Chronic Cough and Throat Sensation: Persistent Symptoms - Otolaryngology

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Chronic cough and persistent throat sensations can be quite distressing, especially when they interfere with daily life and sleep. Your father's symptoms, particularly the sensation of a foreign body in the throat and the chronic cough lasting for several years, warrant a thorough evaluation to determine the underlying cause.

Given that he has undergone health checks and chest X-rays with normal results, it is essential to consider other potential causes of his symptoms. Chronic cough can arise from various conditions, including post-nasal drip, gastroesophageal reflux disease (GERD), asthma, chronic bronchitis, or even less common conditions like vocal cord dysfunction or laryngeal hypersensitivity.

1. Post-Nasal Drip: This is a common cause of chronic cough, especially in individuals with a history of allergies or sinus issues. Mucus from the nasal passages can drip down the back of the throat, causing irritation and a persistent cough. If your father has a history of nasal allergies, this could be a significant factor.

2. Gastroesophageal Reflux Disease (GERD): GERD can cause a sensation of a lump in the throat (globus sensation) and chronic cough due to acid irritating the esophagus and throat. Symptoms may worsen at night or after meals, especially if he lies down shortly after eating.

3. Asthma: Even if he has not been diagnosed with asthma, it can present with a chronic cough, especially if triggered by allergens or irritants. A thorough evaluation by a pulmonologist may be necessary to rule this out.

4. Chronic Bronchitis: This condition is characterized by a persistent cough and mucus production. It is often associated with smoking or long-term exposure to irritants.

5. Vocal Cord Dysfunction: This occurs when the vocal cords do not open properly during breathing, leading to a sensation of tightness in the throat and coughing. It can be triggered by stress or irritants.

6. Laryngeal Hypersensitivity: This condition involves increased sensitivity of the larynx, leading to a sensation of irritation and chronic cough without any identifiable structural abnormalities.

Given the complexity of his symptoms, it may be beneficial for your father to see an ear, nose, and throat (ENT) specialist for a comprehensive evaluation. The ENT can perform a laryngoscopy to visualize the throat and vocal cords directly, which can help identify any abnormalities that may not be visible on X-rays. Additionally, they may recommend allergy testing or a referral to a gastroenterologist if GERD is suspected.

In terms of management, while traditional Chinese medicine may provide some relief, it is crucial to ensure that any underlying conditions are adequately addressed. Encourage your father to maintain a diary of his symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for healthcare providers in diagnosing and managing his condition.

In summary, your father's chronic cough and throat sensation could stem from several underlying issues, including post-nasal drip, GERD, asthma, or vocal cord dysfunction. A thorough evaluation by an ENT specialist, possibly complemented by allergy testing or a gastroenterology consultation, will be essential in determining the appropriate course of action to alleviate his symptoms and improve his quality of life.