chronic cough

[ozark]

my husband has had a clearing throat,dry cough for a few years. He has a large uvula,(always had) that practically sits on his tongue and he smokes. He drinks a lot of coffee and doesnt get much fluids.  He saw an ent md a few years ago who said his nasal passages were inflammed put him on nasal steroid and gave him a mucous thinner.  he also has a deviated septum.  the inflammation decreased. he had a cxr back then that was ok.  my husband  says it's just a cough because his throat gets dry (it drives me crazy).  the other thing is he has chronic tinnitus.   My concern is if it could be lung ca.  he checked his flow meter(my dtr has one) and it was 1000.  He is stubborn and wont go back to the md at this time. Do you think it could be just an uper airway problem.   He has no mucous when he coughs or clears altho he also says he can feel a drip in the back of his throat.  thank you for yur response

[echo_320]

i am 51 male and in pretty good shape. i am from texas near the coast and many chemical plants but i have been sick like this every. yes i have had some sever sinus problems at times but really not in the last 5 yrs. at this time i have sinuses in the upper part of my body but this started out like the flu for the fist week then i started coughing and then a very very sever cough at times think i might pass out. i did stop in the road the other day coughing hoping i wouldn't black out.but it always seems to pass after about 20 to 30 seconds. i had chest pains the other night to the point i could not take another step. i guess from all the coughing. my chest is tight and i have had a reacurrence waking up this morning after being sick with this for 4 weeks. with my blands swollen sore throat and chest pain and a little weak. oh yes and i do work outside.
     list of medication i have taken which has done little good listed in order they where given to me and the changes ( seen 2 doctors )
    
     1. cefdinir-300mg 2 a day
    
2.cough medication ( over the counter)
and an expectant over the cough 2 bottles of both w/drexoil w/antihes.    
change of doctors because i found out my doctor doesn't give shots
     3.smz/tmp ds 800-160 tab tev (did some good )
     4.cpm/pse 8-120 sr cap url
     a change
     5.cephalexin 500 mg
     6.guaifenex pse 120 tab ethex

[National Jewish]

As you have accurately indicated in your message, a chronic cough can be from either the upper or lower airways or both.  The only way to approach this is to have someone evaluate the cause of the cough.  It could be from the sinuses being inflamed from the cigarettes or from an infection.  This inflammation can create the postnasal drainage and cough.  It could be from the lower airways where there are many reasons, including the ones you have mentioned.  I understand the predicament you are in and the fear that your husband has of really evaluating the problem.  However, without an evaluation, you are just guessing as to the cause.

[g350h350]

Ozark, I ssoooo empathize.  I am 47 male, and was bothered by a shallow, dry hacking cough from about 18 to my mid-thirties.  I'm surprised that your husband isn't more concerned about it:  my low point came one day when my boss's boss dropped by after a meeting and told me that, until I got rid of the cough, I should perhaps get one of my employees to do my presentations...the second lowest was when the cough got between my first girlfriend and I, so to speak.

With the help of my wife, who is an RN working in the medical research field, I got an appointment with a respirologist who was actually doing research on chronic dry coughs.  He told me that hard to diagnose coughs like mine were likely to be caused by one of several things:
1.  asthma (my pulmonary function test was normal in terms of volumes and flows, but when I took a histamine challenge test, I broke out into really nasty coughing spells.  The cool preofessional tech administering the test told me to stop coughing and finish the test.  Someone may wish to debate the diagnosis of asthma without a decrease in pulmonary function; the dr. said call it what you want, I have twitchy bronchi, and a puff or two of ventolin will bring the problem under control for awhile.
2.  post nasal drip , a minor contributing element in my case.
3.  esophageal reflux (GERD) the respirologist had a pretty rigorous gastro workup done on me, and diagnosis what he called 'marked reflux'.  This is long before I  was cognizant of any 'classic' GERD symptoms like heartburn.  He prescribed Losec (prilosec in US) and later Nexium;  the cough virtually disappeared.  Now, if I stop taking the Nexium, I get heartburn, asthma (wheezing) incidence goes up, and the cough comes back.

So, for me, the answer is stay on the Losec or Nexium, and have ventolin on hand for those times when circumstances when the cough comes back (cold weather exercise, laughing a lot, a sneezing spell, all seem to do it).

As an aside, the more I read, the more it appears that there may be a relationship between GERD and asthma symptoms.

I'm sure that other posters will come up with their own perspective, and perhaps refine (correct?) mine;  all I'll say is that the cough affected my life for about 17 years, and I have hardly been bothered for the subsequent 12 years.


Good luck!