Severe Coughing and Vomiting: ENT Issues and Treatment Options - Otolaryngology

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Severe coughing that leads to vomiting can be a distressing symptom and may indicate several underlying issues. Given your description, it seems you have been experiencing a persistent cough that is not only uncomfortable but also leads to vomiting, which can significantly impact your quality of life.
From your account, it appears that you have already consulted a pulmonologist who assessed your respiratory function and found it to be normal. This is a good first step, as it rules out significant lung pathology. However, the fact that your cough is severe enough to induce vomiting suggests that there may be other factors at play, particularly related to the upper respiratory tract or gastrointestinal system.

One potential cause of your symptoms could be gastroesophageal reflux disease (GERD). GERD can lead to chronic cough due to the irritation of the esophagus and throat from stomach acid. This irritation can cause a sensation of a lump in the throat, difficulty swallowing, and a persistent cough, especially when lying down. If you have already been prescribed medication for GERD without improvement, it may be worth discussing with your doctor the possibility of increasing the dosage or trying a different class of medications, such as proton pump inhibitors (PPIs) or H2 blockers, which can be more effective for some patients.

Another possibility is post-nasal drip, which occurs when mucus from the nasal passages drips down the back of the throat, leading to irritation and coughing. This can be exacerbated by allergies or sinus infections. If you have a history of allergies, it might be beneficial to consult an ENT specialist who can evaluate your nasal passages and sinuses for any underlying issues, such as chronic sinusitis or nasal polyps, which could be contributing to your symptoms.

Additionally, your symptoms could be related to a condition known as chronic bronchitis, especially if you have a history of smoking or exposure to irritants. Chronic bronchitis is characterized by a persistent cough that produces mucus and can lead to episodes of coughing that may induce vomiting.

Given the complexity of your symptoms and the lack of improvement with initial treatments, it may be advisable to seek a referral to an ENT specialist. An ENT can conduct a thorough examination of your throat, larynx, and nasal passages, possibly using a flexible endoscope to visualize any abnormalities that may be contributing to your cough. They can also assess for conditions such as laryngopharyngeal reflux (LPR), which is similar to GERD but affects the throat and voice box.

In the meantime, there are several strategies you can employ to help manage your symptoms. Staying well-hydrated can help thin mucus and make it easier to clear from your throat. Using a humidifier in your home, especially in your bedroom at night, can also help keep your airways moist and reduce irritation. Avoiding known irritants, such as smoke, strong odors, and allergens, can also be beneficial.

In summary, while your initial evaluation by a pulmonologist was a crucial step, further investigation by an ENT specialist may provide additional insights into the cause of your severe coughing and vomiting. It is important to communicate all your symptoms clearly to your healthcare providers, as this will assist them in determining the most appropriate course of action for your treatment.