Chronic Cough with Blood: Causes and Next Steps - Pulmonology

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Chronic cough with blood can be concerning, and it’s essential to understand the potential causes and the next steps you should take. Given your history of chronic nasal and throat issues, as well as your recent symptoms, it’s vital to consider several factors.

Firstly, the presence of blood in your cough or nasal discharge can arise from various conditions. In your case, the chronic nasal inflammation (chronic rhinitis or chronic sinusitis) and throat inflammation (chronic pharyngitis or laryngitis) could be contributing to the irritation and subsequent bleeding. When the mucous membranes in the nasal passages or throat become inflamed, they can become fragile and bleed, especially when you cough or blow your nose.

Additionally, the fact that you are experiencing discomfort in your trachea and a worsening cough during colds suggests that your airways may be particularly sensitive or reactive. This could be due to underlying conditions such as asthma or chronic bronchitis, which can be exacerbated by respiratory infections. The yellowish-brown color of your phlegm indicates that there may be an infection or inflammation present, which could also be contributing to your symptoms.

Given that you have already undergone a nasal endoscopy and biopsy, which showed chronic nasopharyngitis, it is crucial to follow up on this diagnosis. Chronic inflammation can lead to complications if not managed properly. Your symptoms of coughing when swallowing saliva and the impact on your sleep quality are significant and warrant further evaluation.

Here are some recommendations for your situation:
1. Follow-Up with a Specialist: Since you have a history of chronic nasal and throat issues, it would be wise to consult an ear, nose, and throat (ENT) specialist again. They may recommend further imaging studies, such as a CT scan of the sinuses, to assess for any structural issues or chronic sinusitis that may not have been fully addressed.

2. Pulmonary Evaluation: Given your chronic cough and the presence of blood, a consultation with a pulmonologist may also be beneficial. They can perform tests such as a chest X-ray or CT scan to rule out any lung-related issues, including infections, bronchitis, or even more serious conditions.

3. Management of Symptoms: In the meantime, managing your symptoms is crucial. Staying hydrated can help thin mucus, making it easier to expel. Using a humidifier in your bedroom may also alleviate throat irritation and improve your sleep quality. Over-the-counter saline nasal sprays can help keep your nasal passages moist and reduce irritation.

4. Avoid Irritants: Avoiding smoke, strong odors, and allergens can help reduce inflammation in your airways. If you have allergies, consider discussing antihistamines or nasal corticosteroids with your doctor.

5. Monitor Your Symptoms: Keep a detailed record of your symptoms, including when they worsen, any triggers you notice, and how they affect your daily life. This information can be invaluable for your healthcare providers in determining the best course of action.

6. Consider Lifestyle Changes: If you smoke, quitting can significantly improve your respiratory health. Additionally, maintaining a healthy diet and regular exercise can bolster your immune system and overall well-being.

In summary, while your chronic nasal and throat conditions may be contributing to your current symptoms, further evaluation is necessary to rule out other potential causes. It’s essential to stay proactive about your health and seek the appropriate specialist consultations to address your concerns comprehensively.