Question:

Dear Dr. Eneas,

I have had a slight cough for over four days and I'm taking Histal DM. It hasn't relieved my cough yet. I do not have any other symptoms or a fever, but there still seems to be a lot of chest congestion but nothing is coming out. There is also a slight tickle in my throat. I am normally a healthy male, young at 33; should I try another over-the-counter medication or go see the doctor?

Answer:

Your symptoms are not uncommon for this time of the year. I don't know if you ever had an allergic history, i.e. eczema, hay fever or asthma; but these symptoms can either be due to an allergy or a viral upper respiratory infection.

An allergy is usually due to dust, pollen, smoke or other irritants and could be associated with nasal congestion and mucus production which drips into the back of your throat and causes you to cough. The slight tickle in your throat could be a result of this process. This can usually be treated with an over-the-counter cold tablet with a decongestant and antihistamine (like Allegra D or Claritin D or Clarinase). I usually like to have the patient take a cough medicine that contains guanefsin which is an expectorant which will loosen up the phlegm in your throat so you can cough it out. This would be something like Robitussin. Sometimes the persistent cough could be that the infection has dropped into your lungs and is producing some spasm of the airways which can cause a persistent cough and in this case you would need to see a doctor. Antibiotics are usually not helpful in these situations unless there is a bacterial infection and this would usually be associated with a production of sputum (phlegm) which is yellow or green in color. There may also be a fever.

Your symptoms should clear with over the counter cold medications as long as you also take adequate levels of water and vitamins. Of course if your symptoms persist, then you must seek medical help to evaluate you for any other illnesses that can be treated if caught early enough.

Judson F. Eneas, MD

Internal Medicine/Nephrology

www.newprovidencedialysisunit.com

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