In regards to a chronic cough, the main source of confusion is the common assumption among both patients any many health care providers that the cause ‘must come from the lungs.’  This assumption on the part of many physicians often leads to an erroneous diagnosis.  In fact, the most common causes of chronic cough are postnasal drip, asthma and acid reflux from the stomach.  These three causes are responsible for up to 90 percent of all cases of chronic cough.  A number of other conditions can lead to chronic cough.  These include respiratory tract infections, the use of ACE inhibitors, chronic bronchitis, lung cancer and eosinophilic bronchitis.

           Postnasal drip occurs when secretions from the nose drip into the back of the throat.  These secretions can irritate the throat and trigger a cough. Postnasal drip can develop in people with allergies, colds, rhinitis, and sinusitis.  Signs of postnasal drip include a stuffy or runny nose, a sensation of liquid in the back of the throat, and a feeling you need to clear your throat frequently.  However, some people have so-called “silent” postnasal drip, which causes no symptoms other than a cough.

           Asthma is the second most frequent cause of chronic cough in adults, and is the leading cause in children.  In addition to coughing, you may also wheeze or feel short of breath.  However, some people have a condition known as cough variant asthma, in which cough is the only symptom of asthma.  Asthma-related cough may be seasonal, may follow an upper respiratory infection, or may get worse with exposure to cold, dry air, or certain fumes or fragrances.

           Acid reflux (GERD) develops when acid from the stomach flows back (refluxes) into the tube connecting the stomach and the throat (the esophagus).  Many people with cough due to acid reflux have heartburn or a sour taste in the mouth.  The presence of this acidic material can lead to chronic irritation and coughing.

          Coughing from time to time helps clear particles and secretions from the lungs and helps to prevent infection.  However, when a cough becomes a chronic condition, it is usually defined as a cough that lasts for eight weeks or longer.  A chronic cough is certainly annoying.  It is frequently embarrassing, can make you physically tired, make it hard to sleep, and can cause you to be dizzy, hoarse, to strain muscles, to sweat and to leak urine (especially in women).

          So if you are having some confusion about a chronic cough, don’t assume that the cause is coming from your lungs.  Get to the doctor for simple tests that will be conducted to rule-out the more serious diagnoses.  Chronic cough will typically disappear once the underlying problem is treated.  Treating a chronic cough with a known cause is usually straightforward.  Antihistamines and decongestants are normally given for allergies and postnasal drip.  Inhaled corticosteroids are the most effective for asthma, but the use of inhaled bronchodilators may also be required.  Finally, if your cough is due to acid reflux, medications that block acid production will be prescribed. 



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