Coughing is always unpleasant and can make daily life harder, but coughing is especially difficult when it refuses to go away. A persistent cough can be so troublesome that it gets in the way of school and work. It can also be the cause of sleepless nights. Let’s explore together some of the most common causes of a chronic (long lasting) cough.
A persistent cough can result in many missed work or school days. Determining the cause is key.
Allergies are known to cause a runny nose, sneezing, as well as watery and itchy eyes. They can also cause an annoying issue called post-nasal drip. Post-nasal drip is when the phlegm from your nose drips down the back of your throat. This can cause irritating symptoms like a sore throat and a constant need to clear your throat in addition to a persistent cough. However, an allergy related cough can be present with or without these other symptoms. Unfortunately, post-nasal drip is very hard to treat and can take several medication changes and a varied approach to treat. See your allergist/immunologist for guidance.
“I can’t have asthma, I don’t wheeze.” Even though we associate asthma with shortness of breath, wheezing, and chest tightness, there are quite a few people that have coughing as their only symptom of asthma.
This cough can occur at rest, in the middle of the night, while laughing, and during activities. This cough can be further assessed via a Chest X-Ray, Spirometry, Pulmonary Function Test, Methacholine Challenge, Niox level, Eosinophil levels, and new biomarkers as technology changes.
Depending on the tests the doctor orders and the results, medication may be prescribed. This medication can include pills, inhalers, and injections, depending on the severity of the disease. Talk to your allergist/immunologist or pulmonologist for advice.
GERD, also known as Gastroesophageal Reflux Disease, can also lead to chronic coughing. Some patients also experience a burning sensation the chest. However, not everyone with GERD gets that burning. Some people just have a cough with possible hoarseness of the voice as symptoms of their GERD.
One intervention to help reflux is to stay away from trigger foods such as chocolate, mint, tomato/citrus foods, spicy foods, and coffee. Other treatments include raising the head of your bed up which can help aid natural digestion, avoiding eating within 2 hours of bedtime, and not eating big, heavy meals before bedtime. Several over-the-counter medications exist to help GERD as well. If symptoms persist, see a gastroenterologist for further management.
Chronic sinus infections can also cause a nagging cough. We are used to hearing about headaches and pressure in the face with sinus infections, however, the drainage from these infections can also lead to coughing which requires treatment.
An otolaryngologist/ENT (Ear, Nose, and Throat Physician) can work to see if there is any physical/anatomic reason for these infections. An Allergist/Immunologist can determine if your immune system and/or allergies are a basis of these infections. It is important to have sinus infections treated because once the sinuses are damaged, it is difficult for them to heal on their own.
In addition to these four potential reasons, there are other serious causes for a cough that may need a deeper evaluation. Talk to your doctor and investigate the reason for your lingering cough. Taking care of that cough will give you more productive days at school and work and more restful nights. Relaxation, here you come!
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