Chronic Cough
Cough is one of the most common complaints in patients seeking medical attention. It is responsible for approximately 30 million doctor’s visits annually in the United States.
Acute or Chronic Cough?
Coughs that are less than 3 weeks in duration can have several causes, but the most common cause is an upper respiratory viral infection – the common cold virus, for example. These coughs can range from mild to severe. If the cough disrupts lifestyle, quality of sleep or causes any respiratory distress you should be evaluated and appropriately treated by a physician.
Coughs that last several weeks or several months in duration are categorized as chronic cough. 90% of chronic cough is caused by asthma, post nasal drainage or acid reflux. The most common cause of chronic cough in adults is post nasal drainage. The most common cause of chronic cough in children is asthma.
Diagnosing a Chronic Cough
Having a thorough discussion of your symptoms with a physician can help determine if one of these conditions is the cause of your cough. A breathing test called a spirometry can help your physician see if you have signs of asthma. Allergies play a significant role in the majority of asthmatics and commonly can cause post nasal drainage, both of which are the two most common causes for chronic cough. Therefore, skin testing for allergies is very useful in the evaluation. Treatment for nasal allergies and asthma can help a large percent of patients with chronic cough.
Acid reflux is another common cause of cough. The most common symptom of acid reflux is heartburn. However as many as 40% of patients with acid reflux do not experience heartburn but may have symptoms of cough, hoarseness, throat clearing, sore throat, or a spectrum of other well described symptoms due to acid reflux. A trial of acid suppressive therapy is one approach to see if reflux is the cause of chronic cough. However, a physician may choose other tests which can accurately diagnose reflux, such as an esophageal PH monitor.
Even though asthma, post nasal drainage and acid reflux make up the vast majority of causes for chronic cough, there are still several other important but less common conditions that cause chronic cough. Therefore, patients should have further diagnostic work up to investigate other causes if appropriate.
It is important that patients with chronic cough be evaluated by a physician who has experience in appropriately diagnosing and treating patients with cough. Here at the Arizona Asthma and Allergy Institute our physicians are board certified in Adult and Pediatric Asthma, Allergy and Immunology. We have evaluated and successfully treated thousands of patients with cough. If you have a persistent cough or know someone that does, please schedule an appointment for an evaluation and treatment.
