Severe Coughing: Causes and Seeking Relief - Pulmonology

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Severe coughing can be a distressing symptom, especially when it disrupts daily activities and sleep. Based on your description, it seems that your cough has persisted for about a month, primarily triggered after meals, and is accompanied by throat pain and episodes of severe coughing that lead to redness, tears, and even vomiting. You mentioned a previous diagnosis of allergic pharyngitis and that a recent visit to your family doctor suggested post-nasal drip as a potential cause.
First, it's important to understand that coughing can arise from various underlying conditions, including allergies, infections, asthma, gastroesophageal reflux disease (GERD), and even more serious respiratory issues. Given your history of allergic pharyngitis and the recent diagnosis of potential asthma, it is plausible that your cough could be related to these conditions.

Post-Nasal Drip: This occurs when mucus from the nasal passages drips down the back of the throat, which can irritate the throat and trigger a cough reflex. This is often exacerbated by allergies or sinus infections. The fact that your symptoms improved with antihistamines suggests that allergies may play a significant role in your condition.

Asthma: Since you have a history of a collapsed lung and potential asthma, it is crucial to consider that your severe coughing could also be related to bronchial hyperreactivity. Asthma can cause coughing, especially at night or after exercise, and can be triggered by allergens, respiratory infections, or even cold air. If your cough is accompanied by wheezing or shortness of breath, it would be essential to evaluate your asthma management plan.

Gastroesophageal Reflux Disease (GERD): GERD can also cause chronic cough due to acid irritating the throat and airways. If you notice that your cough worsens after eating, this could be a contributing factor.
Given that your cough has not improved significantly despite treatment and is causing pain in your throat and chest, it would be advisable to seek further medical attention before your scheduled follow-up. Here are some steps you can take:
1. Return to Your Doctor: If your cough is severe enough to cause pain or disrupt your daily life, it is reasonable to return to your healthcare provider. They may want to perform additional tests, such as a chest X-ray or pulmonary function tests, to rule out other causes.

2. Monitor Symptoms: Keep a diary of your symptoms, noting when the cough occurs, its severity, and any associated symptoms (like wheezing or shortness of breath). This information can help your doctor make a more accurate diagnosis.

3. Consider Allergy Testing: If allergies are suspected, allergy testing may help identify specific triggers, allowing for better management of your symptoms.

4. Avoid Irritants: Stay away from smoke, strong odors, and other irritants that could exacerbate your cough.

5. Hydration and Humidification: Staying well-hydrated can help thin mucus, and using a humidifier can keep your airways moist, potentially reducing coughing.

6. Medication Review: Discuss with your doctor the effectiveness of the current medications. If antihistamines are not providing relief, other options such as inhaled corticosteroids or bronchodilators may be appropriate, especially if asthma is a concern.

In summary, while your current treatment has improved some symptoms, the persistence and severity of your cough warrant further evaluation. It is essential to address this issue promptly to prevent complications and improve your quality of life. Please consult your healthcare provider as soon as possible to discuss your symptoms and explore further diagnostic and treatment options.