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  • Tales from the Clinic




The Cough That Won’t Quit
Jan 9th, 2014 Tales from the Clinic

A 38-year old woman comes to the clinic complaining of a nagging cough. She says she developed a “cold” a few weeks ago. She had a sore throat and a runny nose, pill and those symptoms went away within a few days, advice but she is still coughing. She coughs throughout the day, pills but it’s particularly bad at night when she’s trying to sleep. She has no fever, difficulty breathing, or chest pain. She has been trying over the counter cough syrups like Triaminic and Robitussin without relief.  “I can’t stand it anymore!”

Discussion

It seems like everyone’s coughing these days. We’re smack dab in the middle of cold and flu season and it’s the lucky few who escape these winter months without getting sick. And many people are suffering from a cough that just doesn’t seem to quit.

Cough is a common symptom of the Common Cold and unfortunately, can linger weeks after all of the other symptoms resolve. This is often due to residual post-nasal drip or increased sensitivity of the cough receptors that line the airways.

There are many over-the-counter remedies out there, like expectorants and cough suppressants, that claim to treat cough, but many people don’t find them particularly helpful. Perhaps it’s worth a try, but don’t be surprised if you don’t notice much improvement.  But there are some other things that might provide relief…

1)    When we run the heat in our homes, the air becomes very dry.  Breathing dry air can irritate the airways and worsen a cough. A humidifier will add moisture back into the air and can help soothe the airways.

2)    An antihistamine with or without a decongestant may also reduce cough by drying up secretions and post-nasal drip.  Be careful…some over-the-counter antihistamines, like Benadryl, can cause drowsiness…which may be a benefit at night when you’re trying to sleep.

3)    There are other medications such as cough syrups containing codeine and topical anesthetics that can make a difference, but these are by prescription only. So if over-the-counter treatments aren’t doing the trick, give your doctor a call.

If your cough is associated with fever, trouble breathing, chest pain, or bleeding, get medical attention right away.  And if your cough lasts longer than 3 or 4 weeks, it’s time to get in to see your doctor.

Follow-Up

The patient was given a prescription for a cough syrup containing codeine and she was told to use a humidifier in her bedroom at night.  After a few more days, the cough had improved and she is now symptom-free.

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