (active) or a recent visit to a country with TB
3. Post nasal drip due to allergic or non-allergic rhinitis can cause the same constant cough that worsens at night when you have dust mite allergies

If options 1 and 2 have been excluded, a visit to an Alergist for skin prick test or specific IgE blood test can help find what your allergies are.....antihistamines (long acting) and nasal corticosteroids for 6 weeks (minimum) is recommended.
Thanks.
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Pulmonologist Dr. Shashi Dangwal's  Response
The cough that you are experiencing is a result of spasm in your airways. Very often after an episode of viral or bacterial infection, airways become hyper reactive and go into a spasm on getting exposed to allergens. You could also be having post nasal drip as you have phlegm in the throat. Take a montair lc, seroflo inhaler 2 puffs twice a day and a PPI like pantoprazole or omeprazole. Drink plenty of water and do some deep breathing exercises. Hopefully this should go away in few days time.
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Pulmonologist Dr. Arnab Maji's  Response
Hi
Thanks for your query
Yes probably your doctor is right because if your chest is clear then with these symptomatology diagnosis of post nasal drip syndrome (PNDS) or more specifically upper airway cough syndrome (UACS) is more consistent with. You need to have anti-histaminics, proton pump inhibitors, smoking ceasation, nasal spray, plenty of water to drink. I think your physician has already prescribed these.
Thank you.
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Continuous Cough, Constant Tickling In Chest And Phlegm, Episode Of Choking And Clamped Throat, Lungs Seem To Be Clear. Advice?

Hello, Constant cough for 6 weeks requires several critical investigations. 1. If you are a smoker, then a ENT consult to exclude throat pathologies 2. Exclude communicable respiratory diseases like TB, especially if you have been in contact with someone with infection (active) or a recent visit to a country with TB 3. Post nasal drip due to allergic or non-allergic rhinitis can cause the same constant cough that worsens at night when you have dust mite allergies If options 1 and 2 have been excluded, a visit to an Alergist for skin prick test or specific IgE blood test can help find what your allergies are.....antihistamines (long acting) and nasal corticosteroids for 6 weeks (minimum) is recommended. Thanks.