11-17-2009, 09:33 AM   #1
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Crohn's cough

I think I've posted on this before, but I'm curious if anyone also suffers from chronic coughing in the fall/winter. Mine started about 2-3 weeks ago. It's a tickle in the back of my throat that won't go away. I've had it every year since 2002 (around time of initial diagnosis) except last winter when I was on Prednisone. It's an unproductive cough but an annoying one. More I talk, more I cough. And today, with temperature dropping to 30's, I'm coughing like a madman. Chest X-ray is normal. Every year I drag myself to a doctor to get it checked out and nothing works (inhalers, nasonex, more acid reflux meds). It is driving me nuts today!!! And, I know it'll continue for months.

If anyone has this, what clears the symptoms?

Found this article and below is excerpt on IBD. So, I'm not completely insane.



Inflammatory Bowel Diseases
Pulmonary complications of inflammatory bowel disease have been well-described. One report90 in 2003 summarized the published experience of > 400 cases of pulmonary manifestations of inflammatory bowel disease. Ulcerative colitis is more likely than Crohn disease to cause respiratory complications. Ulcerative colitis is well-known to be associated with pulmonary complications including bronchitis, bronchiectasis, bronchiolitis, nodular lung lesions, and pulmonary vasculitis.91929394 These pathologic features are separate from ILD due to sulfasalazine or mesalamine that has been used to treat the primary disease.91 The data from an ongoing registry containing 33 patients with cases of ulcerative colitis or, less often, Crohn disease reported that in several cases, the correct diagnosis and the relation of pulmonary disease to inflammatory bowel disease had not been established for many years.91 In the majority of the patients (28 of 33 patients), pulmonary features followed the onset of inflammatory bowel disease and in the remainder, pulmonary manifestations preceded those of inflammatory bowel disease. Respiratory complications included subglottic stenosis, chronic bronchitis, bronchiectasis, and chronic bronchiolitis. Histologic analysis revealed varied patterns of ILD, mainly bronchiolitis obliterans with organizing pneumonia, pulmonary infiltrates and eosinophilia, and neutrophilic necrotic parenchymal nodules. Systemic corticosteroid therapy resulted in marked improvement in patients with ILD and necrotic nodules, but was not as effective in the resolution of severe airway inflammation or chronic bronchiolitis.91 An interesting finding in this study was that respiratory problems developed postcolectomy in 8 of the 28 patients. This observation stresses the importance of considering the relationship between an unexplained cough and a “treated” nonpulmonary disorder.

Crohn disease is a less well-known cause of respiratory pathology. In a series of 11 patients with Crohn disease, cough was among the presenting symptoms in six patients. Radiologic studies showed bilateral diffuse infiltrates, lung nodules, and “ground-glass” infiltrates. Lung biopsy specimens in these 11 patients revealed chronic bronchiolitis with nonnecrotizing granulomatous inflammation, acute bronchiolitis associated with a neutrophil-rich bronchopneumonia and vague granulomatous features, cellular interstitial pneumonia with rare giant cells, and organizing pneumonia with focal granulomatous features. Four of the patients were receiving therapy with mesalamine, a known cause of pulmonary toxicity.95 This publication also identified descriptions in the literature of another 14 patients with similar pulmonary findings. The variable histologic appearances in these 25 patients were similar to those encountered in patients with ulcerative colitis. A prospective, controlled study of 23 patients with ulcerative colitis, 13 patients with Crohn disease, and 14 control subjects observed pulmonary function abnormality in 21 of 36 patients, whereas HRCT scanning demonstrated air-trapping, fibrosis, emphysema, bronchiectasis, and alveolitis in 19 patients. Even though nearly 80% of the patients with respiratory involvement had active bowel disease, one third of the patients with pulmonary function abnormality and 42% of the patients with radiologic abnormalities had no respiratory symptoms.96 Many of the drugs used to treat inflammatory bowel diseases are known to cause cough by affecting the respiratory system.9095 In addition to inflammatory bowel disease, chronic cough has also been reported as the presenting manifestation of celiac disease.67

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11-17-2009, 10:11 AM   #2
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Very interesting.... just curious if you had bronchial/ asthma problems when you were a kid???
Instead of hiding in the darkness of a grey cloud, why not look for the silver lining?
11-17-2009, 10:14 AM   #3
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Yeah I get it too. I never noticed mine until I started Humira the first time (in fall 2007?) and then that summer it went away and then I was on Remi the next fall/winter... and now I'm on Humira and Imuran and I have it.
11-17-2009, 10:31 AM   #4
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I can't tell if mine is seasonal or what - definitely unproductive though. I don't notice it so much, but my mom says "there's that cough again..." I think it's only when I'm flaring. She says it sounds almost like a nervous cough - like you don't really have to cough but do anyways?
I'll have to see if she says it now that it's almost winter and I'm not in a flare. Wait - I am coughing right now, hmmmm... I think it's just some hot chocolate that went the wrong way.
11-17-2009, 10:32 AM   #5
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Hi John, I have always had a chronic cough that worsens in the fall. It is worse in the morning and also a charming habit when really stressed or anxious.
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11-17-2009, 11:59 AM   #6
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Good to know I'm not alone, I guess.

