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Lung diseases

Cough, mucus and breathing

02/17/2010

Question:

I have been to three doctors, had a chest xray that was clear, three courses of antibiotics, and IM and Oral Predinisone. For one year I have been coughing on and off, lots of mucus. Also, when I lay down at night, there is a crackling noise when I breathe. There is pain when I take a deep breath, and then I start coughing. Symptoms do subside some days. Haven`t smoked for over 30 years, and even then, smoked only a couple of years.

Answer:

Chronic cough can be a very bothersome problem, and finding the cause can be equally challenging. Many things can cause chronic cough (allergic rhinitis, sinus disease, asthma, gastroesophageal reflux disease, medications such as ACE inhibitors, to name a few...). The treatment depends on the underlying cause--although it sounds like you have been evaluated and treated several times in the past year, sometimes more invasive testing such as methacholine testing, bronchoscopy, or pH probe studies are needed to identify the cause. I would encourage you to keep working with your doctors until the cause can be found.

Chronic bronchitis is defined by a chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded. In your case, if you have become symptom-free in between episodes of bronchitis, it would not yet be considered chronic. There are many possible causes for recurrent bronchitis such as infection, underlying lung disease (asthma or chronic obstructive lung disease/emphysema), or weakness of the immune system. Each patient should be evaluated for possible causes and I would encourage you to discuss with your physician.

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Response by:

Jennifer  McCallister, MD Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University