Question: My husband has been suffering from sneezing and coughing attacks for nearly four years. He has seen allergists and they can't find that he is allergic to anything. They do say they think he coughs because his vocal cords are dry, and he should sip water to prevent his coughing and clearing of his throat.
He has seen ENTs, and they don't know why he sneezes. Can you give us any advice on what steps we can take to clear up this situation?
Dr. Hibberd's Answer:
Often sneezing and coughing imply the presence of an inhaled irritant. I assume you are not smoking or exposed to an area where smoke or solvents are used. Whether this is an allergen or some other source of irritation such as cigarette smoke is worth pursuing.
I agree that vocal cord irritation can induce the cough reflex, but sneezing usually implies some co-existing nasal irritation. Your were correct to see the ENT to exclude serious lesions of your airway. Be sure that no unrecognized infections or inflammatory disorders are present, and that no mass lesions are evident on investigation.
It may be time to see your allergist again for further workup. While that is being performed, ask for treatment that is commonly used for allergy patients, such as an antihistamine (Zyrtec) added to a leukotriene blocker (Singulair). A short course of topical nasal corticosteroids may often add further control.
My emphasis on sensitivity and allergy issues highlights concentrating on avoidance instead of long-term medication use, and perhaps seeking immunotherapy if allergies are diagnosed. I encourage you to seek further consultation.
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