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Suggest Treatment For Persistent Cough And Irritation In Throat

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Posted on Wed, 14 Jan 2015
Question: Around two month back i developed persistent cough and irritation in throat.
I checked with my family doctor who is MD put me on cough syrup Bro Zedex, Montair lc and Augmentin 650 mg for five days.
After 5 days when there was no effect he changed the antibiotic to Azax-500.
After 3 days when there was no benefits he dignosed allergic bronchitis and put me on Rotacap Budamate-400 capsules initally two times and then 3 times.
When there was no relief i consulted Allergy and Asthma center whose detailed reports are given
Presently i am taking
Foracort 200 inhaler with spacer three times
Medrol 8mg three times for 15 days
Montair lc 10mg in the night
and Corex lin in the night
With these medicine i have relief but still there are episodes of cough.
Cough always start from throat or it feels that some thing like Phelgm got stuck in the throat and when i try to clear it then cough starts. Though yesterday night at 4 oclock in the morning i had a attack of cough in which for the first time i felt that cough is initiated from deep in side lungs.
There is a mild wheezing when i talk or i can not speak long sentences.
My main concern is that i am teacher around 47 yrs old and require to take classes of Pre-Medical students where i have to speak for at least 1 hour and 30 minutes. I take 2 class in the morning and 2 class in evening. I want to get rid of this problem. I teach human physiology. I have a normal BP a height of 5' 10 inch wt. 93 Kg. There is no loss of wt. recently. Please advice me
doctor
Answered by Dr. Drkaushal85 (34 minutes later)
Brief Answer:
Taper medrol. And start tiotropium inhaler.

Detailed Answer:
Hello dear, thanks for your question on HCM.

And thanks for your reports. I have gone through all your reports.

In my opinion you are having allergic problem. Though your IgE is normal, allergy can present with normal IgE.
And you are improved with Foracort and montair lc with medrol. Which suggest allergic disease only, Mostly Asthma. And asthma can present at older age.

The basic treatment of asthma is as below.
1. Identification of allergen and if possible complete avoidance. Allergen can be dust, pollen, pollution, animal fur etc. Try to avoid all these.
2. Taper Medrol tablet. Instead of medrol you should start foracort 400. This contains budesonide 400 microgram. Inhaled steroids are much more safer then oral steroids.
3. Add tiotropium (anticholinergic) inhaler. As it is having action of 24 hours, so once a day dosing is necessary.
4. Start chest physiotherapy and deep breathing exercise. This will improve lung functions.
Discuss all about this with your doctor.
By these modifications, I think your cough will decrease and wheezing will also reduce.

Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Drkaushal85 (26 hours later)
Actually i have no problem in breathing
Could you check my respirometer findingins to confirm that it is Asthma
I have only problem that something got stuck in my throat and when i try to clear it cough starts.
I have talked to my doctor he is tapering my oral steriods now it is 8 mg medrol twice a day which was earlier 3 times a day. I am taking my medication but still i have irritaion in throat which i can feel in the night. Presently i am feeling that something got stuck in my palate and when i try to clear it cough starts. I have very long history of gas, flauttence and dyspepsia. This all strarted due to my habbit of consuming Rajnigandha. I left it around one month back when this all problem started.
doctor
Answered by Dr. Drkaushal85 (4 hours later)
Brief Answer:
you may have URTI.

Detailed Answer:
Hello dear, thanks for your question on HCM.
I have gone through your spirometry report. It is suggestive of restrictive pattern. In my opinion this is pseudo restriction, due to air trapping, secondary to obstruction especially in expiration. Such restrictive pattern can be seen in asthma.
Your main symptoms are related to throat.
So may be you are having upper Respiratory tract infection. Or may be due to GERD ( Gastro Esophageal Reflux Disease ) secondary to XXXXXXX
So for URTI try to follow these steps.
1. Avoid oily and spicy food.
2. Drink plenty of fluids.
3. Warm water gargles 5 - 6 times a day.
4. Start antihistamine and anti inflammatory drugs.
For dyspepsia, gas and flatuence (symptoms of GERD) try to follow these.
1. Avoid hot and spicy food.
2. Avoid large meals, instead take frequent small meals.
3. Avoid stress and anxiety.
4. Start proton pump inhibitor.
5. Go for walk after meals.
6. Keep 2 - 3 pillows under head in the bed.
Hope these will helpful to you in your throat problem.
Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
You can directly question me on bit.ly / askdrkaushalbhavsar.
Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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Suggest Treatment For Persistent Cough And Irritation In Throat

Brief Answer: Taper medrol. And start tiotropium inhaler. Detailed Answer: Hello dear, thanks for your question on HCM. And thanks for your reports. I have gone through all your reports. In my opinion you are having allergic problem. Though your IgE is normal, allergy can present with normal IgE. And you are improved with Foracort and montair lc with medrol. Which suggest allergic disease only, Mostly Asthma. And asthma can present at older age. The basic treatment of asthma is as below. 1. Identification of allergen and if possible complete avoidance. Allergen can be dust, pollen, pollution, animal fur etc. Try to avoid all these. 2. Taper Medrol tablet. Instead of medrol you should start foracort 400. This contains budesonide 400 microgram. Inhaled steroids are much more safer then oral steroids. 3. Add tiotropium (anticholinergic) inhaler. As it is having action of 24 hours, so once a day dosing is necessary. 4. Start chest physiotherapy and deep breathing exercise. This will improve lung functions. Discuss all about this with your doctor. By these modifications, I think your cough will decrease and wheezing will also reduce. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.