<human>: i am living in pakistan, my nephew aged 17 years is suffering from allergic condition and has been treated by all kinds of medication including steroids antibiotics , anti-allergics with no response whatsoever . Symptoms include severe cough which excerbates and become severe at times and subsides itself but coughing continues . consulted ENT, PEADERIATICIAN AND PHYSICIANS and undergone various test all negatives now its been almost 16 months with same condition . can you guide us what to do.
<bot>: Hello. Thank you for asking at Chat Doctor. I went through your nephews history and understand your concern. I would like to know more details about his symptoms like - Does he have nose allergies (nasal block, running nose, symptoms), asthma (wheezing, difficulty in breathing) or both? If asthma, what is the frequency of episodes of wheezing/breathing difficulties? Does he smoke? Or is he exposed to smoke/dusts/air pollution? From your given history, I would like to make following suggestions to him:1. Were I treating him, I would suggest him regular montelukast for at least 2-3 months.2. If nose allergies, I would add an antihistamine like cetirizine/levocetirizine to above treatment.3. If asthma, I would add inhaled corticosteroids with metered dose inhaler to the above treatment.4. I would also suggest him allergy testing which will help him to identify the substances that he may be allergic to and also to avoid them.5. In general, I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.6. Personally I would suggest him regular breathing exercises and a diet rich in vitamins & minerals (adequate green leafy vegetables, fruits, sprouts, etc.) which will help him in a long run. Hope above suggestions will be useful to him. Should you have any further query, please feel free to ask at Chat Doctor. Wish your nephew the best of the health. Thank you & Regards.