Cough is a common symptom that often results from inflammation of the larynx. Inflammation is characterized by redness and swelling, which can cause discomfort. When the larynx is inflamed, symptoms such as cough, Globus sensation (feeling like something is stuck in the throat), postnasal drip and throat clearing can occur.
Inflammation of the throat can be compared to having a mosquito bite. Scratching a mosquito bite can make it worse because it increases inflammation under the skin. Similarly, when the brain tells the throat to clear mucus due to inflammation, it can make the inflammation worse.
Causes of Laryngeal Inflammation
Chronic symptoms of laryngeal inflammation can be caused by various factors such as colds, respiratory infections, acid reflux, ACE inhibitor medications, sinusitis, allergy, aggressive cough and throat clearing. Sleep apnea, respiratory infections, asthma and ACE inhibitors can exacerbate cough through a chemical called bradykinin, which increases inflammation.
Chronic inflammation has a half-life of 18 days, meaning that after 18 days, half of the inflammation will be gone, but the other half will remain. Macrophages, a type of white blood cell, control chronic inflammation by initiating, maintaining and resolving inflammation.
The intensity of the cause of coughing determines how much someone coughs. Therefore, the source of inflammation does not have to be cured 100% but rather reduced below the threshold.
Testing Options
Flexible laryngoscopy, sinus CT scans, sleep studies and allergy testing can be used to determine the cause of inflammation and cough.
Treatment for Chronic Cough
A combination of Kenalog injection, omeprazole and tramadol is effective in treating chronic cough 85% of the time. Kenalog is a steroid that reduces inflammation and has a half-life of 18 days. Omeprazole reduces stomach acid and treats reflux. Tramadol, a low-level narcotic, is used to treat cough and can reduce the desire to cough or clear the throat in as little as 15 minutes. Men typically take half a Tramadol tablet, and women take a quarter of a tablet.
Speech therapy can also help patients learn ways to reduce coughing and throat clearing.
Don’t put up with chronic cough – Dr. Rosner can help. Call (248) 844-2936 to make an appointment.