I have had intermittent episodes of throat irritation followed by coughing and a choking sensation since 2020. During episodes, breathing feels as if it does not clear properly, sometimes making me feel I may collapse, but it settles after some time. Episodes are more frequent in the morning/before 2 PM and may be triggered by going outdoors, balcony exposure, trees, dust, pollution, or humid/rainy weather. No usual chest pain or wheezing. Sometimes episodes occur after brushing teeth in the morning. I had an HRCT chest in Sept 2020 for similar symptoms. I would like evaluation for allergy, asthma/airway hyperreactivity, laryngeal sensitivity, post-nasal drip, reflux, or other airway problems.
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This pattern sounds like airway hyperreactivity. Thank you for the detailed history - it is very helpful. The pattern you describe (throat irritation then a choking cough, worse in the mornings, triggered by outdoor air, dust, trees, pollution and humid weather, no wheeze) most often comes from upper airway causes: allergic rhinitis with post-nasal drip, laryngeal hypersensitivity, or silent acid reflux, and cough-variant asthma or airway hyperreactivity is also possible. The tests that actually answer this are spirometry with a bronchodilator reversibility test, an ENT laryngoscopy, and allergy testing (skin prick or specific IgE); a repeat HRCT is usually not needed since 2020 was similar and normal. Meanwhile, saline nasal douching twice daily, an antihistamine or a steroid nasal spray as advised by your doctor, avoiding known triggers with a mask outdoors, and reflux measures (no late dinners, head end of bed raised, avoid smoking and alcohol) help most patients considerably. Please treat it as an emergency if you ever have true difficulty breathing at rest, noisy breathing (stridor), lips turning blue, or you nearly faint during an episode - go to the nearest emergency in that case. You can book a consult with me on Practo and I will help you plan these tests in the right order.
HRCT scan doesn’t show any obstructive or restrictive airway disease.so see a pulmonologist or allergy specialist and go ahead with other investigations for allergy or airway hypersensitivity etc
It could be angioedema.
Ever time you are getting exposed to allergen, you are having recurrence of these symptoms.
Check your histamine levels and IgE levels.
And review with reports
Next Steps
feel free to consult me on practo for further evaluation and management
No covid
Steam inhalation with Vicks or eucalyptus oil two times before meals.
Ab phyllinsr200 two times after food for five days. Taxim o200 two times after food for five days.
Zerodol sp three times after food for five days.
Montek lc one at night for five days.
It could be due to upper airway cough syndrome, reactive airway disorder, asthma, gerd etc.Ideally you should consult a pulmonologist for a clinical examination and lung function tests and provocative tests, allergy tests
The HRCT is normal, but the choking and coughing episodes need evaluation for asthma or other related causes.
Please consult me for a proper assessment and appropriate tests and an individualized treatment plan.
Do you feel it happens mostly at night?
Have you ever tried nebulising? If yes has it been benificial?
What is your base line spo2 ? Especially at night when u r asleep.
Have you ever assessed if there is a dip in spo2 levels during night times .
What type of cough do you experience? Dry or wet?
Do you feel that it’s difficult to breath in places that might be too dusty or has a lot of pollen?
HRCT is normal
But your symptoms are needed to be dealt with
I would advise you on some tests such as CBC along with absolute eosinophil count, serum IgE, allergy panel, pft
Also I need to know more about your symptoms
Kindly consult with me on practo app with reports
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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