What causes severe persistent cough along with chest pain?
Different possible causes
The most common reasons from chronic cough are:
(1) Upper airway syndrome which was previously called post nasal drip syndrome
(4)Non asthmatic eosinophilic bronchitis
A person may sometimes have a combination of reasons for a cough.
Other causes would be side effect of medications such as ACE inhibitors (Lisinopril, Enalapril, Ramipril etc) , due to smoking, chronic bronchitis, bronchiectasis, mass in the lung (would have been seen on x ray),heart failure.
Out of these,upper airway syndrome/ post nasal drip syndrome, is the most common. 20% of persons, are actually unaware of the drip itself and only present with the annoying cough.
Has been found to be the cause in over 50% of persons, some studies up the 87% of persons.
Treated with antihistamine/decongestant combination even if there is no nasal congestion eg Zyrtec d, Allegra d, Claritine d, Benadryl d
Montelukast/singulair can be used with one of these. It can unfortunately take 2 to 3 weeks for the medication to kick in, so need to be used consistently.
Non asthmatic eosinophilic bronchitis has been the cause in 13 to 33%.It is treated with inhaled (not oral or nasal) steroids for at least 1 month
Since the cause is not clear- he may want to consider one of the anti histamine decongestant combinations for 3 weeks at least,with the montelukast.
A inhaled steroid can be added.
An anti inflammatory pain killer would temporarily help with the chest pain EXAMPLE: Ibuprofen or Naproxen etc.
Hope I have answered your query.
Let me know if I can assist you further.
Dr. Michelle Gibson James,
General & Family Physician
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