MBH - "there's that cough again" is what I hear all the time. It's annoying that I forget it and others remind me I'm coughing.

Pop - no asthma as a kid. but i've always had weird breathing issues. frequently need to inhale deeply to catch my breath. i carry an emergency inhaler just in case but i've not been diagnosed with asthma.

what do you all take for your cough?
11-17-2009, 12:09 PM   #7
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This is rly interesting. I havn't noticed that problem myself. But my Dad always caughs. We think that I got my crohn's from my dad and his dad even though neither of them have been/were diagnosed.
I will have to tell him this to see what he thinks about it!!
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11-17-2009, 03:13 PM   #8
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Hi Fen, my first thought was some kind of asthma. And as asthma is often an allergic reaction and thus there would be inflammation in there, it makes sesne that the pred would make it go away!
I have asthma but don't get the cough but I have a friend who gtes it that way. She had it really bad a few weeks back and was put on a short course of pred for it.
I would have thought it would happen more in spring with allergies, but maybe there are more pollutants around in NY heading into winter?
Just a thought
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11-17-2009, 05:50 PM   #9
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I have had a cough for about 6 weeks now! Its so annoying! Mine feels like something is in my throat that I need to cough up but there is nothing. Went to my doctor today and she said I dont have any throat or chest infection but it could be that I had a virus which has gone away by itself but I have been left with the inflammation which is causing the cough.

She wanted to give me steroids but im due to have my first colonoscopy on the 1st Dec so she didnt give me the steroids cause they could affect the outcome of the colonoscopy - So she gave me an inhaler (even tho I dont have asthma!) which she said might not help but it was the best she could do!

No idea if my cough is related to crohns in anyway but wish it would go - its such a pain (to other ppl as well!)!

11-17-2009, 07:32 PM   #10
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I did notice that after I was dx I have had a TON of problems with bronchitis and sinus infections. BC (before Crohn's) I had never even had the sniffles.

Don't worry Fen, help is on the way!
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11-17-2009, 10:18 PM   #11
Christ, I have a chronic cough too.

Chest is always fine though, no real infections, just an annoying tickle.

I also get a fluttering feeling in my chest sometimes, like a skipped heart beat and I was told it was a gastro problem, not a heart issue by my cardiologist.

I will find out if I have chrones/cancer by Christmas I guess - finally some news as to why I feel soooooo terrible.
11-17-2009, 10:31 PM   #12
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I also only get a cough when I am flaring and like others I am tired of hearing there's that cough again.
11-17-2009, 11:29 PM   #13
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Tonight my cough is horrible as anyone who has spoken to me can attest. It's a tickle like yours Ezequiel.

Shaz - i thought it was allergies and it certainly could be. perhaps it's the heating system in my apt although the cough started before i moved in here. i've tried all kinds of allergy meds though and inhalers and nothing seems to shake it. i've been tested for asthma and was told i don't have it. although i do breathe funny, especially in cold weather.

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11-17-2009, 11:43 PM   #14
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i've never had a cough that wasn't viral or bacterial caused.. i didn't even know there was such a thing as an IBD related cough! but i have had that feeling where i can't intake a deep breath or a full yawn.. in fact i mentioned it to my surgeon this week, and to my gp last week, as it was really bothering me. the gp said there is hardly ever a worrying reason why people can't take a deep breath, and it's probably an anxiety symptom.

i think, for me, he's possibly right - when i'm tired and relaxed i can yawn beautifully. lol
11-18-2009, 12:14 AM   #15
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dingbat said:
but i have had that feeling where i can't intake a deep breath or a full yawn
happens to me a lot but not anxiety related.
11-18-2009, 02:07 AM   #16
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Do meds cause it by any chance? i just wonder because my Dad has this and was told it was something to do with his blood pressure or cholesterol medication (can't remember which). Changing meds made it a lot better but he still has it - all through the movies this evening in fact, I wanted to smother him with a pillow!
So, maybe meds? Sometimes they have weird, seemingly unrelated side effects.

Or, from a bodymind perspective, just to put it out there, the throat is our centre of communication - perhaps there is something you need to say but can't and so it is irritating your throat? may sound silly, but you never know!
11-18-2009, 10:04 PM   #17
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shazamataz said:
Do meds cause it by any chance? i just wonder because my Dad has this and was told it was something to do with his blood pressure or cholesterol medication (can't remember which). Changing meds made it a lot better but he still has it - all through the movies this evening in fact, I wanted to smother him with a pillow!
So, maybe meds? Sometimes they have weird, seemingly unrelated side effects.

