Chronic cough different than cough from cold, says allergist

American College of Allergy, Asthma and Immunology (ACAAI)Sep 13 2016

There's been a lot of talk about politicians and coughs lately. And we've all seen public figures struggle with it. Sometimes the cough gets so bad the person can't speak. Sometimes it's a symptom of a bigger problem, such as an infection. These public figures no doubt have excellent medical care and the best medical advice, but they continue to have uncontrolled coughing episodes.

"Chronic cough is very different from the cough that goes along with a cold," says allergist Bob Lanier, MD, executive medical director of the American College of Allergy, Asthma and Immunology (ACAAI). "A chronic cough is more of a syndrome; a collection of problems all coming together to produce coughing. There is almost nothing quite as debilitating."

Chronic cough is defined as a cough that lasts for more than three weeks. More than 90 percent of cases result from five common causes: smoking, postnasal drip, asthma, gastroesophageal reflux (GERD) and chronic bronchitis. Although in most patients chronic cough has a single cause, in up to one fourth of patients, multiple factors contribute.

"Allergists are the most common 'go-to' doctors for chronic cough syndrome because of our more holistic approach," says Dr. Lanier. "We tend to look at it as a puzzle and work to put all the pieces together. Sometimes we suggest solutions others haven't considered."

One of the more common reasons people have a continuous cough is GERD - with or without heartburn. A "burned" esophagus causes a reflex to turn on heavy mucus glands in the back of the throat. As the mucus flows over the top of vocal cords, it can trigger a cough reflex.

"Allergies can definitely be a cause of chronic cough. They produce the swelling that is involved when sinuses are obstructed, and then people get sinus infections," says Dr. Lanier. "Also, poorly controlled asthma may make people cough. An allergist can create a personalized plan that involves taking a medical history, getting appropriate bloodwork, and perhaps a few x-rays. In the end, most coughing can be controlled."