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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
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Experience:  Medical Doctor Trained at a Top Academic Institution
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I have a recurring / cough which occurs after I have

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I have a recurring / chronic cough which occurs after I have a cold and typically hangs around for between 1 and 6 months. The current case has been with me for ~10 weeks after I caught a cold in early July. This has been happening since 1995 and despite many tests and treatments, I have never really had a definitive answer as to what causes it, or gets rid of it – I often feel that it just ends up going away of its own accord. The cough is mainly only triggered by talking, i.e. I only need to cough when talking, which makes me think it is some kind of irritation to my voice-box. During previous episodes, I have seen numerous GPs, a respiratory specialist and an ENT specialist, had blood tests, scans and a laryngoscopy (nothing has shown up on any of these) and treatment has mainly been various asthma medications and antibiotics. The doctor I am currently seeing suggested reflux may be the cause and tried me on Nexium for a week – I developed a side effect of a mild bloody nose and there was no discernible change in the cough, so have ceased taking this. He has now referred me for a laryngoscopy to have a look at the voice box / vocal chords – am happy to do this as the last one was probably 6 or 7 years ago, however I cannot get in for another week. Was wondering if you may have any other suggestions. My general health is good (although I have always been quite ‘phlegmy’) and I am a non-smoker.
Hello. I'm Dr. Phil, licensed and practicing Internal Medicine Physician. Excellent service is my goal.

Thanks for this question.

Yes, this is pretty classic post viral airway inflammation or reactive airway disease

Have you ever tried inhalers or steroids?
Customer: replied 3 years ago.

That is typically what has been diagnosed previously and treatments have included inhalers such as Pulmicort, Qvar, Symbicort, Seritide, Spiriva, Tilade, Ventolin and Alvesco, along with Prednisolone which I have had two short courses of during the current episode.

Thank you Marc.

I do believe that this starts out with a viral illness

Sometimes this cough though can become a self fulfilling thing

The cough causes airway irritation which causes more cough and so on and so forth until the cough nerves are very irritated

At that point it becomes what is known as a neurogenic cough

I would recommend you to try a medication called gabapentin for this. There is some evidence it can help.

Here's an article on neurogenic cough.
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