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Q. I have persistent cough problem for five years with vomiting, sometimes. Kindly help me.

Answered by
Dr. B. Vageesh Padiyar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 18, 2021 and last reviewed on: Jun 17, 2021

Hello doctor,

I have cough problem for five years. I have tested for TB as well, but it was negative. Before, I used to take prescribed medicines by the doctor and get relief. But for the last five months, I have a continuous cough with vomiting, sometimes. Kindly guide me on what to do.

Past medications of the same issue:

Tablet Aziwok 500.
Tablet Montas L.
Tablet Deriphyllin.
Tablet Omnacortil 10.
Capsule Bro Zedex.

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#

Hi,

Welcome to icliniq.com.

The most common reason for having these symptoms could be a feature of chronic silent GERD (gastroesophageal reflux) with LPR (laryngopharyngeal reflux). Even though you might be asymptomatic or never had gastric issues in between, the inflammation in the throat often exists in the hidden form and can resurface when adequate care is not taken.

Hidden acid reflux becomes so problematic because, as you know, the stomach usually has got cells that release hydrochloric acid and thus keep the gastric environment acidic in nature.

Your entire mucosal lining from the mouth, throat and food pipe (esophagus) is not meant to handle acidic. Of the three structures, the throat is the most sensitive due to its rich nerve supply. If your mouth, throat, or food pipe chronically comes in contact with acidic contents in a given situation, an inflammation starts which the body initially takes care of, but once this compensation wears out, you start developing symptoms that you have mentioned.

Please try to follow the advice mentioned below.

1) Maintain a strict diet, eat on time.

2) Avoid spicy oily and cold food or drinks.

3) Keep a gap of two hours between meals and before going to bed.

4) Do not overeat, rather keep your stomach half empty and have regular intermittent light food like fresh-cut fruits between major meals.

5) Saltwater gargling 8 to 10 times a day for 15 days.

6) Avoid alcohol and smoking as it can potentiate reflux.

7) Try to maintain a left lateral position while sleeping to reduce the chance of reflux.

I would suggest the following treatment plan:

  • Tablet Pan-D 40 mg (Pantoprazole and Domperidone) or equivalent once in the morning before breakfast for one month.
  • Mucaine gel (Oxetacaine, Aluminium hydroxide, and Milk of magnesia) or its equivalent one tablespoon three times a day 20 minutes before meals for one month

Ensure you follow the precautionary measures as much as possible as Mere medications will not fetch long-term relief. Please understand that this typically takes four to six weeks for things to normalize and for symptoms to subside and chiefly depends on how much you have been able to follow the precautions mentioned above, as 80 percent of the treatment depends on this.

You need to worry about absolutely nothing as this is a treatable entity, and things will be fine.

I hope I have answered your query in detail. If there is anything more you need to know or enquire, please do let me know, and I will get back as soon as possible.

Warm Regards.

Thank you very much for your reply.

As I am really having this continuous cough problem, I have analyzed my routine for a while, and your advice is really very good. I am attaching my laboratory reports and previous doctor's visit as well. Can you please see the attachment and tell me a little more about it? The cough also comes with dark green mucus (phlegm), and I have so much irritation in the ear. Waiting for your support to help me with this problem.

Regards.

#

Hi,

Welcome back to icliniq.com.

I had a detailed look at the reports (attachment removed to protect the patient's identity) you have sent. There is some entity of allergy as well and that is the reason for balgam formation in the throat in addition to the problem discussed above. You need to follow the instructions below in addition to instructions mentioned earlier. Wear N-95 mask and avoid exposure to dust or any substance which can trigger sneezing. I suggest you with:

  • Syrup Bromodex-T (Ambroxol, Guaifenesin, Menthol, Terbutaline) one teaspoon three times a day 15 minutes after food for next two weeks.
  • Tablet Mucomix (Acetylcysteine) one tablet in the morning and evening after food for one week.

As discussed earlier this problem might take few days to weeks to resolve and hence you need to be patient. Hope I have answered your query. Please do let me know if there is anything more you need to know.

Warm regards.


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