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    Suggest treatment for cough and dryness at back of throat?

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Posted on Tue, 21 Apr 2015 in Lung and Chest disorders
Question: I Have at times these little pieces of something that I cough up or it feels like it's stuck to the back of my tongue, it has an odor . And my throat gets really dry in the very back. And I have RA. Can you help?
doctor
Answered by Dr. Gyanshankar Mishra 24 minutes later
Brief Answer:
Dry mouth needs evaluation.

Detailed Answer:
Hi,

Thanks for posting the query on HCM. After going through your query, I would like to comment the following:

1. Your symptom of dry mouth with occasional cough could be due to snoring, mouth breathing during sleep, associated other connective tissue disease like sjogrens, associated rhinitis (cold) or recurrent infections. Also associated sleep apnoea syndrome needs to be ruled out if symptoms point towards that.

2. All the above causes need to be ruled out.

3. The most important thing I would like to know is whether you snore during sleep? What is uour height and weight? Any local teeth problems?

Please do let me know the answers to the above quetions so that I can answer accordingly.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Gyanshankar Mishra 9 hours later
This doesn't only happen while I'm sleeping , it's all day long. I don't have sleep aponea. I'm 5'7 and 203lbs. , and my teeth are fine and so are my gums. You didn't address the little specks that I cough up and that had an odor.
doctor
Answered by Dr. Gyanshankar Mishra 5 hours later
Brief Answer:
Detailed evaluation is required.

Detailed Answer:
Hi,
Thanks for the follow up info. After going through the follow up info, I would like to comment the following:

1. During sleep , I am concerned with only two things - Please ask your near ones regarding your history of snoring during sleep or mouth breathing during sleep. I do not expect any other symptom during sleep right now. Early morning dryness of mouth followed by coughing of mucus specks can be an early manifestation of obstructive sleep apnoea syndrome especially considering your body mass index of 31.8 which classifies you as obese. Remember that normal body mass index ranges from 18.9 to 24.9.

2. No teeth problems rules out local causes.

3. The initial evaluation for your cough will include - early morning sputum examination, chest xray pa view and pulmonary function test. If there is evidence of respiratory tract infection then a course of antibiotics may be required. Considering your increased BMI (body mass index) , you need to get an overnight screening sleep study done.

4. Other associated causes need to be ruled out with specific investigations like extractable nuclear antigen profile. Sometimes RA also involves the lungs. This involvement if suspected can be detected on HRCT scan of the thorax.

5. Thus you need to get yourself clinicaly evaluated in detail as outlined above, by a Pulmonologist.

I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Gyanshankar Mishra 42 minutes later
I've had a sleep study done before and I don't snore. The dentist is the one that said it didn't involve my teeth. So what could the specks be? Where could they be coming from?
doctor
Answered by Dr. Gyanshankar Mishra 1 hour later
Brief Answer:
Symptoms could be infective or inflammatory in origin.

Detailed Answer:
Hi,
Thanks for the follow up query. After going through the query, I would like to comment the following:

1. If sleep studies have ruled out sleep apnea then as pointed in my previous post, the etiology is likely to be infective or inflammatory.

2. Please get the work up done as outlined in the previous post for the etiology of your symptom.

3. The possibility of an lower respiratory infective or inflammatory disorder can be kept in mind if you do not have any associated cold / nose blocks or any other upper respiratory tract symptom as is seen from your history.

4. Investigations as outlined in points 3 and 4 of previous posts (excluding sleep study) will help. Please get evaluated on these lines in consultation with a Pulmonologist.

I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

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