Posted by: | 2020/02/08


Persistent cough since 2013

I have a chronic/persistent cough since February 2013. I have seen my GP. She referred me to many specialist doctors. Over the years I have seen 3 pulmonologists, 2 gastroenterologists, 4 (Ent's) ear nose and throat specialists, 1 surgeon. I have also been to the UCT Allergy and Immunology Unit - UCT Lung Institute, But I am still coughing. The following tests was done: Lung function test, x-rays of the chest, gastroscopy, colonoscopy, nasal endoscopy, brongoscopy, barium swallow, allergy tests, physiotherapy on the chest, tuberculosis test. There was only an old TB spot found on the x-rays. For about 3 years my pulmonologist treated me for a cough varient asthma. He prescribed Foxair Accuhaler and Omnair Nasal Spray, but since last year it did not help for my cough anymore, Everytime I use it, my cough gets worse. Before this I have been using lots of other inhalers and medications for my cough. I am also using the following medication for Bipolar Disorder: Aspen Trazodone 50mg, Camcolit 200mg and Arizofy 2.5mg. I have also used medication for GERD, like Topzole, ect, because doctor thought maybe it could be acid reflux. When I went to go see my pulmonologist the last time in November 2019, He said he don't think I have asthma, but maybe it could be allergies. Then I went to go see an ENT specialist. He said he will put me on a treatment for 2 months, After that I would feel much better and my cough will be gone. I am still having this persistent cough. I need help urgently. Can you please help?

Expert's Reply


Cough Expert
- 2020/03/02

Oh dear!  I really do feel sorry for you.  You've certainly been through a lot of investigations and I cannot think of a single additional investigation to exclude another causes.  You have a condition called idiopathic chronic cough.  There are a variety of mechanisms including a neurogenic set point, hereditary factors, and hitherto unknown pathophysiological factors.  I have a couple of suggestions:
1. At UCT Private Academic Hospital there are excellent respiratory therapists and I suggest that they see you for some breathing synchronisation exercises.
2. There are several medications, including those used to treat certain types of epilepsy, that may be useful in cases of idiopathic chronic cough.  You should talk to your pulmonologist about this.

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