Should I be worried about my bad cough?
I have a persistent cough which is becoming annoying. Cough medicine doesn’t help. Do you have any advice?
ANALYSING a persistent cough is best done face-toface. If you are a smoker and a cough has lingered for three to four weeks, a chest x-ray is imperative if you haven’t got any obvious infection.
Coughs can also be caused by issues that have nothing to do with the lungs. For example, acid reflux can give a nocturnal cough without giving any gastric symptoms.
Certain drugs may also be the underlying cause of cough, especially a group of drugs called ACE inhibitors, that are used to treat blood pressure.
Other causes include a postnasal drip, bronchitis and asthma. Other less likely possibilities include allergy, inhaled irritants, whooping cough and even cardiac conditions.
At this time of the year — with the prevalence of respiratory tract infections — the most likely cause for your cough is probably the so-called postinfectious cough. This is a cough that lasts longer than three weeks after a respiratory infection.
So while the actual infection is gone, the cough seems to linger. You generally feel well so the cough is more of a disruptive feature rather than a feeling that you are sick.
Cough medicine doesn’t help much in this instance. Normally as GPs, we tend to prescribe inhalers, focusing on the inflammatory component of the cough.
The aim is to reduce the inflammation in the airway and in turn reduce the cough. These types of inhalers are normally steroid-based and take a few days to start to produce an effect. We often use them for a two-week period.
Based on your persistent symptoms, you definitely need to see the GP. Mention any recent infections, your smoking history, any relevant family history such as asthma or allergies and any gastric symptoms.
A prolonged cough is more sinister if it is associated with weight loss, fatigue or shortness of breath. Coughing up blood is also a very worrying symptom. Ultimately however, you can’t self-diagnose this one. You need to be seen by a doctor. The likelihood is there is a simple solution, so get seen and get it sorted. I’m a man in my 60s who has always enjoyed a healthy relationship with my wife. There’s no easy way of saying this — but lately I’ve noticed a bend in my penis. Is this old age or something more sinister? IT is likely that you have what’s called Peyronie’s disease. This is where you get scar tissue formation on the penis.
As well as causing a curve in the penis, it can also result in pain and a change in size. Some patients feel a palpable lump along the shaft. It can occur at any age but is most common in middle age. Officially it affects 5% of men, but in reality it probably impacts as many as one in ten — but many simply don’t report it, possibly due to embarrassment. Interestingly, it is sometimes associated with a similar fibrosis in the palm of the hand knows as Duyptren’s contracture.
The condition can give rise to pain in the initial stage and then a stable phase where there is little change in the curvature. Some men experience further pain and a further increase in the curvature, in others it remains static and in one in ten there can be spontaneous improvement.
Treating it depends on how much it bothers you. Drugs don’t really work. There are mechanical devices which are essentially a bit like traction which can be worn, with reasonable effect. In some cases, injections can be performed to try to break down the plaque. You may however need as many as eight injections to see a result. Surgery carried out by an experienced urologist is the final option.
In terms of the cause, we are not 100% sure — but injury or trauma may be a trigger. There is also some suggestion that high blood sugar, smoking and pelvic trauma may setting off the process.
So in answer to your question — age isn’t to blame with this problem.