When a cough just won ’t go away

Who has never had a cough? I bet no one can raise their hand. We see this in clinic all the time. But chronic cough— one that lasts at least eight weeks — can be hard for patients to deal with and difficult for doctors to figure out. In the October 20, 2016 issue of the New England Journal of Medicine, lung experts describe a step-by-step approach doctors can use to help treat patients with chronic cough. Most often a prolonged cough is due to one of the “usual suspects.” But when it’s not, we have a long list of increasingly rarer conditions that we should run through and rule out. If it isn’t due to any of those, experts now recognize that the culprit may be overactive nerves that cause an exaggerated cough response to certain triggers. The “usual suspects” that may be behind a chronic cough The authors describe a typical patient with chronic cough, and she is very similar to many of my patients. She’s a middle-aged lady with a cough lasting many months. Of course, first we want to ask a whole lot of questions. Has she had chronic allergy symptoms such as itchy, watery eyes and nose, stuffy nose, and postnasal drip? If so, it’s worth trying antihistamines and nasal steroids. Undertreated allergies can lead to chronic sinus infection, which causes cough by postnasal drip, so we may want to treat for this as well. Could she have “cough variant” asthma that causes a cough but no wheezing? Many of my patients would rather not wait for an appointment wit...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Cold and Flu Health Lung disease Source Type: blogs