Diet and Health FAQ

Tagged As: Cough Headache

Question:
I am a mid-30s non-smoking male in relatively good health. For about 10 weeks now, I have had a persistent deep cough that I just can't seem to shake. For the first 8 weeks, all I would ever cough up if anything was clear. These past two weeks the sputum has changed to a thick medium green color. I have had no fever with this and the doctor can't hear any lung congestion when listening with his steth. As I would assume is typical with something, I have gotten on and off again sinus infections because the cough just pushes gunk into my head. To clear those up, the doctor prescribed Augmenten and Clariton-d and Nasonex. That all did a great job to clear up my sinuses (and rip up my stomach), but never did any good on my lung problems. On the next trip to the Doctor, he prescribed Benzonatate pearls, Guaifnsn (sp?) and an Atrovent inhaler. None of this seems to have any effect on minimizing my cough or clearing out the green junk. There is one other curious symptom related to this cough. When I go to bed at night, I seldom if ever cough but as soon as I get up and get moving, the cough seems to come and go in waves. The cough is so violent that it turns to a gagging cough unless I really try to put the reigns on it. Does anyone have any suggestions on what more can be done to diagnose and/or treat this? One more thing...I have had an unusual side-effect related to this cough. Several times during the day during a coughing spell I will get an instant headache that feels as though I were hit in the back of the head with a baseball bat. These headaches typically last 5-20 minutes. I have searched around the web and found that these symptoms sound like a cough headache potentially caused by a change in CSF in the brain. Are there other possible reasons for these cough headaches? If not what would you suggest should be done about them. To a certain extent, I feel that if we can get the cough to go away, the headaches will go too. Thanks in advance for your help.

Answer:
A chronic cough can be due to several different items: sinus disease, lung disease or gastroesophageal reflux. In people who smoke, one is always concerned about lung cancer. With a persistent cough like that, one would usually get a chest X-ray, and if that was negative, then one pursues other diagnoses: Sometimes empiric therapy is useful for relieving the problem and figuring out what is going on. For example, Chronic cough due to gastroesophageal reflux may be present without other symptoms of GERD, like heartburn. For these patients, often a 30-day treatment with high-dose proton-pump inhibitors, like Prevacid or Prilosec, may provide relief from the cough. Some patients with asthma have a cough, but don't have wheezing. For them, the inhalers may be useful. Sinus disease may be chronic, in which case plain films don't reveal as much as a CT can. Alternatively, an evaluation by an ENT physician can reveal evidence of chronic sinus disease, polyps and post-nasal drip, as likely causes of cough. Treatment for chronic sinusitis often includes antibiotics for several weeks and prescription nasal sprays. Depending on your exposures, physical examination, life-style, you may also benefit from testing for TB or HIV. You might start by letting your doctor know that you're not responding to the treatment and see if he can proceed with a further evaluation. Is he an internist? (My own bias) H2