Bouts of Severe Cough with Vomiting - What Is It?

[the-wombat]

I have been recovering from a cold and generally feel well, but I do get bouts of severe coughing that seem uncontrollable.  These tend to occur if there is a rapid temperature and/or humidity change (e.g., going outdoors).  Sometimes it occurs after eating a meal. The cough becomes very severe and I feel shortness of breath.  Additionally, I often vomit when this happens.  Typically, it is primarily clear phlegm (or so it appears).  There are usually food particles as well, but it is primarily a clear substance consistent.  I often feel extreme nasal drip when this occurs.  Often after vomiting once or twice, the cough subsides.  Shortness of breath persists, but clears up quickly, within 3 or 4 minutes.  Also, I notice (a curiousity) that my scalp becomes quite sweaty when these bouts occur.  I would say this has happened about 3 times a week for the last 2 weeks.  

My question is, what am I experiencing?

[National Jewish]

From the symptoms you have described, it is most likely that the infection you had has created some degree of postnasal drip.  This is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One reason is an allergy.  A second reason is a non-allergic, non-infectious inflammation in the sinuses that could be lingering after your recent cold.  A third reason is chronic sinusitis.  Postnasal drip can cause coughing to the point of vomiting and shortness of breath as a result of irritation of the throat and lungs.  You may experience the postnasal drip as a constant feeling of mucus at the back of your throat.  Typically this is worse at night when you lay down to sleep.  Generally this irritation feels the worst when you wake up and gets better as the day goes on.

The fat content in dairy products can thicken mucus.  Generally eating dairy products with less fat content is helpful.  Drinking plenty of water will help to thin the mucus so that it moves more easily.  As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.  Clearing your throat can irritate your throat and make it sore.  When you feel the need to clear your throat sip some water to clear the mucus.

An antihistamine can dry up the postnasal drip.  However, it may make the mucus thicker and more difficult to move.  A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier.  A combination antihistamine-decongestant will do both.  Check with your doctor to see which would help you more.  Often an antihistamine and decongestant are taken only when the postnasal drip gets bad.  It may be more helpful to take the antihistamine and decongestant on a regular basis.

A nasal wash helps remove mucus and germs from your nose and sinuses.  This can temporarily decrease the postnasal drip and lessen coughing, vomiting, and shortness of breath.  It is most helpful when done daily before using any nasal spray.  When the postnasal drip is thin and watery Atrovent® Nasal Spray (ipratropium bromide) may help to dry this up.  A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses.  This may prevent the postnasal drip, coughing, vomiting, and shortness of breath.  A nasal steroid spray does not provide immediate relief of symptoms.  It may require several weeks of routine use to become effective.  Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the Atrovent® Nasal Spray (ipratropium bromide), and the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.

[Sean83]

I have exactly the same problem. I went to the doctor, I have polent/mold induced asthma, and she throught that was the problem. I have been using Albuterol for this. In the last three days since seeing the doc it has not gotten better. I wake up every 3 hours or so coughing. I had a cold two or three weeks ago and this is all that is left. I am swore like I have a cold. I cough up clear/white mucus so it's not an infection. The cough is now bad when I wake up and go to sleep. The area around my ribs hurt from coughing. Can anyone help? I am going back to the doc sometime this week.

[Concerned lady]

Dear Wombat,

You wrote: "Sometimes it occurs after eating a meal. The cough becomes very severe and I feel shortness of breath. Additionally, I often vomit when this happens."

Have you been tested with a "ph probe" in your esophagus, to see if you might have a high up (intermittent) type of gastric reflux, called LPR (laryngo pharyngeal reflux)? Have you had a laryngoscopy done, to see if there are any physical signs of LPR? (such as redness in throat or in vocal cords, swelling of vocal cords, excessive mucus in vocal cord area)?

You may want to ask your primary care doctor if a referral to an ENT/ear, nose & throat specialist, and to a gastroenterologist, and to a pulmonologist (lung specialist) might be helpful, for getting fully and accurately diagnosed.

Good luck in getting diagnosed and treated. Hope you feel better soon.

Concerned lady
http://cantbreathesuspectvcd.com