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What causes severe persistent cough along with chest pain?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15941 Questions

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Posted on Sun, 21 Oct 2018 in Medicines and Side Effects
Question: My brother who is 48 has had a cough for 2 years we have been to lung doctor and a ear nose throat and no one can find anything wrong but he coughs all the time that it hurts his chest and says about shortness of breathe any ideas
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Answered by Dr. Michelle Gibson James 1 hour later
Brief Answer:
Different possible causes

Detailed Answer:
Hello,

The most common reasons from chronic cough are:
(1) Upper airway syndrome which was previously called post nasal drip syndrome
(2)Asthma
(3)GERD
(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.

Regards,
Dr. Michelle Gibson James,
General & Family Physician


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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