Got a Chronic Cough?

What's causing that chronic cough, anyway? When doctors evaluate a complaint, they form a "differential diagnosis", which is a list of possible diagnoses that should be ruled out. Complaints of cough are most likely due to sinusitis or bronchitis, but can also be caused by allergic drainage dripping down the throat. Sometimes, cough may be the only symptom we see when we make the diagnosis of asthma (called 'cough-variant asthma'). Once in a while, gastro-esophageal reflux presents as chronic dry cough. Many different medicines have cough as a side effect, but ACE inhibitors, used to treat high blood pressure, are some of the worst offenders.

Names of some ACE inhibitors include Vasotec (enalapril), Prinivil or Zestril (lisinopril), and Altace (ramipril).

Successful treatment of a cough depends on the underlying cause. I mentioned above that reflux can present as cough. Sometimes, the cough is present in the total absence of heartburn. Nevertheless, modifying the diet and taking one of the proton-pump inhibitors, such as Prilosec, Prevacid, Nexium, Protonix or Aciphex can provide relief. When post nasal drip is a factor, we can try antihistamines, anticholinergics and nasal steroids to get rid of the drip, thus decreasing the cough. Often, though, the best way to stop the cough is by not coughing. Wait, that's not as stupid an idea as it sounds. The more you cough, the more you irritate your airways, making you more susceptible to further cough. I often recommend that a combination of cough suppressants be taken around the clock for a week or two to totally stop the cough.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.