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Suggest treatment for dry cough and salty reflux

Answered by
Dr.
Dr. Krunal Karade

ENT Specialist

Practicing since :2009

Answered : 1000 Questions

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Posted on Fri, 18 Jul 2014 in Ear, Nose and Throat Problems
Question: Hi,
I have had a dry cough starting almost a month ago and it has still persisted. It is especially present when trying to speak. I have seen an ENT specialist who has looked at the throat through the nasoendoscopy. He has prescribed two weeks of proton pump inhibitors because of acid reflux. However, I have taken about 10 doses of the ppis and the problem doesn't appear to be getting better and could be worse.

I have tasted reflux despite the ppis but is a salty reflux without acidic taste. Could the problem be bile reflux and could bile reflux cause the same symptoms? Also, I noticed that the scope could only look at the top of the vocal chords, as it only provides a view from the tops of the throat downwards. Perhaps there is an issue with the bottom of the chords. How could that be detected?


Thanks,
Regards
doctor
Answered by Dr. Krunal Karade 2 hours later
Brief Answer:
Dry cough due post nasal discharge.

Detailed Answer:
Hi,

Thanks for query.

I would like to know whether you have any allergies , cold ,post nasal discharge, sneezing .
If I am your treating doctor, I would as advice you steam inhalation , plenty of fluids , antihistamine + montelucast combination, cough suppresant & continue PPI.

Salty reflux is due post nasal discharge , it is not due to bile reflux. There is no need to examine under surface of cord for dry cough. Discuss about post nasal discharge with the treating doctor.

Hope this information helpful to you. If you have any further query I will happy to help.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Krunal Karade 2 hours later
Thanks Dr. Karade,

Yes I do have a dust allergy and dustmite allergy but have not really noticed a runny nose. I do not have a cold now and sneezing is also quite rare.

The reason I suspect bile reflux is due to a past gastroscopy showing some changes in the stomach and esophagus cells suggestive of either bile reflux or NSAID involvement. Also, the reflux is definitely coming up the throat. I would say it is difficult to describe but is not completely salty, it does cause a need to cough immediately though but is not acidic because it doesn't really cause any pain of the throat. It only lasts about 15 seconds when it happens.

Also, I forgot to mention that to treat the cough, my ENT prescribed the dry-power inhaler (not sure if it is called buterol) but commonly used to treat COPD. Is this a recommended way to treat the cough?


Thanks
Regards.
doctor
Answered by Dr. Krunal Karade 2 hours later
Brief Answer:
dry cough due combination of PND & Reflux.

Detailed Answer:
Hi XXXXXXX ,
Thanks for follow up query .
To get relief from symptoms you have , I would advice you steam inhalation 3 times per day , Saline nasal spray 3 times per day , plenty of fluids ,Antihistaminic + Leukotriene antagonists combination & mucolytic cough syrup . For reflux use antacid syrup & PPI .
Your dry cough might be combination of allergic post nasal discharge & reflux.
I have seen many patient like you having dry cough & reflux getting relief from above treatment.Discuss this with your treating doctor.
Stop inhaler.
Hope this information helpful to you, take care and have a nice day.
Regards.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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