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vagus nerve/chronic cough HELP

PLEASE HELP

My wife has had a chronic cough for seven years.  The cough started when she had pneumonia and then never stopped after the pneumonia was cleared.  She has been seeing an expert/cough specialist without much success.  There are some peculiarities to her cough which I believe offer a clue as to the cause; however, the specialist does not seem interested in pursuing the matter.  My wife has had multiple airway tests, swallowing tests, allergy tests etc.  It does not seem that the cough is related to a physiological lung/airway condition.

*The cough stops when pressure is applied to the abdomen (just below the rib cage/ just off the centerline).  I once made a contraption with a tennis ball and ace bandages which placed pressure on this abdominal area.  The cough stopped completely.
*The cough is managed with use of chlorpromazine.  The side effects are obviously a concern.  
*The cough stops when she lies down.

I have done a fair amount of research and believe that the cough is caused by a neurological condition.  Could the Vagus nerve be the culprit?  Could something be irritating the Vagus nerve and the act of putting pressure on the abdomen provides relief to the nerve?  Could this be as simple as a hernia?  
35 Responses
Avatar universal
HI! I'VE HAD A CRONIC COUGH FOR 22 YEARS. MY SYMPTOMS ARE ALOT  LIKE YOUR WIFES. MY COUGH IS TRIGGERED BY A PRICKY FEELING ON THE RIGHT SIDE OF MY THROAT. AND SOMETIMES I HAVE TO PUT PRESSURE ON MY  UPPER ABDOMAN  RIGHT BETWEEN MY RIBS OR ON  THE RIGHT SIDE OF MY THROAT AND THE  FEELING OF COUGHING STOPS.  I COUGH AT LEAST 10 TO 15 TIMES A DAY.  I HAVE MENTIONED  THIESE SYMTOMS TO THE DR'S AND THEY DON'T SEEM TO TAKE IT SERIOUS.  I FEEL LURCHES FROM MY STOMACH  AND IT TRIGGERS MY COUGH.  EVERYTIHING I DO CAUSES MY  COUGH.  I WILL BE USING A HOLTER MONITOR FOR TWO WEEKS. I HOPE THAT GIVES THEM A CLUE. I'M CONVINCED  ALL MY SYPTOMS ARE CAUSED BY THE VAGUS NERVE
I HAVE SPASAMS IN MY THROAT THAT CAUSE MY COUGH. I HAVE ALSO HAD ALL THE TESTING, SUCH AS, ENDOSCOPY, BARIUM SWALLOW, BREATHING TESTS AND STILL I COUGH.  I'M SO EXCITED I FOUND THIS FORUM WITH PEOPLE THAT CAN RELATE TO MY  PROBLEM.  I'M REALLY HOPING TO FIND SOMEONE THAT KNOWS HOW TO TREAT THE VAGUS NERVE PROBLEM. PLEASE LET ME KNOW IF YOU HAVE FOUND HELP.   GOOD LUCK!
Avatar universal
I will be sure to let you know of any info.  She has had all of those tests as well.  It seems only logical that if something as simple as pressure stops the cough that should be considerred/explored in making a diagnosis.  If you had a car that would only run if you pushed on the dashboard the mechanic would certainly be interested?????
Avatar universal
my husband has chronic cough and after everything else was ruled out diagnosis made by ENT man was "silent" reflux and he was put on prilosec.Silent reflux can also be linked to hiatal hernia/vagus nerve syndrome.

Apparently an applied kinesiologist/chiropractor has the skill to manipulate the hernia out of the diaphragm.i.e. pull it down and apparently also this skill can be taught to the patient.. applying pressure must be part of the technique since some relief is given with that.
Avatar universal
I read your story and I too have had a chronic cough for 11 years.  I won't bore you with all the details of doctors, tests, meds but will tell you that my last doctor (only 1 week ago)  who was an ENT diagnosed vagul neuropathy and put meon elevil 20 mg at night.  My night coughs were horrific.  I have been virtually cough free for  one week forthe first time in my 11 years  of this ailment.  Just wnted to share it with you.
Stay in touch and good luck
1 Comments
did you have any wet cough or just dry cough?
Avatar universal
I've had "the cough" since 2003. My situation started also with a weird flu/pneumonia type episode with fever, I've never had a sickness like that before & I've definitely never had a fever like that before as an adult, so I had my wife take me to the ER & they administered liquids & some type of I.V. medication. I was a smoker back then so once the "flu" subsided I woke up for one of my morning smokes & on my first hit noticed a pain/pressure in my lower esophagus I've never felt before & the start of the first "cough" that has lasted now for 5+ years. I no longer smoke & my symptoms are still there. I've been to every ENT, Allergist, Gastronologist BUT have never seen a neurologist. I think this is the route I'm going to go next because not only is the next step it's pretty much the only step left.

I remember being left with a weird condition, I couldn't clean my right ear with a q-tip for months because as soon as I stuck the darn thing in my ear I would cough uncontrollably! Over the years I can stand to clean my ear but if I press firmly on certain spots & or tug the bottom of my ear lob, yup I'll start coughing! That tells me it's a nerve somehow!  Things you may share with me.

