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Question
Posted by: | 2017/10/06

Chronic cough and ringing in right ear.

Hi Dr, I have had a chronic cough emanating from the throat since march 2017 (Dry Barking- croup like cough). Feeling a bit weak, I also went down to the coast in May 2017, and when I arrived back my ear started ringing, mostly right ear but sometimes in both. I am a smoker. I have been to 4 x GPs, 2 x Pulmonologists, 1 x Allergy Specialist, 2 x ENT’s. I was prescribed between them four courses of antibiotics, during April, May, June & July 2017, 20 x Pulmison cortisone - (2 weeks with no tapper) 30 mg a day finished, them on 28 April 2017, what a nightmare this drug can be, caused all sorts of horrible side effects, Singulair Air, Fox Air, Avamys, Latest Medication: Lancap – 2 x a day 30mg, Gaviscon - 4 x a day, Dazit 1 x a Day, Flonase – 2 x day. They have diagnosed me from Asthma, Sinus, Allergic Rhinitis to Reflux. I have had numerous tests Lung X-Ray (clear), Sinus X-Ray showed Allergic Rhinitis , Numerous Blood tests - Full Blood count with raised white blood cells - 2 x Dr’s said it was bacterial infection. The white blood cell count did come down, however, the last three tests, white blood cells were @ 13 ,Throat swab – clear, Allergy tests – Cat, Mould & Dog confirmed, Lung function test - came out as normal (82%), Camera up my nose and looked down my throat all clear. Latest test from the ENT on Monday was a Barium swallow, which they think they saw a Web… Now the ENT has scheduled me for a Laryngoscopy and Oesophogoscopy for next week Thursday, The ENT said to open the web up a bit… I am at my wits end as you can tell…. About what is actually going on , Could it be from a virus or bacterial infection?, but for so long? Or is it something else? Most of the Dr’s have said its re-flux but for 7 months with ringing in ear for 4 months? Been on Lancap now for over 2 months. Please advise?

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Our expert says:
Expert ImageCough Expert
- 2017/10/17

The main symptom of oesophageal webs is difficulty in swallowing.  They are often incidentally discovered.  In other words, many people have them but they don’t really cause any symptoms.  Your main problems are those of a chronic barking dry cough and ringing in your right ear.  I’m struggling to see how the oesophageal web might be cause those symptoms.  It’s important to continue using an antihistamine and the nasal spray as chronic postnasal drip is a common cause of this syndrome.  It also blocks the eustachian tubes thus explaining the ringing in the ear.  You have 2 tiny tubes connecting the back of your throat to your ears to equalise pressure and with chronic inflammation of the back of the throat and the top of the voice box causes coughing and also blockage of the ears.  Sometimes changing the type of antihistamine may help.  There are various options including fexofenadine.  Another option is to have a camera tube test looking beyond the voice box and to a CT scan of the chest, a much more detailed x-ray which can show up things that normally don’t show up on a conventional x-ray.  If a pulmonologist thinks this is not asthma and there is no benefit of these inhalers after 3 to 4 months then it’s best to stop them as they are associated with long term side-effects including increase risk of pneumonia and TB.  This sounds like a complex issue and you need to stick with a pulmonologist that you have some faith in to get you through this.  Ask about some of the things that I have mentioned.

Good luck!

 


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