PERSISTANT COUGH WITH SECRETIONS / DYNAMIC COMPRESSED AIRWAYS

[veda]

my husband has been plagued by a progressively worsening cough
with/without secretions since 4-2004. Initially he was diagnosed
with allergies and give zyrtec. Recently; he has consulted with
a pulmonary specialist. He has had xrays; cat-scan,broncoscopy
allergy tests ;pft; blood work. The diagnosis thus far has been
dynamic compressed airways; severe irritated back of throat;
post nasal drip; and possible acid reflux. His medications are:
nasonex; nasacourt; singular; prilosec; pearl beads; cough
syrup robitussin;zyrtec; lopid; zocor; zinc;complex b with b12
aspirin; antibiotic for acne. He was exposed to corn and soy
bean dust for over 30 years until five yrs ago. At times his
cough subsides for several days; but returns even worse; with
no respite. The only relief is when he is active. I presume
this is because he is explanding his airsacs upon excertion.
However; with the allergies and postnasal drip; one would think
he would still cough upon excertion; if this was the cause.
I have tried to research his condition and have come up possible
causes of aat protein deficency; marfan syndrome and emphysema.
He has no marfan characteristic's. I have him on a no dairy; no
gluten diet; to see if this helps. Do you have any idea's please!! This cough is beginning to incapacitate him.
Please allow me to add; when he takes a deep breath or laughs
it precipitates a coughing episode. I am considering having
him seen by an ent. His pulmonary specialist is stumped .

[National Jewish]

Your husband’s lungs could be the source of his persistent cough.  Perhaps his lungs are chronically irritated from over 30 years of exposure to corn and soy bean dust.  However with the testing that he has had done the problems that you mention such as alpha-1 antitrypsin deficiency, emphysema, and Marfan syndrome would be obvious to his pulmonologist.  The dynamic compressed/collapsed airways could be a sign of other lung problems, such as:
· Tracheobronchomalacia, a rare condition that causes the airways of the lungs to narrow or collapse when breathing out because of softening of the airway walls.
· Bronchiectasis, a more common condition that is due to inflammation causing the airways of the lungs to become dilated and distorted with areas where mucus can collect.  Usually these changes can be seen with a CT scan of the lungs.
Either of these conditions can cause cough.  It may be necessary to biopsy one of the compressed airways to find the problem.

If your husband has no lung disease, the 2 most likely causes of his persistent cough are acid reflux and postnasal drip.

Gastroesophageal reflux disease (GERD) is the back flow of stomach contents, including digestive juices, into the esophagus or food tube.  This is most commonly called acid reflux or heartburn.  This reflux can come all the way up into the mouth and nose.  When this happens the material can be aspirated, dribbling into the windpipe and lungs.  This could explain your husband’s persistent cough.

Acid reflux 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.

A pH probe is the best test to find out if your husband truly has acid reflux.  This test measures the acid in the esophagus to see if digestive juices are coming up from the stomach.  Please read our Gastroesophageal Reflux Disease MedFact at http://www.nationaljewish.org/disease-info/diseases/asthma/about/relate-other/gastro-reflux.aspx for more information about things to do to lessen acid reflux.  A gastroenterologist is the type of specialist to let your husband know if further testing is needed to identify acid reflux and the best treatment.

Another cause of your husband’s persistent cough could be postnasal drip.  This is drainage from the nose and sinuses dripping down the back of the throat.  This can be very irritating to the back of the throat.  A nasal wash helps remove mucus from your nose and sinuses.  It is most helpful when done daily before using any nasal spray.  A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses.  This may prevent the postnasal drip.  A nasal steroid spray does not provide immediate relief of symptoms.  It may need to be used every day for several weeks to months for it to help.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/disease-info/treatments/alt-ther/nasal-wash.aspx for more information about this technique.  Share this information with your husband’s doctor to see if he would benefit from this daily treatment.

[Inanga]

i had something similar but way less dramatic that turned out to be food allergy related - antihistamines and steroid helped a bit but only avoiding gluten and dairy do any real good. I went rhough xrays for chest pains but it was just caused by the constant coughing. To do the diet you must read every leable on everything - for instance instant coffee can contain gluten as a texturing agent - one sip sets my mucous off. There may be several allergies so maybe get help with a pro with a formal elimination process - I would suspect anything that he was exposed to a lot. This may have caused a sensitisation. I haven't heard of a corn start allergy but it's worth investigating.

a couple of years ago I could not walk 50 metres without chest pain and struggling to breathe - I has started easting lots of apsta for energy but it was triggering an allergy. Now I can breathe as clear as a bell - as long as I keep away from certain stuff. The improvement has been dramatic - it's been literally years since I felt so well. Doctors have unfortunately been a waste of time and money - I met someone by good fortue that had the same problem and got better by avoiding wheat. So I started that day and got better and better. Dairy became obvious after a few weeks. I now know within a few minutes whether something has caused a problem.

Apparetly when you give up the allergens you become even more sensitive to them so you have to take it seriously. best of luck.