Can dry cough and wheezing in the chest cause bronchitis?

Question

Hello doctor,

I am 19 years old and have had acid reflux for the past five years. I have had a cough and whistling sound (wheezing?) with it for five years, and over the past few months, I have had rattling in my chest. The doctors cannot hear the rattling, but I feel it mostly when I lie down. In addition to the rattling, the cough has gotten worse. It is much more of a dry cough, and it burns. Also, for the past five years, it feels like it is hard to breathe, but the doctor says my lungs sound clear. An X-ray was also performed a few weeks ago, and they said the results were normal. What could cause this? My biggest fear is chronic bronchitis. I am having another endoscopy soon, but would a bronchoscopy be better?

Kindly guide.

Answer 1

Hello,

From your history, it is very clear that you were suffering from too many problems in your teenage years. First thing, I want to clarify is that you are having morbid obesity. Also, you suffer from chronic gastroesophageal reflux disease, i.e., GERD. So you are having a dry cough for such a long duration. The current symptoms you suffer from are suggestive of bronchial asthma. GERD is the aggravating factor for your dry cough. The most important investigation to rule out asthma is spirometry, also called a pulmonary function test (PFT). Obesity is making all symptoms worse. So you should also concentrate on weight reduction and regular exercise. If PFT is suggestive of asthma, you need definitive inhaler treatment to keep your asthma under control. Chest x-ray may appear normal, but a dry cough for such a long duration again suggests asthma. Priority should be given to weight reduction. The probable causes include allergy to dust, GERD, and obesity. Investigations to be done are PFT or spirometry, AEC (absolute eosinophil count), and a blood test. The differential diagnosis is bronchial asthma and GERD. The probable diagnosis is bronchial Asthma. The treatment plan includes inhaled corticosteroids through metered dose inhalers, antacids for reflux, and weight reduction for obesity. A preventive measure is to avoid spicy food. You need regular monthly follow-up with your doctor to keep your asthma under control.

I hope this helps.

Thank you.