DR ELLIE CANNON: Why can't anything help shift the cough I've had for years? trends now
I have had a cough for years. It's there, to some extent, nearly every day. Mostly it's dry but occasionally it's so severe it feels like I'm choking and bringing up bile. I've had numerous scans, blood tests and even had a camera inserted to have a look around. I've been given nose sprays, antihistamine tablets and an inhaler. My GP has more or less said that there is now nothing more that can be done. Can you help?
Getting to the bottom of a chronic cough can be very tricky. It is also a distressing symptom for you to have to endure every day, particularly as you don't know what is causing it.
The first places doctors tend to investigate are the upper airways or lungs, for conditions such as allergies, asthma, nasal problems and even lung cancer, but if these are fully explored and nothing is found, things can get tricky.
Medications can cause a cough – for instance, an ACE inhibitor for blood pressure such as lisinopril or ramipril. Discuss with the GP whether it could be a side effect and if switching to another drug might help.
A chronic cough can also be related to acid reflux, where small amounts of stomach acid leak upward into the oesophagus, irritating the throat. If this is a problem, people often find they wake up coughing in the middle of the night, because it's easier for the acid to travel the wrong way when lying down.
I have had a cough for years. It's there, to some extent, nearly every day
Acid reflux may not be seen on an endoscopy – when a camera is passed down the throat and into the stomach – but may still cause symptoms. It's worth a two-week trial of an over-the-counter medication to suppress the acid, such as omeprazole, to see if the cough reduces.
It is also worth discussing with your GP medications that have already been tried before, such as antihistamines, as often people do not take these for long enough or at a high enough dose to have a decent effect.
I suffer from mild rosacea on and around my nose. I've managed to keep it in check with various gels, creams and antibiotics, but for the past three months it's become really bad. My nose is sore, swollen and red, and looks horrendous. Is there anything you can suggest that might help?
People with rosacea experience redness or flushing of their face, alongside spots, broken blood vessels and inflamed skin that may appear like acne. Other symptoms include burning or stinging skin and sore eyes.
Patients often find there are triggers that worsen it, including sunlight, wind or heat waves and spicy foods.
Alcohol, stress and exercise can also make rosacea worse. As can medications, particularly calcium channel blockers, which are used to treat high blood pressure, and steroid creams.
Some people find that using a high SPF sunscreen helps, and sunglasses can ease sore eyes.
There are also green-tinted moisturisers available in many high street chemists which can help to reduce the appearance of the redness somewhat. A dermatologist can prescribe brimonidine, also known as Mirvaso, for redness, but this should be used with care as it's been reported that once it wears off, for some people the redness can come back with a vengeance.
Ivermectin cream is used to treat the spots.
Doxycycline is the first-line antibiotic used for the condition. If it is no longer working or