Coughing more after quitting smoking: What's the problem?

r Flo,

I quit smoking in July this year and had smoked for about 23 years. I was a heavy smoker but I managed to do it in one day when I decided to quit. My problem is that after one month of quitting, I started having a very irritating and persistence cough but there is no blood in the sputum and no chest pains. Is this normal and if it is, for how long am I supposed to live with it?

Michael

Dear Michael,

Some ex-smokers develop a cough for several weeks up to a year after quitting smoking. This is usually a good thing because it is a sign that the respiratory system is recovering. Cilia are a protective barrier between the outside world and the delicate tissue of the lungs.

The bronchial tubes in healthy lungs are lined with a thin coating of mucus and cilia, which are small hairs that clean your airway by “sweeping” unwanted particles that have been trapped in the mucus layer back out. When the mucus reaches the throat, it is coughed or spat out or swallowed. Cigarette smoke has many damaging chemicals, one of which is tar, which stains the teeth, fingers, clothes and furniture. Tar slows down the motion of the cilia, leading to a build-up of mucus and other particles (smoke, dust, germs) in the lungs, which increases the risk of infection, bronchitis and cancer. When you stop smoking, cilia start working again to remove all the trapped mucus and other particles. This activity can trigger a cough that will go on until the lungs recover.

Since the cough has been present for a while, it is advisable for you to be reviewed by a doctor to rule out any infections or any other causes of prolonged cough such as chronic bronchitis. In the meantime, stay well hydrated, take honey to ease the irritated throat and use a humidifier if your sleeping environment is very dry. Avoid cough suppressants unless the cough is really bad.

Hi doc,

What causes Bartholin cysts and what can I do for them not to recur? I have been to different hospitals in the last two years but they always recur. I have taken medication and had them drained, but after three-four months, they recur.

Ro

Dear Ro,

On each side of the vaginal opening, there are bartholin’s glands, which produce fluid to keep the vagina lubricated. The openings of these glands can become blocked by infection or injury, resulting in fluid accumulating in the gland. This accumulation is called a bartholin’s cyst and is usually painless. However, if it gets infected, it becomes painful and may accumulate pus, which is then called a bartholin’s abscess. The infection may be from organisms that are normally found on the skin or the gastrointestinal tract, or they may be from sexually transmitted infections.

If the cyst is small and uninfected, sitting in warm water for 20 minutes at a time, several times a day, for three to four days, may resolve the symptoms. Antibiotics are given if the cyst is infected or there is a sexually transmitted infection. The cyst can be drained surgically if it is large or if it is infected. If the cyst is recurrent, then it is advisable for you to be seen by a gynaecologist. Tests will be done to identify the infecting organism and also to check for sexually transmitted infections. The cyst will be removed and examined, and marsupialisation will be done. With marsupialisation, the doctor keeps the wound open a few millimetres by placing stitches on both sides, and a drainage tube may be inserted for a few days to continually drain the site. This is to prevent recurrence. Very rarely, if all else fails, the bartholin’s gland may be removed completely, though this has a higher risk of bleeding, infection and other complications.

When I take water, it causes chest pain/pneumonia/excess sweating. What could be the problem? Eli

Dear Eli,

The chest has different organs and tissues within it, including the trachea (windpipe) and other airways, and the lungs, in addition to the heart, the oesophagus (the food pipe), bones, cartilage, muscles and others. The symptoms you experience after taking water may be arising from the temperature of the water, which may then cause symptoms - taking hot water can cause sweating while taking very cold water can trigger difficulty in breathing if you have allergies affecting the airway. It is also very likely that the pain may be from the food pipe, which is the path the water follows when you swallow it. The pain may develop when you swallow an air bubble or if you have oesophageal injury or inflammation of the oesophagus due to infection, reflux, hiatus hernia, triggered by medication, alcohol or tobacco, and other inflammatory conditions. The oesophagus may also have movement disorders that make swallowing difficult and/or painful. It is advisable to visit a doctor for a comprehensive evaluation and any necessary tests so that the underlying problem can be identified. The treatment will be on specific cause of the problem. In the meantime, take room temperature or lukewarm water in small sips over the course of the day.

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