Contant hacking throat - sinus, post nasal drip

[LDR]

Have always been prone to sinus and brochitis probs. Taken Flonase for years. 5 yrs ago I had pneumonia. I started with a dry hack following that; drs said it would go away. It got really bad at first and had some breathing probs, used inhalers,antibiotics and got somewhat better over year or so.  The hacking stayed and has gotten progressively worse.  Been to ENT, pulmonologist, others; nothing has helped. ENT says GERD (I don't feel those symptoms at all) with some Post Nasal Drip (I only felt this last few months). Have had most all tests with nothing to report. ENT does the nose/throat scope every time and says HE thinks GERD. Have done the Guaifensen, Nexxium and Protonix (at least 6 wks at a time) with Zantac - notice no difference. Allergy tests showed nothing. Doing research, I gave up my daily ice cream - niced 80% difference that week only.  Have not gone back on, and still eliminate dairy as rule, but cannot understand anything else different that one week. Sometimes I hack and cannot catch my breath. It's embarrasing and people think I'm dying because it's so often. Chest hurts from coughing. It's worse after 10a, better after abaout 7p. Much worse when ANY stress and I tense up. I can feel it start when I feel pressure or something and I tighten up.  Only other meds are Synthroid .137; low-dose natural compounded hormone - Biest & Progesterone. Eat well, balanced meals; no alcohol, avg weight.  I am at a loss. Sorry for such long story - just looking for help or advice! Should I go to Mayo for diagnosis?

[National Jewish]

This is a diagnostic dilemma.  Mayo Clinic is a viable option.  Other options where there has been good success at finding the cause of a chronic cough are:
National Jewish Medical and Research Center in Denver, CO,
Johns Hopkins Hospital in Baltimore, MD, or
Dr. Richard Irwin's Cough Clinic at University of Massachusetts School of Medicine in Worcester, MA.

GERD can cause the following symptoms:
· Heartburn or a sour taste in the mouth;
· Pain occurring in the middle of the chest;
· Coughing and/or choking while lying down;
· Increased trouble breathing while asleep; and
· Even no symptoms at all.  This is called “silent reflux” and it is common.
Please read about Gastroesophageal Reflux Disease at http://www.nationaljewish.org/disease-info/diseases/asthma/about/relate-other/gastro-reflux.aspx for more information about things to do to lessen GERD.  Even though your symptoms did not get better with the proton pump inhibitors, GERD could still be the cause.  A pH probe is the best test to find out if you truly have GERD.  This test measures the acid in your esophagus to see if digestive juices are coming up from your stomach.  A gastroenterologist is the type of specialist to let you know if further testing is needed to identify GERD and the best treatment.

[Inanga]

i have suffered from post nasal drip for years - it got really bad about 3 years ago. I could not sleep much because I'd wake up choking on mucous. When it was really bad I got about 3 hours sleep a night. Dairy is the big culprit for me - I tried a small amount of custard last night - coughed for about 4 hours with mucous. I also suspect gluten is a factor for me - but I need to reevaluate that since I discovered dairy to be the big problem. This is not just a little mucous - it used to be bucket fulls streaming down my throat - I would spit the stuff out for an hour and struggle to get a breath sometmies. It also affects below the post nasal area I'm sure - it seems to generate mucous further down. It's definitely an abnormal reaction - the doctor thinks it's normal and I've given up with him now.

i learned a few years ago to avoid all the coughing and chest pain by sucking the mucous down into my mouth before it gets a change to go down. That really relieved the chest a lot.

Dairy and gluten are in just about every processed food. Knocking out icecream is a good start - but I had problems eating cheese, yogurt, etc etc. Gluten and wheat are used as tickeners in sauces etc - have to start reading the labels and through trial and error you should be able to zero in on what the problems are - there may well be several allergens. I can't srink instant coffee (yes eve black)- presumably because gluten is used as to give it texture.

i found doctors to be of little help since I passed the blood tests they think I'm imagining it. Good luck

[LDR]

Thank you for your comments.  I very well could have the gluten thing, too. Or others.  Another one I read about is corn - they say many people have that one - and it is in every conceivable food, soft drinks, even capsules for medicines. Same with the gluten.  And the drs really don't believe the coughing is such a problem because I don't usually have the problems in the office.  I am extremely busy, and this is the last thing on my list to spend time doing - going to drs.  My bed has been raised 6 inches for 2 yrs, but I seldom have a problem in evening or night time - it's just so odd.  My throat always feels raw, and dry, and my worry is that because I can't get this under control, that it will damage my larynx or esophagus something. The nasal drip part didn't come into this until about 6-8 mnths ago, before that it was all dry hacking.  I wondered if maybe taking the Allegra for several months dried up my nasal or sinus' and started a problem. I have't been doing the saline irrigation as much lately, but will get back on that tonight.  Have a feeling it might help if I just make the time. Good luck to you, too.  I'll post if I find something that helps!

[Inanga]

I can relate to your "it's so odd" comment - I'd had really bad evenings up until about say 2am then come right until after breakfast - only looking back did it become obvious that I was eathing something and it took time to get out of my system - that's why the early mornings were okay - than I'd dose up on some allergen from breakfast and it would start all over again. Knocking out wheat and dairy made the biggest difference for me. I would try an elimination diet preffereably with some suitable guidance - I worked out my triggers though being stringent about what I consumed and researching ingredients when they are not listed properly - eg instant coffee gives me post nasal drip - apparently it's full of added stuff like gluten - i can drink real coffee fine. all the best man.

[Inanga]

forgot to mention - i spent a few years managing relux - but the real problem with me was not acid coming up but mucous going down - relux was a problem but not very often.
also I thought the sinus rinses were good but I found that if I had an infection it could spread the stuff through the sinuses and make it worse - i probably comes down to technique - if you can rinse without speading stuff further into the sinuses it's probably still a good thing.

[LDR]

Thanks for the tips.  I will add those to my list of trials!

[LDR]

Thank you so kindly for responding. I have little if any of the Gerd symptoms.  The ENT always went into my throad thru my nose with the tube of some sort - and always said it was irritated "down there," but is the probe you are talking about different?  I had a Endoscope and Colonoscopy about 3 yrs ago, before this got as bad as it is, it was in beginning stages.  It was all clear.  Do I need to go back to Gastro dr, or would the ENT treat? Is the probe you are talking about an office procedure? I blame myself for not asking the right questions, but the drs are always so fast and they never discuss stuff with me.  None has ever sat down and talked. I go in with notes but never come away with anything concrete. My nose is ALWAYS very dry, and I wondered if maybe the thick mucus going down back of my throat was affected by that.  I'm trying to use some saline mist when I can remember. I stopped the Allegra and others because I thought they might be making the dryness worse and it all feeds on itself.  The reason I mentioned Mayo is because I will be in Rochester MN next month for a week with relatives, and I thought I could take advantage of already being there.  I will look at the site you mention.  Thank you again for your attention!

[LDR]

I'm sorry, I just reread and saw you did say to work thru a Gastroenterologist. I also looked at the site you suggested and it was very interesting.  I just feel it's such a combination of several things but can't get a handle on one problem to get the process going.