Chronic Cough and Throat Issues: When to Seek Medical Advice

Throat issues

I have been experiencing a persistent cough for several months, starting around July or August, possibly even earlier.
Every morning when I wake up, I definitely cough to the point of feeling nauseous.
After a while, I also experience a burning sensation in my throat, feeling like I might catch a cold, along with weakness in my limbs.
My stool has been somewhat dark green or black.
The clinic doctor suspects bronchitis, and since I do not have a fever, pneumonia has been ruled out.
After listening to my lung sounds, the doctor prescribed medication, which has significantly improved my condition.
I was given Doxymin capsules; I felt better while taking the medication for a few days, and my stool returned to normal.
However, once the medication wore off, the coughing returned.
After finishing the three-day course of medication, the burning sensation in my throat and weakness in my limbs reappeared a few days later.
Could you please advise me on which specialty I should consult for further examination? What should I pay attention to in terms of daily health care?

Niming, 30~39 year old female. Ask Date: 2020/12/29

Dr. Hong Yuanbin reply Internal Medicine

Hello, I would like to know if you have allergic rhinitis and post-nasal drip, or if you have gastroesophageal reflux disease (GERD)? If you have these two issues, they could be the cause of your cough.
You can treat both conditions.
If not, it may be necessary to see an otolaryngologist to examine your throat.
If your throat is normal, you should consult a pulmonologist for a detailed examination.
It is also important to avoid irritating foods, limit coffee and tea intake, exercise regularly, and maintain a consistent routine.
I believe this will be helpful.
Thank you for your inquiry.

Reply Date: 2020/12/29

More Info

Chronic cough, especially one that persists for several months, can be a significant concern and may indicate an underlying health issue that requires further evaluation. Based on your description, it seems that you have been experiencing a persistent cough, throat discomfort, and other systemic symptoms such as fatigue and changes in bowel habits. Given these symptoms, it is essential to approach this situation methodically.

When to Seek Medical Advice
1. Duration of Symptoms: A cough lasting more than eight weeks is classified as chronic and warrants a thorough evaluation. Since your symptoms have persisted for several months, it is crucial to seek medical advice if you haven't already done so.

2. Associated Symptoms: The presence of additional symptoms such as throat discomfort, fatigue, and changes in bowel habits (like the dark green or black stools you mentioned) can indicate a more complex issue. Dark stools can sometimes suggest gastrointestinal bleeding or other serious conditions, and this should be evaluated promptly.

3. Response to Treatment: You mentioned that antibiotics like Doxymin provided temporary relief but that symptoms returned after completing the course. This pattern suggests that the underlying cause of your cough may not be purely bacterial, and other factors such as viral infections, allergies, or even chronic conditions like asthma or gastroesophageal reflux disease (GERD) could be contributing.

Recommended Specialists
Given the complexity of your symptoms, it would be advisable to consult with the following specialists:
1. Pulmonologist (Chest Specialist): A pulmonologist specializes in respiratory issues and can conduct further tests such as pulmonary function tests, imaging studies (like a chest X-ray or CT scan), and possibly a bronchoscopy if needed. They can help determine if there is an underlying lung condition, such as chronic bronchitis, asthma, or even interstitial lung disease.

2. Ear, Nose, and Throat (ENT) Specialist: An ENT can evaluate your throat symptoms and check for any issues related to post-nasal drip, chronic sinusitis, or other upper respiratory conditions that could be contributing to your chronic cough.

3. Gastroenterologist: If your dark stools persist or if you have symptoms suggestive of gastrointestinal issues, a gastroenterologist can evaluate for conditions like GERD, which can cause chronic cough due to acid reflux irritating the throat and airways.

Daily Care and Lifestyle Modifications
In addition to seeking medical advice, consider the following lifestyle modifications that may help alleviate your symptoms:
1. Hydration: Ensure you are drinking plenty of fluids. Staying well-hydrated can help thin mucus and soothe an irritated throat.

2. Avoid Irritants: Stay away from smoke, strong odors, and allergens that could exacerbate your cough. If you have known allergies, managing them with appropriate medications can be beneficial.

3. Humidification: Using a humidifier in your home, especially in your bedroom, can help keep the air moist and may reduce coughing, particularly at night.

4. Dietary Considerations: Monitor your diet for any foods that may trigger reflux or throat irritation. Spicy foods, caffeine, and alcohol can exacerbate symptoms in some individuals.

5. Sleep Position: If you experience coughing at night, consider sleeping with your head elevated to reduce post-nasal drip and acid reflux.

6. Regular Follow-ups: Keep track of your symptoms and maintain regular follow-ups with your healthcare providers to monitor your condition and adjust treatment as necessary.

Conclusion
Chronic cough can stem from various causes, and it is essential to identify the underlying issue to receive appropriate treatment. Given your symptoms and their persistence, consulting with a pulmonologist and possibly an ENT or gastroenterologist would be prudent. Additionally, implementing lifestyle changes can help manage your symptoms and improve your overall quality of life. Always communicate openly with your healthcare providers about your symptoms and any changes you experience.

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