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Sue asked...

I have developed a terrible cough.

I am on holiday with my elderly mother and have developed a terrible cough caused by intense irritation in what feels like the entire length of the oesophagus.

I am sitting upright to sleep but wake up choking/coughing after one hour max and find it difficult to stop. I am taking omepraxole for slight acid reflux and was given a beclometasone inhaker before departure for a slight wheezy cough - but it is now infiniteky worse.

Can you suggest anything to alleviate this while I am away as I dont want to spoil things for my mother? I realise I have to see my gp on my return.

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The answer

There are a surprising number of causes of cough, and as you have discovered they don’t all start in the chest. Acid reflux, in which acid from the stomach leaks backwards up the gullet and sometimes into the throat, fairly often causes a dry, irritating cough.

However, the most common cause of cough by far is a viral infection in the upper airways. This tends to produce a dry, harsh cough (although you can cough up green or yellow sputum with a virus infection). The cough is almost always much worse when you lie down. That’s because the mucus you produce from your nose, which normally trickles down your throat and is swallowed when you’re upright, lands on your soft palate when you’re lying down. This can trigger the cough reflex. Keeping yourself more upright in bed by making a nest of pillows can help reduce this.

The warning signs doctors advise patients to be aware of if they have a cough include sharp stabbing chest pain when you breathe (rather than just when you cough); coughing up blood or rust coloured sputum; shortness of breath all the time/when you exert yourself rather than just when you’re coughing; and increase in wheezing.

Provided you don’t have these symptoms, it’s probably safe to buy a codeine linctus from the chemist in the short term (as long as there is no medical reason such as previous adverse reaction to codeine for you not to take it). This can help suppress the cough. However, we don’t recommend these regularly or long term as your cough is part of your body’s attempt to rid itself of the infection, and suppressing the cough might make you more prone to more serious chest infection.

 

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