Dear Doctor,

I have had a dry and painful cough for the past month. After taking several syrups the cough has visibly reduced yet I still have a lot of pain in my chest. What could be the problem?

Jacob

Dear Jacob,

Is the cough more after midnight or when outdoors or it comes at any time? Is the chest pain localised to one site, occurring on inspiration or is it vague and generalised.

Chronic cough can be due to chronic bronchitis. Smokers, people exposed to dust /smoke for long time are prone to it. One can have chronic cough due to allergy to any substance present in atmosphere or consumed or applied locally over body. Presence of worms in the intestines can also result in cough due to allergy to the worms. There may be a family member suffering from asthma, eczema or frequent cold due to allergy. In these conditions, pain is due to muscular strain caused by coughing.

Pneumonia is a condition of infection and inflammation of lung tissue. Here along with cough there is severe pain over the site affected. Inflammation of the covering of lung can also cause localized chest pain, which is enhanced by inspiration. Tumors of the lungs can also cause chronic cough with chest pain. But in such case one would have bloody sputum, loss of appetite and weight loss. Similar symptoms can be due to tuberculosis of the lungs. But the features of a chronic infection would then predominate .

A complete blood count, X-ray chest, sputum and stool examination are needed to know the underlying cause of your cough. Cure depends on underlying cause. Cough syrups only suppress the cough due to various ingredients present, which reduce cough, clear the phlegm. That is why it is visibly reduced. But cure will be obtained after treating the cause.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital