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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31326
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have had a cough for about 7 years. I cough up phlem and

Customer Question

I have had a cough for about 7 years. I cough up phlem and sometimes get a taste of bleach or chlorine. I have pain in my chest sometimes while coughing or sneezing or laying on my back like I have a chest bruise.
JA: Have you ever dealt with this before? Are you having any shortness of breath?
Customer: I just thought it was allergies or something... been going on since at least 2009 when a gf pointed it out.. and yes i do get shortness of breath
JA: Anything else in your medical history you think the doctor should know?
Customer: No
Submitted: 1 month ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 month ago.

I am Dr. Arun and will be helping you today.

Your symptoms are suggestive of acid reflux (gastroesophageal reflux disease / GERD). This may be associated with hiatal hernia. This can cause all of your symptoms namely, chest bruise, cough, taste of bleach/chlorine, pain in chest while coughing or sneezing or laying on back.

Anti reflux therapy is;

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight, if overweight.

4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products

5) avoiding large meals. Eat 5 small meals in a day.

6) wait three hours after the meal before you sleep.

7) elevate head end of the bed by 8 inches.

Following also would be helpful;

A. Herbs;

1) Cranberry
2) Peppermint

B. Homeopathy

1) Nux Vomica
2) Pulsatilla

C. Nutrition and supplements;

1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
2) Probiotic supplement
3) Omega 3 fatty acid
4) Avoid; cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.5) Also avoid; white breads, pastas, and especially sugar, red meats,
6) Eat lean meats, cold water fish, tofu, beans, olive oil

Helpful investigations to establish and confirm the diagnosis are;

1) Esophageal manometry; evaluates esophageal motor pattern.
2) Esophagram / Barium swallow
3) Ambulatory esophageal manometry
4) CT scan of the chest.

The other possibilities of the diagnosis arel

1) Esophageal spasm
2) Esophageal motility disorder
3) Esophagitis.

The diagnostic and management protocol for the chronic cough is as following;

1) we will do a chest x-ray first;

2) pulmonary function tests or spirometry is the second step

3) starting of empiric therapy for postnasal drip, asthma, or gastroesophageal reflux. The GERD can be sometimes uncontrolled despite the medications and this will need further evaluation in the form of esophageal manometry (food pipe pressure study) and pH study of the food pipe (esophagus).

4) methacholine challenge testing to evaluate for airway hyperreactivity; done for the bronchospasm / bronchial asthma.

5) sputum or phlegm examination for eosinophils or empiric trial of corticosteroids for eosinophilic bronchitis.

If despite these measures, cough persists we would consider further investigations like esophagoscopy, 24-hour pH probe monitoring, high-resolution chest CT, or bronchoscopy.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 1 month ago.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 1 month ago.

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Thank you.

Expert:  Dr. Arun Phophalia replied 1 month ago.

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Expert:  Dr. Arun Phophalia replied 1 month ago.

Hope you are doing good.

Let me know if I can do anything more for you.

Expert:  Dr. Arun Phophalia replied 1 month ago.

My goal is to provide you with the best service possible. If you feel I have done so, then an "Excellent Service" rating is greatly appreciated! If not, please click "Reply" to let me know how I can better assist you with any additional information or clarification.

Thank you very much for the opportunity to be of help!

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