Upland, Pa. - Coughing up phlegm, infectious agents and foreign matter is one way that the lungs protect themselves. Under these circumstances, or when you have a cold, a cough is perfectly normal. But if the cough persists and lingers for three months, it is then defined as a chronic cough — a condition that requires medical attention.
“Chronic coughing associated with a normal chest X-ray most often results from postnasal drip, asthma, gastroesophageal reflux disease (GERD) or a combination of these conditions,” says Thomas Prestel, M.D., chief of the Section of Pulmonary Disease at Delaware County Memorial Hospital. “Other common causes include smoking and certain medications, particularly ACE inhibitors commonly used to treat high blood pressure.”
In rare cases, lung disease, pneumonia or tuberculosis can be the cause of the cough. Lung cancer is usually only suspected when a patient is a smoker or has an abnormal chest X-ray.
“The first step in treating a chronic cough is identifying its cause,” says Jerome Rudnitzky, M.D., chief of the Division of Pulmonary Disease at Crozer-Chester Medical Center. “This is best done with a chest X-ray, a lung function test and closely reviewing the patient’s medical history.”
The most common cause of chronic cough is postnasal drip caused by rhinitis or allergies. When postnasal drip is caused by rhinitis, it is best treated with a steroid nasal spray. If allergies are the cause of the postnatal drip, an antihistamine is the best treatment option.
Asthma is the second most common cause of chronic cough, and is usually associated with shortness of breath. However, some people with asthma have chronic cough as their only symptom. Treating the asthma should help relieve the cough.
GERD (the flow of stomach acid into the esophagus) is the third most common condition responsible for chronic cough. About 40 percent of people with GERD do not have the traditional symptoms of heartburn and indigestion; instead, a cough is their only symptom. If GERD is suspected, treatment of the disorder is the only way to determine if it is the cause. Treatment for GERD usually includes lifestyle changes such as avoiding large meals, acidic or fatty foods, caffeine, alcohol and smoking. Medication may also include antacids.
“Since a chronic cough is not a disease, but a symptom, most cases can be successfully treated by resolving the underlying condition,” says Daniel DuPont, D.O., chief of the Section of Pulmonary Diseases at Taylor Hospital.
All three Crozer-Keystone pulmonary specialists agree that any cough that causes shortness of breath, severe pain, or brings up blood requires medical attention. They also note that taking cough drops or syrups for more than a week may only mask an illness while it gets worse. If a cough persists, it’s best to follow up with a physician.