[34F] Chronic productive cough and runny nose

Patient Description

A 34-year-old female has been experiencing a chronic productive cough for approximately one year, which becomes more severe when drinking water and is particularly more frequent in the morning. The patient also experiences a runny nose that coincides with the coughing episodes. She has a history of idiopathic intracranial hypertension, ulcerative colitis, GERD, and eczema, diagnosed between 2000 and 2019. Current medications include Cymbalta, Entyvio, Abilify, Levothyroxine, and Omeprazole. The patient reported a single instance of blood in the phlegm, no fever, chills, heartburn, sour taste in the mouth, significant weight loss, or night sweats. Additionally, the patient experiences occasional wheezing.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Chronic Bronchitis: This condition is characterized by a long-term cough with mucus production. It's a type of chronic obstructive pulmonary disease (COPD). Chronic bronchitis often occurs in people who smoke, but can also develop in non-smokers. It is usually diagnosed after a person has had a cough with mucus on most days of the month for at least 3 months.

    • Treatment typically involves medications to help reduce inflammation, open up the airways, and treat infections if they occur.
  • Gastroesophageal Reflux Disease (GERD): Although you've mentioned that you're not currently experiencing heartburn or a sour taste in your mouth, GERD can sometimes cause a chronic cough. This happens when stomach acid backs up into your esophagus and irritates your throat.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Postnasal Drip: This condition occurs when excess mucus from your nose drips down the back of your throat. This can lead to a chronic cough. Postnasal drip can be caused by various conditions including allergies, colds, and sinus infections.

    • Treatment typically involves addressing the underlying cause. For example, if allergies are causing your postnasal drip, your doctor might recommend allergy medications.

Please remember that while these are possible diagnoses, they are not definitive. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions that might help alleviate your symptoms:

  1. Stay Hydrated: Drinking plenty of fluids can help thin the mucus in your throat, making it easier to cough up.
  2. Use a Humidifier: This can help keep your throat and nasal passages moist and relieve the cough.
  3. Avoid Irritants: Smoke, dust, and other irritants can make your cough worse. Try to avoid these as much as possible.
  4. Over-the-Counter Remedies: Cough suppressants and expectorants available at your local pharmacy may provide some relief.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Difficulty breathing or shortness of breath
  • Coughing up blood
  • Unexplained weight loss
  • High fever (over 100.4°F)
  • Chest pain

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare provider for accurate information.

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11 mo ago

People Also Ask


What are the common causes of a chronic productive cough?

Common causes of a chronic productive cough include chronic bronchitis, postnasal drip, GERD, asthma, and infections like pneumonia or bronchitis. Smoking and exposure to irritants can also contribute.


Can GERD cause a cough even if there are no typical symptoms like heartburn?

Yes, GERD can cause a chronic cough even without typical symptoms like heartburn. This is because stomach acid can irritate the throat and airways, leading to a cough.


How can postnasal drip lead to a chronic cough?

Postnasal drip occurs when excess mucus from the nose drips down the back of the throat, irritating it and causing a cough. It can be triggered by allergies, colds, or sinus infections.


What lifestyle changes can help manage symptoms of chronic bronchitis?

Lifestyle changes to manage chronic bronchitis include quitting smoking, avoiding lung irritants, staying hydrated, using a humidifier, and engaging in regular physical activity to improve lung function.


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