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"I have a persistent dry cough. What can it be?"

ZocdocAnswersI have a persistent dry cough. What can it be?


I have a really persistent non-productive dry cough for more that a year now. I'm always coughing but it's worst at night and in rooms with a/c. The cough hasn't bothered me that much (I guess I got used to it) but lately I'm been experiencing some chest pain, a little pressure also and I feel I don't get enough air. I take deep breaths but I feel my lungs aren't getting enough oxygen. It's a very unpleasant feeling. Another thing is that sometimes in my upper back I get this sharp (stabbing like) pain when I cough a lot.


I am sorry to hear about your symptoms. You should meet with your primary care physician for further evaluation, but here are some thoughts that I hope you will find useful. There are many causes of persistent dry cough, but the three most common are post-nasal drip (now called upper airway cough syndrome, or UACS), asthma, and gastric reflux (GERD). If you have nasal congestion or notable allergies, UACS is possible. This often responds to intranasal steroid sprays or antihistamines. Asthma would be more likely if you notice wheezing and shortness of breath, especially with exercise or exposure to cold, dry air. There is also, however, an entity called "cough-variant" asthma that might have cough as its sole symptom. Inhalers to dilate the airways and prevent inflammation are used to treat asthma. Finally, GERD is an under-recognized cause of chronic cough that is made worse after meals, with certain foods (chocolate, caffeine, spicy foods), and with lying down. It is often associated with burning chest pain and a sour/acid taste in the mouth. GERD can be very well managed with proton pump inhibitor or H2 blocker medications. The symptom description that you have provided would be most consistent with either cough-variant asthma (worse with cold, worse at night, shortness of breath, can cause "chest tightness") or GERD (worse at night, associated with chest pain). Again, I would recommend that you meet with your primary care physician to discuss some of the above possibilities.

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