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Suggest Treatment For Coughing Fits And Acid Reflux

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Posted on Mon, 26 Sep 2016
Question: Hello,
I have had a persistent couch for months. I have had two chest x-rays and a cat scan of my chest. My doctor has given me steroids 3 times,tessalon perles twice and now I am on dexilant. I have an appoint with a pulmonary specialist, but it is not until November 10th. I have these horrible coughing fits that come from my chest until I gag. My doctor keeps saying that I have acid reflux, hence the dexilant. I do not have any of the symptoms of acid reflux except for the cough. I don't think I have acid reflux. I have multiple coughing fits all day long and it keeps me awake at night. Any thing that you can tell me? Also, can I stop taking the dexilant? I don't think the tessalon perles are helping either. My doctor says to take them regularly even if they don't help. My upper chest hurts, but he says that is because my chest is sore from coughing.
doctor
Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
post nasal drip is the most common cause

Detailed Answer:
HI, thanks for using healthcare magic


A cough that persists for more than 8 weeks is typically called a chronic cough.

There are different possible causes but 4 main ones according to our medical statistics and literature.

The 4 more causes are: (1) post nasal drip- this is the most common out of the 4. 20% (1 out of 5) of persons are not aware of the drip itself and only present with the cough.

(2)GERD or reflux
(3)asthma
(4)non asthmatic eosinophilic bronchitis- eosinophils are a type of white blood cell that are particularly involved in allergies etc.
In this condition a high number of eosinophils are found in the lungs. This condition responds really well to inhalers.


Treatment: (1)because post nasal drip is the MOST common cause, treatment is usually started here
If you have known allergens or irritants, these are avoided. If this is not clear, then allergy tests are consider

Antihistamine decongestant combinations, which are usually over the counter, are started along with a nasal spray eg nasonex, nasocort, flonase etc
Most people respond within 2 weeks though rarely can take months

(2)in some cases a person can have more than one condition eg post nasal drip and reflux and require treatment for each

(3)non eosinophilic - a sputum sample to the lab would show up the eosinphils if this condition is present
As mentioned , can be treated with the steroid inhalers normally used in asthma, response in 4 weeks


You can consider trying the anti histamine decongestant combination, take regularly. In some persons with post nasal drip other prescription meds are needed.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (10 hours later)
By post nasal drip do you mean drainage down the back of the throat? I don't think this is it. I have had that often in the past and I only coughed when I was lying on my back and the drainage went down the back of my throat. Now lying on my back in a half position is the only way I can sleep ( with a throat lozenge in my mouth.) I cough all day long just walking around or sitting.) It is a barking cough that comes from my chest. Sometimes I cough until I start to gag and almost throw up.The doctor has already given me inhalers. I was supposed to use the first one during my coughing attack. I would cough so hard that I could not use it. I could not inhale or hold my breath for the 10 seconds necessary for the stuff to go down the back of my throat. Then he gave me the non-emergency kind that I did not use during an attack. Using the thing brought on an terrible attack. (Lumera? I think) One thing, I generally don't cough if I am outside. I can cough at any time, but I always start to cough when the central air comes on. I told my doctor this and asked if having the duct work cleaned might work. He said no. If that was the problem, it would cause my husband to cough also. Is this true? Do you think that I should continue to use the Tessalon perles? My doctor told me to take them three times a day until I had used them all up. He gave me 90. My cough is getting worse every day.
Thank you.
doctor
Answered by Dr. Michelle Gibson James (45 minutes later)
Brief Answer:
getting it cleaned is a good idea

Detailed Answer:
HI

it is possible that you may be more sensitive to any allergens or substances in the AC environment as compared to your husband or any one else

We all react differently to chemicals.

You can try to have the cleaned to see if this has any effect especially since you notice the coughing is worse inside.
Allergy tests to allergens that may be found inside may also be helpful, this can be in the form of a blood test

Please feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Suggest Treatment For Coughing Fits And Acid Reflux

Brief Answer: post nasal drip is the most common cause Detailed Answer: HI, thanks for using healthcare magic A cough that persists for more than 8 weeks is typically called a chronic cough. There are different possible causes but 4 main ones according to our medical statistics and literature. The 4 more causes are: (1) post nasal drip- this is the most common out of the 4. 20% (1 out of 5) of persons are not aware of the drip itself and only present with the cough. (2)GERD or reflux (3)asthma (4)non asthmatic eosinophilic bronchitis- eosinophils are a type of white blood cell that are particularly involved in allergies etc. In this condition a high number of eosinophils are found in the lungs. This condition responds really well to inhalers. Treatment: (1)because post nasal drip is the MOST common cause, treatment is usually started here If you have known allergens or irritants, these are avoided. If this is not clear, then allergy tests are consider Antihistamine decongestant combinations, which are usually over the counter, are started along with a nasal spray eg nasonex, nasocort, flonase etc Most people respond within 2 weeks though rarely can take months (2)in some cases a person can have more than one condition eg post nasal drip and reflux and require treatment for each (3)non eosinophilic - a sputum sample to the lab would show up the eosinphils if this condition is present As mentioned , can be treated with the steroid inhalers normally used in asthma, response in 4 weeks You can consider trying the anti histamine decongestant combination, take regularly. In some persons with post nasal drip other prescription meds are needed. I hope this helps, feel free to ask any other questions