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 lay 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 say my lungs and says it 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?
Hello,
Welcome to icliniq.com.
From your history, it is very clear that you are suffering from too many problems in your teenage. First thing, I want to clarify is you are having morbid obesity. Also, you suffer from chronic gastroesophageal reflux disease i.e. GERD. So you are having dry cough for such a long duration. The current symptoms you suffer 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 as 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 dry cough for such a long duration again suggest asthma. Priority should be given for weight reduction.
The Probable causes:
Allergy to dust, GERD, and obesity.
Investigations to be done:PFT or spirometry, AEC (absolute eosinophil count) blood test.
Differential diagnosis:Bronchial asthma, GERD.
Probable diagnosis:Bronchial Asthma.
Treatment plan:Inhaled corticosteroids through metered dose inhalers, antacids for reflux and weight reduction for obesity.
Preventive measures:Avoid spicy food.
Regarding follow up:Needs regular monthly follow up with your doctor to keep your asthma under control.
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