Chronic Cough – Common Causes, Diagnosis and Treatment

Chronic cough is a condition that affects many Texans. It is a cough that lasts 8 weeks or longer in adults and 4 weeks in children. The nagging cough is not only annoying but can also interrupt your sleep pattern, cause you to feel dizzy, hoarse and strain muscles. In this article we will discuss the most common causes and treatment of chronic cough in adults.

Common Causes of Chronic Cough

• postnasal drip
• asthma
• acid reflux

The above accounts for about 90 percent of all cases of chronic cough. Less common causes include infections, medications, and lung diseases.

Postnasal drip occurs when the secretions from the nose drip into the back of the throat. This can irritate the throat and cause a cough. Symptoms of postnasal drip include stuffy/runny nose, sensation of liquid/fluid in the back of the throat, and the feeling you need to clear your throat. Although sometimes with postnasal drip, people have no symptoms other than cough.

Asthma is another common cause of chronic cough and is the leading cause in children. In asthma you might have coughing as well as wheezing and feeling short of breath. Some people may have a condition known as cough variant asthma in which the only symptom is cough. Your cough may get worse with exposure to cold, dry air, or certain fumes or fragrances.

Lastly, acid reflux also known as gastroesophageal reflux disease (GERD) is another common cause of chronic cough. GERD occurs when acid from the stomach flows back into the esophagus (the tube connecting the stomach and the throat). Many people with GERD have heartburn or a sour taste in their mouth. However, some may have a cough as their only symptom.

Other less common causes of chronic cough to keep in mind are upper respiratory tract infections (URIs), medications known as angiotensin converting enzyme (ACE) inhibitors such as lisinopril, which are commonly used to treat high blood pressure and lastly chronic bronchitis in people who are current or past smokers.

Diagnosis and Treatment for Chronic Cough

To investigate the cause of a chronic cough your primary care doctor will ask about your symptoms and perform a thorough physical examination. Based upon your symptoms and physical exam findings your doctor may recommend a trial of treatment before pursuing further testing.

Treatment for chronic cough is specific to the underlying cause as described above. Below are a few examples of medication which your doctor may use for treatment. Please visit your doctor to talk about the best treatment option for you.

• Postnasal drip. Use of an oral decongestant (Sudafed), nasal or oral antihistamine (Zyrtec, Allegra or Claritin), and/or nasal glucocorticoid (Flonase).
• Asthma. Standard treatment of asthma includes an inhaled glucocorticoid as well as an inhaled bronchodilator, such as albuterol. Further pulmonary function testing may be needed.
• Acid reflux. May respond to lifestyle changes such as avoiding certain foods, avoiding eating for two to three hours before lying down, and losing weight if you are overweight. In addition, medications such as H2 blockers (Pepcid) and proton pump inhibitors (Prilosec) can help with your symptoms.

Hopefully armed with the above information you can go to your primary care doctor informed about what may be causing your chronic cough and work together to find the best treatment option for you.

Dr. Kaheri is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community