Chronic Cough

chronic coughCough is the most common symptom for which medical treatment is sought in the outpatient setting. A cough is typically the result of something that is irritating the airway causing the muscles in the chest and throat to contract. A cough can be either a ‘dry’ or a ‘wet’ cough. A dry cough is a non-productive one, which means the cough does not produce mucus. A wet cough is one that produces mucus. If you have chronic cough please contact San Diego Ear, Nose & Throat Specialists to schedule an appointment today. Serving all San Diego and Orange Counties

In adults, a chronic cough is a cough that lasts longer than 8 weeks. Other than being annoying, a chronic cough can disrupt your sleep leaving you feeling exhausted. If it’s severe it can cause vomiting, lightheadedness, and even cause rib fractures.

Chronic cough can be caused by a number of different reasons. Some of the most common causes are tobacco use, postnasal drip, asthma, acid reflux, allergies, and post upper respiratory infections.

Some less common pathologies are certain medications, (such as ACE inhibitors which treat high blood pressure), heart failure, Laryngeal sensory neuropathy, damage to the nerve responsible for sensation in the larynx (voice box), interstitial lung disease and lung cancer.

Your doctor will take a detailed history of your cough and any other symptoms you may have, and perform a physical examination. On examination they may perform a laryngoscopy, which is when a small camera is inserted in your nasal passages and takes a look at the back of the throat, looking for any abnormalities. There are many methods used to diagnose the cause of chronic cough. Your medical history and physical examination help determine which tests your doctor will order

If the postnasal drip is seen on a physical exam, it may be recommended to have your allergies tested and do a CT scan of your sinuses to evaluate if you have any underlying sinus issues. It is a possibility you could be started on nasal steroids, nasal rinses, and antihistamines to help your symptoms.

You may have gastroesophageal reflux or GERD, this is when acid in the stomach goes up through the esophagus and causes chemical irritation in the back of the throat. This can be identified by the patient’s history of upset stomach, burning in the esophagus or cough is worse after eating or when lying down or with a pH study. This can be treated with lifestyle modifications like avoiding spicy foods,  limiting eating and drinking to greater than 2 hours before bedtime, limiting alcohol use,  or the use of antacid medications. If it is severe you may be referred to a gastroenterologist for further evaluation.

Many lung conditions can cause a chronic cough. Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common conditions which can present with shortness of breath, cough, and/or wheezing. This can be diagnosed with pulmonary function testing and imaging. Further evaluation and treatment would be performed by your pulmonologist.

Some types of high blood pressure medications such as ACE inhibitors (lisinopril, benazepril) can cause a chronic cough. It would be recommended to talk with your primary care physician and see if you can change your high blood pressure medication to see if your cough improves.