[50F] Severe persistent cough with difficulty breathing

Patient Description

A 50-year-old female has been experiencing severe, uncontrollable coughing for four months, rated 10/10 in intensity, leading to difficulty breathing and throat swelling. The cough is both productive and non-productive, initially producing yellow sputum, followed by milky and clear fluid. Symptoms worsen when eating or laying down. Short-term relief has been achieved with antibiotics and steroids. There is no chest pain, blood in the sputum, fever, or chills. The patient has a past medical history of acid reflux but no other chronic conditions, and is not currently on any other medications. There are no known allergies to medications, but the patient is allergic to grass.

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Arora's Assessment

What might be happening

Based on the information provided, here are a few possible conditions that could be causing your symptoms:

  • Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease (COPD) that results in a long-term cough with mucus. It is typically caused by long-term exposure to irritants that damage the lungs and airways.

    • Treatment usually involves medications to help open the airways and clear mucus, as well as lifestyle changes like quitting smoking and avoiding lung irritants.
  • Gastroesophageal Reflux Disease (GERD): This is a more severe form of acid reflux, where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause a chronic cough.

    • Treatment usually involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Asthma: This is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

    • Treatment typically involves long-term asthma control medications, inhaled corticosteroids, and rescue inhalers for quick symptom relief.

What you can do

  1. Consult a healthcare professional: Given the duration and severity of your symptoms, it's important to see a healthcare professional for a proper diagnosis and treatment plan.
  2. Lifestyle changes: Avoid smoking and exposure to secondhand smoke or other lung irritants. If GERD is a factor, avoid foods and drinks that trigger heartburn, eat smaller meals, and don't lie down after a meal.
  3. Over-the-counter remedies: Over-the-counter cough suppressants can provide short-term relief for a severe cough. Antacids or H-2-receptor blockers can help with acid reflux symptoms.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms get significantly worse in a short period of time.
  • You have difficulty breathing or experience chest pain.
  • You cough up blood or have a high fever.

Please remember that this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

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People Also Ask


What are the common causes of a chronic cough lasting several months?

Common causes of a chronic cough lasting several months include chronic bronchitis, gastroesophageal reflux disease (GERD), asthma, postnasal drip, and certain medications like ACE inhibitors. It's important to consult a healthcare professional for an accurate diagnosis.


How can GERD contribute to chronic coughing and what are the treatment options?

GERD can cause chronic coughing by allowing stomach acid to irritate the esophagus and airways. Treatment options include lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Medications like antacids, H-2-receptor blockers, or proton pump inhibitors may also be recommended.


What lifestyle changes can help manage symptoms of chronic bronchitis?

To manage symptoms of chronic bronchitis, it's important to avoid smoking and exposure to lung irritants. Staying hydrated, using a humidifier, and practicing breathing exercises can also help. In some cases, medications to open airways and clear mucus may be prescribed.


When should someone with a chronic cough seek immediate medical attention?

Immediate medical attention should be sought if a chronic cough is accompanied by difficulty breathing, chest pain, coughing up blood, or a high fever. These symptoms could indicate a more serious underlying condition that requires prompt evaluation.


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