“Woah, Your cough sounds bad! You should see a doctor.”
How many times have you heard this at your workplace? Quite often after an upper respiratory tract infection. Lets discuss what else could cause cough.
Truth be told, cough is the most common symptom for which patients seek medical attention. Some estimates suggest, as much as 12% of the general population report chronic coughing, defined as a cough lasting for more than 8 weeks. Chronic cough is more common among women than among men, most commonly occurs in the fifth and sixth decades of life, and can persist for years, with substantial physical, social, and psychological effects.
Chronic cough is a feature of many common respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease and bronchiectasis) and of some common non-respiratory conditions (e.g., gastroesophageal reflux and rhinosinusitis), and it may be the presenting symptom of patients with some rarer conditions (e.g., idiopathic pulmonary fibrosis and eosinophilic bronchitis). Cough could be a side effect of many drugs, however, it is known that 20% of patients who are on angiotensin-converting–enzyme (ACE) inhibitors, can have cough.
Professional guidelines describe systematic approaches to the evaluation and management of chronic cough, however most of these guidelines are based largely on consensus opinion. Initial evaluation of the patient, including a medical history, clinical examination, chest X-ray, and spirometry, can identify or rule out a wide range of conditions that may underlie chronic cough. If the chest X-ray and spirometry are normal, the most common conditions associated with chronic cough are asthma, gastroesophageal reflux disease, and rhinosinusitis. Usually you should be referred to specialist physicians by this time. They will do further testing to resolve this or do a trial of medications. More rarer causes of cough will require more intense testing. One other cause could be a disorder of the nerves controlling the cough reflex. More research is needed into the mechanisms and associated potential treatments, but so far with the knowledge we have, we can do the best to treat you.
Let us help you with your cough! Contact our office at any time with questions or concerns! (208) 377-4000