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Suggest Treatment For Chronic Cough And Lump In The Throat

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Posted on Tue, 7 Mar 2017
Question: my symptoms started 3 months ago. first was a lump in throat like a pill was stuck. then it has progressed to throat pain that sometimes goes from ear-to-ear and down the neck into the chest to below my ribs. Chronic cough, sometimes to the point of not being able to catch my breath and it feels like I am choking. Chronic mucus and trying to clear it from my throat. voice changes/hoarseness/speaking quite. throat/esophageal/chest pain every time I eat until the pain gets quite bad by the evening. It does not matter what I eat or drink; everything makes it hurt. i have tried to cut out the major allergen foods, but it doesn't affect the pain. EGD and chest xray negative. only thing the GI doctor said was that he saw enlarged lymph nodes when he did the EGD. after a thyroid ultrasound, I tested positive for was two small (1-2 cm) thyroid nodules. the General Surgeon says these would not be causing my pain but he put me on sythroid to try to shrink the thyroid gland and nodules to see. I am tired/exhausted. no energy and sleep a lot. the pain goes away somewhat when I sleep (although i typically cough through the night) but starts again as soon as I eat/drink. i have an appt with an ENT in a month, but am still researching what this could be. no dysphagia, achalagia, ? jackhammer esophagus, peristalsis issue? the pain sometimes goes into my lower esophagus/stomach (no other GI issues/colonoscopy was perfect). thank you.


the "pain" in my chest is a pressure/tightness. no SOB. rib pain/pressure when exhaling. and when pressing just below collar bone.
doctor
Answered by Dr. Uday Nath Sahoo (9 hours later)
Brief Answer:
lump in throat,pain in throat,chest pain,cough is due to viral lymphadenopathy

Detailed Answer:
Hi,
Thanks for your question.
I do understand your pain and discomfort.
As per your clinical history is concerned please follow my advise below from grassroot level:-
1)Do full blood count with differential
2)Do T3,T4,TSH to confirm, Throat swab to see any growth of bacteria.
3)Take Cextriaxone one gram once a day for 3 days then cefixime 200 with lactobacillus twice a day for 7 days, These are prescribed medicines. You'll have to meet the local doctor to get them prescribed.
4)Do warm saline gargle 3 times a day
After blood report i will add other medications

I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me.
Wishing you all the best.
Thanks
Dr U N Sahoo

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Uday Nath Sahoo (10 hours later)
thank you. this is a direction no one has spoken of.

Curious...why does pain/discomfort increase when I eat? i have currently not eaten today and while I still have a minimal amount of discomfort in my right chest area, i do not have the tightening/discomfort in my throat, just the globus sensation.

FYI, TSH was normal previously. T3 an T4 not tested previously.

Curious how to approach my physician with the request for abx. Any thoughts? are they typically receptive? I know some are anti-internet for diagnosing!

i have an ENT appointment March 16. Are these tests/prescriptions that he can order?

thank you.

doctor
Answered by Dr. Uday Nath Sahoo (42 minutes later)
Brief Answer:
first step towards diagnosis

Detailed Answer:
Hi,

The pain in the throat is due to inflammation of muscles. Saline gargle every hour, warm compression and aforementioned medications will help you. If solid food is painful you can take liquid diet like milk and bread.

Discuss about these possibilities with your physician and if he agrees with it, you can discuss about starting antibiotics.

If you have taken appointment with ENT doctor, I will recommend a detailed clinical examination of thyroid gland if nodule found ,it can be easily removed in a surgical way and it is a minor surgical procedure.if you have past ultrasound report you can share with me .
ADD-[Sputum RE/ME/Culture along with tuberculin test ]

Thanks
Dr U N Sahoo

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Uday Nath Sahoo (19 hours later)
Dr. Sahoo-
I have uploaded the reports for your review.
thank you. XXXXXXX burkett
doctor
Answered by Dr. Uday Nath Sahoo (10 minutes later)
Brief Answer:
Upload reports

Detailed Answer:
Hi i could not find reports,please upload soon.[Thanks]
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Uday Nath Sahoo (31 minutes later)
trying again. it is a pdf.
thank you!
doctor
Answered by Dr. Uday Nath Sahoo (59 minutes later)
Brief Answer:
Thyroid nodules

Detailed Answer:
Hi
as per your report indicates your problem is due to nodules only because every side in the report is normal .As you have already done ultrasound examinations so do one [Fine-needle aspiration biopsy in ultrasound guidance only]then go for surgery soon[Thyroidectomy].

Thanks
Dr U N Sahoo

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Uday Nath Sahoo (8 minutes later)
thank you. Already spoke with surgeon and he will no do surgery as he says the nodules, nor the thyroid, are enlarged enough. He prescribed Synthroid to see if it will shrink the gland or nodules. I will return in 2 months for labs, then 6 months for another ultrasound.
doctor
Answered by Dr. Uday Nath Sahoo (10 minutes later)
Brief Answer:
Thyroid nodules

Detailed Answer:
Hi,

You can try as per your treating doctors advise.

Thanks
Dr U N sahoo
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Uday Nath Sahoo (3 days later)
thyroid tests uploaded
doctor
Answered by Dr. Uday Nath Sahoo (2 hours later)
Brief Answer:
Details below

Detailed Answer:
Hi,
As per thyroid report it is good so no problem at all. So you can wait and observe without any fear.(Thanks)
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Uday Nath Sahoo

General & Family Physician

Practicing since :1969

Answered : 2462 Questions

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Suggest Treatment For Chronic Cough And Lump In The Throat

Brief Answer: lump in throat,pain in throat,chest pain,cough is due to viral lymphadenopathy Detailed Answer: Hi, Thanks for your question. I do understand your pain and discomfort. As per your clinical history is concerned please follow my advise below from grassroot level:- 1)Do full blood count with differential 2)Do T3,T4,TSH to confirm, Throat swab to see any growth of bacteria. 3)Take Cextriaxone one gram once a day for 3 days then cefixime 200 with lactobacillus twice a day for 7 days, These are prescribed medicines. You'll have to meet the local doctor to get them prescribed. 4)Do warm saline gargle 3 times a day After blood report i will add other medications I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks Dr U N Sahoo