[18F] With chronic productive cough and halitosis

Patient Description

An 18-year-old female reports coughing up snot or phlegm for several months. The patient feels that this has caused bad breath. Initially, she thought she had tonsil stones but clarified that she does not have tonsils. The cough itself does not cause pain, but it is persistent, leading to frequent episodes of coughing up phlegm.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Chronic Sinusitis: This condition involves inflammation of the sinuses that lasts for more than 12 weeks. It can cause mucus to drain down the back of your throat, leading to a persistent cough and phlegm production. Bad breath can also be a symptom due to the mucus buildup.

    • Treatment: Treatment often includes nasal corticosteroids, saline nasal irrigation, and sometimes antibiotics if a bacterial infection is suspected. In some cases, a doctor may recommend a CT scan to get a better look at your sinuses.
  • Postnasal Drip: This occurs when excess mucus from the nose and sinuses drips down the back of the throat, causing a cough and phlegm. It can be caused by allergies, infections, or other irritants.

    • Treatment: Over-the-counter antihistamines or decongestants can help manage symptoms. Staying hydrated and using a humidifier can also be beneficial.
  • Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease (COPD) characterized by a long-term cough with mucus. It can be caused by smoking, air pollution, or other irritants.

    • Treatment: Treatment may include bronchodilators, steroids, and pulmonary rehabilitation. Quitting smoking and avoiding irritants are crucial.
  • Gastroesophageal Reflux Disease (GERD): GERD can cause a chronic cough due to acid reflux irritating the throat. This can also lead to bad breath.

    • Treatment: Lifestyle changes such as avoiding certain foods, eating smaller meals, and not lying down after eating can help. Medications like antacids, H2 blockers, or proton pump inhibitors may also be recommended.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Stay Hydrated: Drink plenty of water to help thin the mucus and make it easier to expel.
  2. Use a Humidifier: Adding moisture to the air can help soothe your airways and reduce coughing.
  3. Nasal Irrigation: Using a saline nasal spray or a neti pot can help clear out mucus from your nasal passages.
  4. Avoid Irritants: Try to avoid smoking, secondhand smoke, and other environmental irritants that can worsen your symptoms.
  5. Maintain Good Oral Hygiene: Brush your teeth and tongue regularly, and consider using a mouthwash to help with bad breath.
  6. Track Your Symptoms: Use the MDandMe app to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Worsening Symptoms: If your cough or mucus production worsens or doesn't improve with home remedies.
  • Fever: A persistent fever could indicate an infection that needs medical treatment.
  • Shortness of Breath: Difficulty breathing or wheezing should be evaluated by a healthcare professional.
  • Chest Pain: Any chest pain should be taken seriously and assessed by a doctor.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common causes of a persistent cough with phlegm?

Common causes of a persistent cough with phlegm include chronic sinusitis, postnasal drip, chronic bronchitis, and gastroesophageal reflux disease (GERD). These conditions can lead to excess mucus production and drainage, causing a cough.


How can chronic sinusitis lead to bad breath?

Chronic sinusitis can lead to bad breath because the mucus buildup in the sinuses can drain down the back of the throat, creating an environment where bacteria can thrive, leading to unpleasant odors.


What lifestyle changes can help manage GERD-related cough?

Lifestyle changes to manage GERD-related cough include avoiding foods that trigger reflux, eating smaller meals, not lying down immediately after eating, and elevating the head while sleeping. These changes can help reduce acid reflux and its associated symptoms.


When should I seek medical attention for a persistent cough?

You should seek medical attention for a persistent cough if your symptoms worsen, if you develop a fever, experience shortness of breath, or have chest pain. These could indicate a more serious condition that requires medical evaluation.

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