Continuous Coughing for Several Months
As a 30-year-old man with a mild history of asthma, I've been dealing with a persistent cough for the past three months that intensifies after meals. Initially, I suspected it might be due to acid reflux, so I consistently took Pepcid and Tums for a fortnight. I also made sure to remain upright for an hour post-meal, elevate my sleeping position, and avoid eating late at night, yet these changes brought little relief. I've considered that it could be post-nasal drip from seasonal allergies and have tried several allergy treatments. Additionally, I wondered if a food allergy might be responsible, so I've been experimenting with eliminating different food items from my diet. Despite these efforts, I maintain good physical health, largely avoid fast food, and sustain a healthy BMI and regular exercise routine. I visited my doctor who prescribed Symbicort, believing that my existing inhaler wasn't sufficient, as I found myself using it eight times daily without improvement. While the Symbicort does alleviate my coughing after dinner somewhat, the next day, I typically revert to coughing again post-meal. Occasionally, I experience similar coughing spells after breakfast, but never after lunch. There's a sensation of irritation right behind my suprasternal notch that triggers the persistent urge to cough or clear my throat. I can spend hours dealing with an unshakeable itch, but occasionally, a good cough seems to relieve the discomfort momentarily. I have no difficulties with swallowing, and food or liquids never feel as though they're lodged in my throat. There’s no wheezing, and my cough doesn’t produce anything. At times, my throat can feel rough, possibly due to the constant irritation. I would greatly appreciate any insights into what this condition might indicate, as I feel like I'm out of options. Is there a risk of something more serious, perhaps like cancer or an unusual esophageal condition? I've scheduled a follow-up appointment with another doctor; however, navigating the Canadian healthcare system can be quite slow. Thank you for taking the time to read this.
Answers (1)
9/6/2025, 11:20:36 PM
OpenHealth AI
It sounds like you've been experiencing a persistent and frustrating cough that has been resistant to various treatments. Given your background with asthma and the details you've shared, it's understandable to feel concerned about the cause of your symptoms. Let’s clarify some important points and outline next steps.
Key Points:
- Persistent Cough: Coughing for three months, particularly after meals, can stem from several factors including acid reflux, post-nasal drip, or irritation caused by asthma or allergies.
- Current Treatments: You've tried several strategies (elevation, over-the-counter medications, and an asthma inhaler) with limited success.
- Symptom Appreciation: The itchiness behind the sternum and the sensation of irritation suggest ongoing irritation or inflammation that needs addressing.
Explanation:
Your cough, especially since it worsens after meals, is often associated with gastroesophageal reflux disease (GERD) or post-nasal drip from allergies. Since you are already both treating for these and using Symbicort, it may not just be one condition but a combination contributing to your symptoms.
The lack of wheezing, no difficulty swallowing, and the absence of productive coughing are good signs; they lower the risk of immediate serious conditions like esophageal cancer. However, persistent or worsening symptoms should always be evaluated further.
Prioritized Next Steps:
- Re-evaluate Dietary Habits: Keep a food diary to track any correlation between specific meals or ingredients and your symptoms. Pay attention to spicy foods, caffeine, chocolate, and acidic foods, which can exacerbate acid reflux.
- Consider a Trial of Antihistamines: If you suspect allergies or post-nasal drip, using a non-drowsy antihistamine (like cetirizine or loratadine) daily for a few weeks may help reduce nasal drainage, thus potentially relieving your cough.
- Use Humidification: Consider using a humidifier at home, especially if you live in a dry climate. This can help soothe throat irritation.
- Cough Management: For immediate relief, honey in warm water may help soothe irritation (in moderation and only if you're not allergic).
- Follow-Up Appointment: Continue with your scheduled follow-up. If waiting is an issue, express your ongoing symptoms and concerns, which might escalate the need for faster management options. You might discuss additional diagnostic options like a chest X-ray, referral to an allergist, or a gastroenterologist to rule out other underlying issues.
While it’s encouraging that you maintain good physical health, addressing your specific symptoms and their triggers is vital. I hope this gives you some direction on how to proceed. Please keep me updated on your progress or if you have further questions!
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