12 year old with chronic cough

[brown eyed]

12 year old has chronic cough now lasted 2 weeks. No sinus or post nasal drip. X-ray-clear. Had stomach flu on Dec 27 w/vomiting followed heart and stomach burn followed by acid reflux diagnosis by a ped. stomach specialist. Blood work-clear, urine test-infection, ultrasound-clear. Put on Sulfamethoxa200-40MGSUS(for urine infection), Omeprazole (prev. on Prevacid, but discontinued due to stomach irritation & increased pain) for acid reflux, and Miralax (for constipation-was on Tylenol/codeine). On 1/31, caught upper respiratory from all of family (coughing/aches/fever). Family recovering w/some coughing and blowing, but 12 yr old continues w/dry, hacking cough with absolutely no drainage, no vomiting, no fever. Coughs every 3-5 seconds except when sleeping.  Pertussis ruled out. Medicines tried with no effect have been Amoxicillan, Robitussin DM, Mytussin AC, Zithromax. Currently on Histinex (6 doses so far and see no relief), Miralax (to continue regular BM), Omeprazole and Tylenol as needed.  Child is worn out from coughing & not returned to school since Christmas.  Hard to tell if acid reflux problem is better due to all coughing pain. No heart/stomach burn at the present. Been on a bland/low-fat free diet and drinks a lot of water, no caffeine. Some of the medicines like Amox., Zithromax burned the stomach & took Mylanta to soothe.  Local doctor seems at a lost. Ped. stomach specialist is 3 hrs away, but been in touch w/to share any possible drug interaction. None concerned about. Connection to acid reflux? Viral? Just need time. Ideas? Timeframe for recovery?Thanks

[National Jewish]

Viral infections, like the flu or a cold, can cause inflammation of the airways of the lungs.  When this occurs your daughter may cough, especially when she is active or laughs.  If a virus were the cause neither of the antibiotics she took would be effective in getting rid of the infection.  After the infection is gone, it is possible for the inflammation to linger.  This inflammation can last for 2 to 6 weeks.  Sometimes this inflammation may linger for 3 to 6 months.  Eventually the inflammation will go away, and then the coughing will stop.  This is called reactive airways disease (RAD) and behaves a lot like asthma.  On a simple breathing test, called spirometry, this may not show up.

A cough lasting just 2 weeks, no matter how severe, is not considered a chronic cough.  Usually after at least 4 to 6 weeks then it’s considered a chronic cough.  It really is tough for both parent and child to put up with such a cough.  Your daughter doesn't need more antibiotics for this or other medicines that might irritate her stomach.  She should be given whatever is necessary to relieve her cough.  An inhaled steroid medicine, which is given to treat asthma, will often clear this inflammation more quickly.  Usually this medicine does not provide immediate relief of symptoms.  It may need to be used every day for several weeks to months for it to help.  Your daughter’s doctor is the best judge of this.

There can be a definite connection between acid reflux and a continuing cough.  I would accept the diagnosis of the pediatric stomach specialist.  I suggest that you work closely with that doctor to gain control of the reflux.  This could bring a stop to your daughter’s cough.