Dear doctor,

I’m 22 years old. For about three months now, I’ve had a very persistent cough. I have tried all the medication that doctors have given me but nothing seems to work. I rarely get cough and I’m not a smoker. I never hang around smokers either.

The last time I went to run some tests, the doctor told me I was fine and that the cough would heal in time but that was a month ago.

I’m really worried now that I may have something more serious like tuberculosis, pneumonia or lung cancer. I haven’t been to another doctor yet since the last one told me there was nothing serious to worry about. But why isn’t this cough healing? Please help me.

Andrea, 22, Kimironko

Dear Andrea,

I understand your agony. But the way things look; it does not seem to be serious. If you have no fever in the night, no night sweats, no loss of appetite or weight, no close contact with a case of T.B., it is unlikely to be T.B.  As you said, all tests done were also negative.

You are young enough to have cancer of the lungs. Some young adults do get tumors of the airways, but the prevalence is more in men. Moreover, having a good appetite with no weakness or weight loss, a cancer of any form is unlikely.

The other information you need to give is whether you have changed your residence or place of work or added something new in your diet in the past three months before this problem started. Is this coughing present all the time or it fluctuates? For example, like getting aggravated while being exposed to dust during travelling or during rains or cold weather. Does any blood relative (parents, siblings, uncle or aunt) have a problem of asthma and or recurrent cold, or cough or eczema or skin rashes?

These problems occur due to allergy and tend to run in families, from one generation to another. At times there may be no family history but after being exposed to something more than once, the body may develop antibodies to it and manifest as allergy. Later on it may be passed on to next generation.

That is what I suspect is your problem. It seems to be allergic bronchitis, i.e. cough occurring due to exposure to some substance eaten or inhaled or used over the body in any form to which your body is allergic. The list of substances potentially producing allergy is very long. Common substances producing allergy after being inhaled are dust, fumes of petrochemical products, smoke, pollens and spores.

Among edible items, high protein foods like eggs, beans, meat and milk products can cause these problems. One can have an allergy to any one or more of the wide range of chemicals present in our daily life from cosmetics, toiletries to those present in ready to eat foods.

Best way for you is to keep your mouth and nose covered while being exposed to dust. Quit any new product you have started using.

Among food items, you can try avoiding one substance each for two to three days from your daily diet and then resume its intake. Thus it can be assessed if any of the food substance is causing allergy, stopping it shall reduce symptoms while resuming it will aggravate it.

Taking anti-allergy tablets for a week or so will definitely help to reduce cough. Drinking lots of water and if possible hot water two or three times shall also be beneficial. There are various kinds of herbal treatments available like using basil leaves or drinking them as decoction with tea gives good results with such cough. 

Dr. Rachna Pande is a  Specialist in Internal Medicine at Ruhengeri Hospital