1. Can't eat crispy crusty things without coughing such as, cookies, pies, french fries
2. Soon as I lay down to go to sleep within 1 minute I'll cough 1 last time & then as far as I know I sleep all the way through the night & then just like clock work a cough will wake me up exactly the same time every morning 5:47am.
3. Carry a bottle of water almost everywhere I go. I used to buy those cheap 32 cases at Costco & leave those in my car!
Avatar universal
I too have been coughting for 10 years, as well as experiencing sharp pain in my outer ear,  without a diagnosis.  Please let me know any medication or physician specialty that could give me some relief.  It is causing me difficulty at my job, since I can't always answer the phone due to coughing spells and hoarseness.
Avatar universal
I also have had these same symptoms getting progressively worse over the last 10 years with not much luck in finding an answer or relief. The only thing that seemed to stop or slow the coughing down for me was the drug Tramadol which I took after a major accident. It also is losing its effectiveness though. I also have the q-tip problem and the crusty food problem. I also will cough from being over heated, lots of hot or cold air, old spice aftershave, pepper, and lots of other things. I have acid reflux which I have just started treating and will possibly have surgery for but I have tested for everything else and nothing has been found. I don't believe the acid reflux will be the complete answer either. The more I read about the vagul nerve thing the more I think that is something I need to suggest to my doctor to check into. Let us know more when you find anything and I will do the same. Thanks!!
Avatar universal
I too have been coughing for 10 years, have the q-tip problem, the crusty food problem etc. I have been to several Doctors. The vagul nerve interests me because after reflux surgery that was supposed to cure my cough, I get the sensation of a pinched nerve on the left front section of my neck usually if I overeat. No pills, nasal sprays, inhalers, etc. have helped more than a litlle bit. It affects my life 365 a year, 24 hours a day. Someone else's posting referred to "us" meaning every person in our lives is affected. I feel the same way. My family, friends and coworkers are saints for putting up with my cough and I appreciate the 100's of customers who have made suggestions trying to help. I too feel alone. I too feel like the doctors humor me and don't have a clue. More than one doctor admitted, "some people just cough." UGH!!! I sometimes feel guilty because they have patients with cancer. I just cough and cough and cough and cough!
Avatar universal
Hello All, I read about your plight while studying for my mid-terms at medical school. I am a first year medical student so please take my advice with a grain of salt. Your coughs are likely caused by the vagus nerve somehow becoming irritated. The q-tip syndrome is one real sign as the vagus has afferent fibers in the ear, so that stimulating your cough points to a somehow over sensitized vagus.
I also found that people with epileptic seizures can receive implants onto their vagus to stimulate it periodically in order to reduce their symptoms. Oddly enough, one of the side-effects is persistent cough from irritation/damage to the vagus.
In terms of treatment that is tricky. As you're all probably aware, the vagus is a very important nerve involved with everything from your heart rate, to digestion to your voice box. I would imagine - though I don't know for sure - that any kind of surgical treatment or therapuetic (medicine) would have considerable side effects.
I would, however, recommend speaking with a neurologist as they would know the most about what to do for this. Another option may be to try acupuncture as that tends to ease nerve pain/irritation for some patients (not specifically with vagus but just in general). Hope that helps!
Avatar universal
My mother is an Epilepsy Patient and this morning she is coughing uncontrolably...should we take her to the hospital or is there something we can do at home because she is also bed ridden and its hard to transport her.
Avatar universal
Your comments line up with what my doctor recently told me.  I've had a cough for about a month now.  As a kid, I used to get really bad coughs, but this was like nothing I've ever experienced.  I was initially put on an antibiotic, which did improve my condition.  All of the other cold symptoms went away, but the cough stayed on.  In fact, the cough changed to something quite different.  Now when I cough, I become very red in the face, become light headed to the point of nearly blacking out and I can not inhale for several seconds.  I mentioned this to my doctor and his diagnosis was that the vagus nerve was at the root of the problem.  He said he could not do much for me.  He prescribed some asthma medication to help reduce the lung inflamation.  Otherwise, he suggested rest and lots of liquids.  I've plateaued for the past two weeks.  I feel fine except for this debilitating cough, which never seems to get better.
1 Comments
there are meds for vagus nerve irritation.  look up - Gabapentin, Amitriptyline, Nortriptyline and Pregabalin
Avatar universal
I've had the chronic cough you all describe for about 8 years. I had a bad case of pneumonia that made the condition much worse and have never gone more than a week or two where I can breathe normally. The coughing is so bad I black out. I've tried all doctors, allergist, lung function,been told it was asthma, etc. as described by many been treated for acid reflux with aciphex and been given Tussinex to calm cough at nite to sleep. My ear, nose and throat doctor that I just recently found was looking at my sinuses and by accident discovered a growth in my throat. It turned out to be a baseball sized schwannoma tumor growing on the Vagus nerve. This has probably been the source of all my problems. I believe the nerve as been stimulated by the tumor and been sending wrong signals everywhere else. As I am in process of getting this removed I will have to update if conditions improve.
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