15 year cough

I have had a chronic, dry cough for 15 years (I am a 30 year old, average weight, average height female, nonsmoker, not around excessive pollution/irritants).  I have tightness in my chest, a feeling of an "itch" between my lungs that almost takes my breath away sometimes.  I never feel like I get a good breath because of the itch.  My cough is always dry and is somehow a result of the itch in my lungs.  I have to really hack to get the cough out,  or there in an itch in the bottom of my throat too.  By back always hurts because of how hard I cough, and I often lose my voice or become hoarse.

Of course the symptoms vary in severity over the months, but the cough especially is always there.  Sometimes I get a metallic taste in my mouth after it.

I have tried Advaire, been treated for GERD (prevacid), and told to take over the counter allergy medications, all in response to this.  Nothing works and no one seems to take this seriously.

Any thoughts on what this could be?

[National Jewish Health]

Your chronic cough problem is one that should be taken seriously, both as a sign of untreated disease and the effect of this cough on your quality of life.  You have been treated for 2 of the 3 most common causes of chronic cough, gastroesophageal reflux disease (GERD) and asthma, with the third deemed to be postnasal drip.  Our understanding of cough and the mechanisms that cause it is much greater than even 5 years ago.  Appreciation of the magnitude of the problem has led to the formation of cough clinics at most university hospitals.  Given the duration and severity of your cough your best bet would be to seek consultation at one of these clinics.

Richard S Irwin, MD is an international expert in the diagnosis and treatment of cough.  I suggest you contact him regarding consultation in his clinic in Worcester, Massachusetts.  If that is not feasible, then ask him or members of his staff to recommend a cough clinic in your geographic area.  Here is his contact information:
Correspondence to: Richard S. Irwin, MD, FCCP, University of Massachusetts Medical School, Room S6-842, 55 Lake Ave North, Worcester, MA 01655; e-mail address: ***@****.

Here is the citation for an article developed by a panel of experts whose chairman was Richard S Irwin, MD.  Diagnosis and Management of Cough Executive Summary ACCP Evidence-Based Clinical Practice Guidelines by Richard S. Irwin, Michael H. Baumann, Donald C. Bolser, Louis-Philippe Boulet, Sidney S. Braman, Christopher E. Brightling, Kevin K. Brown, Brendan J. Canning, Anne B. Chang, Peter V. Dicpinigaitis, Ron Eccles, W. Brendle Glomb, Larry B. Goldstein, LeRoy M. Graham, Frederick E. Hargreave, Paul A. Kvale, Sandra Zelman Lewis, F. Dennis McCool, Douglas C. McCrory, Udaya B.S. Prakash, Melvin R. Pratter, Mark J. Rosen, Edward Schulman, John Jay Shannon, Carol Smith Hammond and Susan M. Tarlo in Chest, 2006 January, Volume 129, Number 1, pages 1S-23S.