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Chronic Cough

DEFINITION

Chronic cough is defined as any cough lasting eight or more weeks. Chronic cough is annoying, frustrating, draining and can be difficult to manage both around your family and in public. Chronic cough can be especially annoying at night if it causes you to lose sleep. Chronic cough is extremely common. The three most common causes of chronic cough include low-grade asthma, acid reflux (gastroesophageal reflux disease or GERD) and postnasal drip from allergies. If the cause of the chronic cough is treated, the cough will disappear. Chronic cough can be caused by the irritation of tiny hairs in the respiratory tract. Many things can trigger these hairs to cause cough such as mucus from postnasal drip, stomach acid from acid reflux or environmental triggers like perfumes. Other less common causes of chronic cough include having a cold, certain blood pressure medications, chronic bronchitis due to smoking, bronchiectasis (chronic lung condition characterized by widening of the smaller airways in the lungs) and lung cancer (though this is not a common cause of chronic cough). Risk factors for chronic cough include smoking and being a woman.

SYMPTOMS
Chronic cough, runny nose, wheezing heartburn, feeling of liquid running down the back of the throat

DIAGNOSIS
Your doctor will begin by talking to you about your symptoms. Your doctor will also want to know about symptoms of allergies, acid reflux and asthma. Your doctor will do a physical exam including looking at the nasal passages and throat and listening to the lungs. Your doctor may try some medications to treat acid reflux, allergies or asthma to see if your cough resolves with these medications in order to diagnose the cause of the cough. If these medications do not work, your doctor may want to take pictures of the lungs with chest x-ray or computerized tomography (CT). Lung functions tests may help your doctor determine the cause of your cough. If no cause is found, your doctor may recommend placing a thin tube with a camera on the end (a bronchoscope) into the lungs (bronchoscopy), nose (nasal endoscopy), or esophagus (upper endoscopy).

TREATMENT
After your doctor determines the cause of your cough, he or she will treat the cause of the cough with appropriate medications. If allergies are the cause of your cough, your doctor may recommend antihistamines (like Benadryl, Claritin or Zyrtec), decongestants (like Sudafed), or nasal steroids. If acid reflux is the cause of your cough, your doctor may try medications like H-2 blockers (like Zantac) or proton pump inhibitors. Your doctor will also recommend lifestyle changes like avoiding food that trigger reflux, not eating before bed and eating smaller meals. If asthma is causing your symptoms, you doctor may recommend inhaled bronchodilators. Depending on other causes of chronic cough, other treatments may be available. You should discuss all your treatment options with your doctor.

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