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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for chronic coughs and vomiting

Answered by
Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 11320 Questions

Posted on Sat, 18 Jun 2016 in Lung and Chest disorders
Question: My husband has been ill since we came back from China in October. He has a horrible cough, he coughs so hard he vomits and his sides hurt from coughing. He can't sleep at night because all the mucus and drainage gags him. He has propped himself up with pillows still no relief. He has a headache all the time at the base of his neck. He says he has a metalic taste in his mouth, nothing tastes good and he has lost weight. He has been to the doctor 3 times. Once to a walk in clinic and they said he had phyarangitis and gave him a Z-pac. His PCP saw him 2 wks ago and gave him a Z-pac and a shot of Kenalog. No antihistamines work. We are at our wits ends.
Answered by Dr. Michelle Gibson James 2 hours later
Brief Answer:
post nasal drip is the most common cause of chronic cough

Detailed Answer:
HI, thanks for using healthcare magic

A cough that lasts more than 8 weeks is called a chronic cough.

The most common causes of chronic cough, other than smoking are post nasal drip, gastroesophageal reflux (GERD) and asthma.

Based on the history given , post nasal drip is likely for him though in some persons, it may be a combination of problems eg have both reflux and post nasal drip

There are some medications as well that can cause coughing particularly medications in the ACE inhibitor family eg ramipril, enalapril, lisinopril- these are used for high blood pressure, heart disease or kidney protection in diabetics
If he is on any of these then would need to be discontinued

TREATMENT: (a) though can be due to a combination, as mentioned post nasal drip is most common so treated for this first

He should consider the use of a decongestants (both oral and topical to the nose) along with the anti histamine

Oral decongestants such as pseudoephedrine or phenylephrine are over the counter and usually combined with antihistamines. Would be in allergy meds

Topical decongestants such as otrivine or normal saline should also be over the counter

(b) topical nasal steroid eg nasocort, nasonex, flonase, rhinocort- should also be considered
These are also commonly used for post nasal drip

(c) in most persons there is an allergy source for the post nasal drip. If this is the case for him and the allergen can be found and his exposure to it limited , then this would be helpful

Allergy testing would help with this

(d)Medications such as montelukast or ketotifen can be used to replace the antihistamine if it is not helpful

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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