QUESTION:
Dear Dr. Heller,
Looking at my screen you seem to give the impression you are experts in the field of chronic cough which I have had for 2 yrs. Please expand.
ANSWER:
The obvious answer is find all the reasons and treat them. It can be more than one thing going on. The most common causes include:
a) post nasal drip b) asthma / allergies c) sinus infections d) GERD (gastroesophageal reflux disease) e) heart problems like a leaky valve or heart failure f) chronic bronchitis g) chronic lung infections, including TB h) medications – especially ACE inhibitors i) something wrong with the vocal cords or bronchial tubes
Additionally, chronic coughing causes more coughing by irritating the bronchial tubes.
Depending on the age, the following tests are reasonable and should be done if coughing persists:
a) sputum culture (the material you cough up)
b) posterior nasal culture (getting the material that could be dripping down the throat)
c) chest X-ray and possible CT scan of the chest
d) CT scan of the sinuses
e) ENT direct visualization of the vocal cords and upper airway
f) bronchoscopy (looking directly at the bronchial tubes)
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