Or, from a bodymind perspective, just to put it out there, the throat is our centre of communication - perhaps there is something you need to say but can't and so it is irritating your throat? may sound silly, but you never know!
Meds are ruled out because I've been on different ones over the years.

Something I need to say....hmmm. That's an interesting one. I think it's got to be allergy related but nothing seems to suppress it.
11-20-2009, 11:22 PM   #18
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mommy1st said:
I also only get a cough when I am flaring and like others I am tired of hearing there's that cough again.

Great Avatar mommy1st!!!!
04-04-2010, 04:51 PM   #19
i call it my winter cough. Every winter, allwinter, without fail. It's just letting up now and were starting spring.

i've been off mess for two years. Prednisone or no, had the cough.

Definitely a nervous laugh sound that turns into an airy substanceless cough, whenever I breathe in suddenly when about to talk.

Doctor hasn't confirmed, but i've always imagined it:

low level heartburn I don't even notice
coupled with winter weather
causing post-nasal drip
drip drips with the breathe in
drip causes the cough

I hates it.

I drink hot water drinks (tea, sometimes just water) all day, wear a scarf (inside), herbals, losenges, etc. Nothing really "solves" the problem
04-04-2010, 05:56 PM   #20
I am 51, but think I've had Crohn's since I was 17. I was officially diagnosed 4 years ago... after a major flare. I've always had a cough... we've checked everything, and they never found the cause. Personally, I think it's Crohn's related and think of it as my first hint of a flare starting up. Crohn's is supposed to be in any part of the digestive system... I've always wondered if I have a Crohn's irritation that simply causes the 'tickle'.

Otherwise, I rarely get colds, never have had bronchitis, or asthma, or sinus infection (which cause tickles for people).

Just my two cents. Good luck to you.
04-04-2010, 06:13 PM   #21
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Wow! Another thing I can blame on Crohn's. I have had this a unproductive cough as well on occasion that would not go away. My doctor gave me an inhaler and that cleared it up. I also used to get that feeling of not being able to take a full breath, but that stopped when I started yoga, so I chalked it up to anxietyl

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04-04-2010, 06:21 PM   #22
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This is really interesting!

I don't hvae a cough but have had bad post-nasal drip requiring nasal spray a couple of times in the past few months. Also a drippy nose. Not enough to blow, just enough to be annoying.
04-08-2012, 03:55 PM   #23
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I had cough about 2 years ago, winter in morning and at night. Final when to GP before I got drag my partner. Gp said ' mucus seem collect at bottom of throat' I had not cold or chest infection. It same it when. I get in cold weather.
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04-13-2012, 12:24 PM   #24
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I have a constant cough too. Doc says its a combination of weak immune system and Humira:-( Also have a choking problem as a result of the Humira.

Meds: Asacol HD 800mgx3
Humira every 2 weeks(which is no longer effective)
Bentyl 3x's daily
Tramadol as needed
B12 injections monthly
And of course the Hated Prednisone during our recurrent flares!
04-16-2012, 01:53 PM   #25
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I carry around a thermos full of tea everywhere I go (my purse is always stocked with tea bags so I don't have to pay...I just ask for water!) Anyone have any flavors they like? I'm addicted to all the Yogi brand teas: throat comfort is great, same with Kava Stress Relief.
04-18-2012, 09:39 PM   #26
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When I flare I get a wicked cough... I haven't had that pop up in a while. Plenty of other fun things to fill my extras quota....
05-04-2012, 09:00 PM   #27
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Perhaps as the pharynx is part of the digestive system it could also be a point of inflammation causing mucus buildup in the throat. I know from my own (caveat: undiagnosed) experience that I think I've pretty much always had irritation in the back of my throat, and often I have to cough to clear the mucus from that irritation, especially after speaking a lot because as it dries it thickens.

I am going to have to bring that up next time I see my doctor.
07-27-2012, 02:31 PM   #28
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Very interesting.... just curious if you had bronchial/ asthma problems when you were a kid???
That's my question to everyone. My daughter started to have bronchial problems from an early age. Got so bad, that when she turned 4 years old, she had to use a pulmoaid 3-4 times a day with vental, proventil , etc. Eventually,her asthma got much better, but she started to have GI problems.
07-27-2012, 10:43 PM   #29
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I noticed a cough also when I was diagnosed with crohn's last year. It mainly happens late afternoon or early evening. It does produce phlegm and it usually only lasts a half hour or so. Very strange phenomenon to me until I read this page. Teresa
08-03-2012, 09:25 PM   #30
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Wow, I had no idea IBD could manifest that way. I've had a chronic cough, bronchitis, sometimes develops into pneumonia, it's been going on around seven years now. I got a really bad lung infection awhile back and figured it never went away because I was on so many immunosuppressants. I also had an asthmatic cough when I was younger, and I've been smoking for ten years... so I thought I was to blame! I guess I'll have to see what happens, finally quitting smoking now, so we shall see what becomes of this nasty cough!
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