Chronic Cough Got You Down?

chronic cough austin txIt is a very frustrating problem to have a chronic cough. It interrupts your daily life, makes conversations difficult, it interrupts sleep, and can make people feel like you have a contagious infection.

Finding the cause can be quite difficult and frequently a patient may bounce around with many doctors trying very many different types of therapy without relief.

Many times there is more than one factor that may be causing the cough.

The proper approach includes a thorough evaluation of the ear, nose, and throat and starting with an ENT doctor is the best bet.

Common causes include:

  1. Chronic sinus infection – It may seem strange but you can have a sinus infection and not even know it. Chronic infections that have been present for many months have little in terms of sinus symptoms but very frequently cause chronic cough. A video nasal endoscopic exam and office based CT scanner can help determine if a sinus infection is the cause. Medical therapies for sinus infection that you may have had may not have resolved the infection and sometimes balloon sinuplasty needs to be performed to relieve the infection.
  2. Allergies – Allergy can be persistent despite using allergy medicines. Sometimes the degree of allergy is just too severe. Allergy skin testing can be used to identify what you may be allergic to as well as the degree of sensitivity. Modern allergy drop therapy can be used in addition to your present therapy to block the allergic reactions much more successfully.
  3. Reflux – Many times night-time reflux occurs silently when the patient is sleeping. This is especially true if the patient is over weight and if there is snoring or apnea. Sleep apnea actually greatly increases the risk of reflux during sleep. The acid comes up and burns the vocal area and keeps the cough present. Treating the reflux and any snoring/apnea can help greatly.
  4. Mouth breathing – Congestion secondary to anatomical issues in the nose such as a deviated septum or swollen turbinates causes mouth breathing during exercise and during sleep. This mouth breathing dries out the vocal cords and causes irritation keeping the cough persistent. Modern endoscopic septoplasty procedures can be performed as a simple office procedure with limited down time to resolve this issue.
  5. Cough – Yes…the cough. Unfortunately, all of the issues above can be addressed and the cough itself can cause irritation and perpetuate the cough. A speech pathologist can help along with medication to suppress the cough and allow the enhanced cough reflex to resolve.
  6. Lungs – There may be primary lung issues as well that may be causing the cough. Chest X-ray, pulmonary function studies, and an evaluation by a pulmonary specialist can help identify these causes and provide the right therapy.

If you are frustrated by chronic cough and have seen physicians without relief, see an ear, nose and throat physician to work through the possible causes and get back to a life without a cough.

Daniel Slaughter, MD


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Posted in: Allergies, Chronic Sinus Infection, Cough

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