coughing fits

[4hope]

I am very concerned about my 60 year old mother. She has had a severe chronic cough for the past 7 months. The main symptom is coughing fits throughout the day and night due to what she described as a dry spot in her throat that is always in the same location.  She saw a Dr. who said she had acid reflux. Yet, she has never shown any other signs of that disease, no heartburn or indigestion, nothing ever bothered her to indicate acid reflux. The Dr. has increased the dose but her symptons do not change.  She has put a 5 inch slant on her bed and makes sure to have several hours before sleeping after her last meal.  She has cut back on caffeine and has only occasional alcohol.  She has also had two chest x-rays that came back clear of any problems.  Other wise she has had no other diagnostic tests. Shouldn't she undergo a throat endoscope?  How many months do you wait to have that procedure with these symptoms?  How can GERD be diagnosed definitively?

What else could be the cause of this symptom? She can hardly do or say anything without having a coughing fit. She has never been a smoker but her parents, husband, and friends used to smoke so she was probably exposed to second hand smoke for a couple of decades. Unfortunately we are divided by an entire country so I can't accompany to her Dr. visits but I would like to advise her what to ask and what course to pursue to find some answers and relief. I am very concerned, can you help me?

Thank you for your assistance. Your forum is a blessing.  4Hope

[National Jewish]

I recommend that your mother have a pH probe, which measures the acid in the esophagus to see if digestive juices are coming up from the stomach.  This is the best test to find out if she truly has gastroesophageal reflux disease (GERD).  She should also have a careful examination of her nose, sinuses, and throat.

Even though her chest x-ray is normal, it is still possible for a problem in her lungs to cause her cough.  A CT scan of her chest will show more detail and may be needed to find the problem.  A pulmonologist would be the type of specialist to examine her to determine if there is a problem in her lungs that is causing her cough.  Ultimately, she may have to have a bronchoscopy.  This is a procedure done by a pulmonologist where a tube called a bronchoscope is passed through the nose into the windpipe to look into the lungs.  With the bronchoscope tiny pieces of lung tissue can be taken for further testing.  This is called lung biopsy.

She should not accept GERD as the cause of her cough.  There are too many other possible causes, some of them serious.

[glennia]

Hmmm.  I have a 78-year old mother who is experiencing something similar to yours.  We just yesterday returned from the Mayo Clinic in Rochester, MN where she was seeking treatment for this.

She has had a persistent cough for approx. 3 years.  It has gotten progressively worse over time, to the point where she is no longer able to attend some public functions (such as musical concerts) as her hacking is so disruptive to others.

The cough comes from the back of her throat, not way low like a bronchial cough would be.  At times, she coughs so hard that she actually is choking.

Some days, she has a coughing spell every hour or so, other days, maybe only two or three episodes.  Her coughing wakes her many times at night, as it does for anyone else in a near bedroom - it is loud and very, very harsh.

Her doctor insists it is acid reflux and she has been taking prilosec, nexium alternately to see if anything works.  It doesn't.  He just doubled her prescription of Prilosec and also is starting her on a nasal spray as well as one other med.

Sound similar?

[ozark]

she may have developed allergies and has post nasal drip...has she ever tried a decongestant or nasal spray?