vagus nerve/chronic cough HELP

[JBjork]

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?  

[caib]

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!

[JBjork]

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?????

[researcher327]

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.

[nanci7149]

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

[secretmode]

did you have any wet cough or just dry cough?

[repooc1970]

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!

[MomMom1213]

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.

[jojo1963]

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!!

[witsendinga]

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!

[envirodoc]

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!

[Joyce_54]

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.

[dmoro67]

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.

[secretmode]

there are meds for vagus nerve irritation.  look up - Gabapentin, Amitriptyline, Nortriptyline and Pregabalin

[macgyver_paul]

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.

[tired13209]

my husband has developed a "cough" that turns into a "seizure" event.  He starts coughing, his face turns beet red, his eyes water, his torso begins to twist as well as his arms and hands.  It seems he is never going to get his breath. He has fallen out of bed, off the couch and in the floor many times from blacking out.  He doesn't totally faint but he has no memory of what has happened.  He has been hospitalized twice.  He is being treated from GERD and has ulcers and esophagitis.  This has helped but he is still experiencing these episodes of seizures and coughing.  Anybody else ever hear of this or knows what is going on?

[KellKell40]

I have had a chronic cough for the past 7 1/2 yrs, and I have been to two ENT doctors and one family doctor, and so far, nothing is being done for me about the cough.  I was diagnosed with having grade B Esophagitis, and a slight Hiatal Hernia, when I had an outpatient procedure done in the hospital in Oct, 2009.  It feels as though there is something grainy way down deep in my throat that causes me to cough constantly.  One of the ENT doctors told me in Dec., 2009 that my vocal chords were swollen.  I also get an odor coming up from down there.  I especially notice the odor after I drink some water.  Now, ever since sometime in Feb., 2010, I have been getting a cobwebby and numbness type of feeling on the outside of the left side of my mouth, and like a crawling sensation there and like a hair is brushing up against my face.  Also, on Friday, February 12, 2010, my lower lip feels odd now.  Whenever I draw my lower lip taut, it feels like a string is being pulled against my lower lip.

[susiejan]

This is exactly what I have been suffering for 10 months. I eventually got amitryptiline off the doc after practically begging. It seemed to help at first decreasing the cough. However it is still chronic and i have many severe bouts day and night. i have been sick on occassion. My tongue is also affected , it is numb and tingling with episodes of severe waves of tickling leading to coughing. I cannot work  my social life is curtailed. It is highly embarrassing and debilitating.Help susie J

[stslavin]

I am plagued with this same condition. I had a reaction to a drug in the summer of 2008. After the symptoms of my reaction cleared, I was left with bi-lateral pain in my hands and feet and a persistent cough. I too have been in and out of the allergist, pulmonologist, 2 neurologists, several primary care and 2 ENTs. I have took tests and many drugs including, amitriptyline and lyrica. I'm currently taking lyrica...primary care suggested it because it is now used for nerve related therapy for fibromyalgia patients. It may lessen the cough at times but I still have terrible episodes! I have also had experimental botox injections in my throat. They "numb" the muscles surrounding your voice box. The doctor was hoping this would "numb" the nerves leading up my throat such as the vagus nerve. It helped for about 3 weeks and then wore off. I had it a second time but did not help this time. It seems like a hit and miss therapy that is expensive and only done in one city in the whole state. I too am looking for permanent relief. My 4 year-old daughter thinks it's just "normal" for mommy to cough all of the time! If anyone has suggestions or questions regarding my care. Please comment!

[pjmt]

I have similar problem with permanent cronic cough since about 10 years . The trigger points are the left side of the pharynx, left ear, speaking.
Lots of examinations where negative for oncologic problems.
I was not taking medications for hypertension that cause cough (IECA group).
Some degree of gastro-esophageal reflux and respiratory allergy was well controlled with omeprazol and symbicort inhaled. But the cough still persisted.
The conclusion was that was caused by hypersensitivity of the vagus nerve, that can be a rare cause of asthma. The surgical option of cuting the nerve has many side effectes, said to me a very good ORL surgeon. He suggested to diminish the reactivity of the nerve with Gapapentin (Neurontin), beginning with a small dose and monitoring the results.
It's what I

[Simplify]

Please have your b12 checked or google B12 deficiency.  Your symptoms sound like classice Pernicious anemia. See:  http://www.ajcn.org/content/93/3/542.abstract

[MindyG74]

Did the Elavil work?  I'm 9 years into this thing and absolutely want to jump off a cliff.

Thanks!

[MindyG74]

Did the Elavil work?  I'm 9 years into this thing and absolutely want to jump off a cliff.

Thanks!

[diane4421]

OMG..I am so shocked to see how many other people have this chronic cough..I had a tumor wraped around my vocal cord and since then I have been coughing for 9 years..found the only thing that helps is medications that dull the nerve...was told by 5 doctors that is not a recomended form of treatment..but for everyone with this cough I feel for you and if you are on a plane or in a public place I would be honored to have you sit by me..I swear I wont stare and think your terribly ill...Good luck to all of us out there

[papt99]

wow.  I have had my cough for over 25 years.  I am 40.  I too have had all of the tests: MBS, gastroscope, laryngoscope, allergy testing and shots, inhalers, nose sprays, even had a uvulectomy. then last year I had  pH probe and it was highly positive for reflux.  So I had a nissen fundoplication.  well no more reflux, lost 30 pounds since my stomach is smaller, but still coughing.  I can stop it with narcotic cough meds but I became very addicted had to continue to up my dose.  I am weaing now but my cough is always there.  My main irritation is to the right side of my throat, just below my adam's apple.  I cadefinitely sympathize with all of you.  I have weird nerve symptoms as well with the ears, seasoned food, cold air, crackers, etc.  someone let me know what works.  UUGGGGGHH

[LinDarley]

I had all of those tests and no specialist could find what was wrong with me.  I was told to 'stop coughing' and 'did I think it was in my head'.  So I googled 'chronic cough and neurology'  and discovered I had an undiagnosed bout of shingles and now had PHN.  The virus had attacked my Vagus nerve and my diaphragm and peristalsis muscles were damaged to the point of barely working, my pelvic floor muscles weren't working at all.  I was breathless because of the non working diaphragm, coughing because of non working oesophagus muscles.  I went to a physiotherapist and reflexologist for help.  I insisted to my GP that I had PHN and started with Gabapentin for the pain.  This has helped enormously, but my muscle recovery is slow.  My diaphragm and pelvic floor muscles have only just started working again after 4 years and I have to exercise them everyday.
I am 53 now was 49 when got undiagnosed shingles.

[secretmode]

your diaphragm and peristalsis muscles are damaged because too much coughing?

[SophieMae13]

I too have had the surgery, but it was almost 20 years ago. I have had this cough since 1992, when I was diagnosed with GERD. Since then I have seen tons of doctors to try to get the coughing under control. I was told by a doctor at Emory, it was all in my head, and I was making my self cough. I cough so hard, I throw up and have at least 3 or 4 bouts like this a day, plus just coughing all the time. I was told what I have is neurogenic cough. In 1997, I was told I had vagus nerve damage. It has affected a lot of things in my body, such as restless leg syndrome, blood pressure issues, and fybromyalgia. I am on several drugs to help with nerve inflamation, and they help some. I try to work out 3 times a week, and stay active.