[27M] With ear popping and nighttime wet cough

Patient Description

A 27-year-old male presents with ear popping, a moderate wet cough that occurs only at night, excess sweating, and fatigue. The cough has been present for 4 days and is exacerbated by physical activity, particularly when the heart rate increases, leading to sudden onset of coughing episodes. These episodes typically last for the rest of the night. No specific triggers for the cough have been identified aside from physical activity. The patient is seeking further evaluation and management of these symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you have described—ear popping, a wet cough at night, excess sweating, and fatigue—here are some possible explanations:

  • Upper Respiratory Infection (URI): This is a common cause of cough, especially if it is wet and occurs at night. The ear popping could be due to congestion in the Eustachian tubes, which connect the middle ear to the back of the nose. Fatigue and excess sweating can also be symptoms of an infection.

    • Treatment: URIs are often viral and resolve on their own. Treatment typically includes rest, hydration, and over-the-counter medications to relieve symptoms. If bacterial, antibiotics may be prescribed by a doctor.
  • Postnasal Drip: This occurs when excess mucus from the nose drips down the back of the throat, causing a cough, especially at night. Ear popping can also be a symptom due to the connection between the nasal passages and the ears.

    • Treatment: Over-the-counter antihistamines or decongestants can help reduce mucus production. Staying hydrated and using a humidifier can also be beneficial.
  • Asthma: Exercise-induced asthma can cause coughing, especially during physical activity. The ear popping might be unrelated but could be due to changes in pressure or congestion.

    • Treatment: Inhalers prescribed by a doctor can help manage asthma symptoms. Avoiding known triggers and using a peak flow meter to monitor lung function can also be helpful.
  • Gastroesophageal Reflux Disease (GERD): GERD can cause a chronic cough, especially at night when lying down. Ear popping is less commonly associated but could be due to pressure changes.

    • Treatment: Lifestyle changes such as avoiding large meals before bed, elevating the head while sleeping, and taking antacids or other medications prescribed by a doctor can help manage GERD symptoms.

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 fluids to help thin mucus and keep your throat moist.
  2. Use a Humidifier: Adding moisture to the air can help ease coughing and congestion.
  3. Elevate Your Head: When sleeping, use extra pillows to keep your head elevated, which can help reduce coughing at night.
  4. Avoid Triggers: If you suspect certain activities or foods are making your symptoms worse, try to avoid them.
  5. Over-the-Counter Medications: Consider using decongestants, antihistamines, or cough suppressants to relieve symptoms.
  6. Track Your Symptoms: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Worsening Symptoms: If your cough, ear popping, or other symptoms worsen or do not improve after a week.
  • High Fever: A fever over 100.4°F that does not go down with over-the-counter medications.
  • Shortness of Breath: Difficulty breathing or wheezing, especially if it occurs suddenly.
  • Chest Pain: Any chest pain, especially if it is severe or accompanied by other symptoms like shortness of breath.

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago


People Also Ask


What could be causing my ear popping and wet cough at night?

Ear popping and a wet cough at night could be caused by an upper respiratory infection, postnasal drip, or even gastroesophageal reflux disease (GERD). These conditions can lead to congestion and mucus buildup, which may cause ear popping and coughing, especially when lying down.


How can I manage a cough that worsens with physical activity?

A cough that worsens with physical activity might be due to exercise-induced asthma or postnasal drip. Managing it can involve using prescribed inhalers for asthma, avoiding known triggers, and staying hydrated to thin mucus.


What are some home remedies to alleviate night-time coughing?

Home remedies for night-time coughing include staying hydrated, using a humidifier to add moisture to the air, elevating your head with extra pillows while sleeping, and using over-the-counter medications like decongestants or antihistamines to relieve symptoms.


When should I seek medical attention for my symptoms?

You should seek medical attention if your symptoms worsen or do not improve after a week, if you experience a high fever over 100.4°F, if you have shortness of breath or wheezing, or if you experience severe chest pain.

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