Chronic Cough (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
George Schiffman, MD, FCCP
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is chronic cough?
- What are causes of chronic cough?
- What are the different types of coughs?
- How is chronic cough treated?
- Are there home remedies for chronic cough?
- Can chronic cough be prevented?
- Find a local Pulmonologist in your town
What are the different types of coughs?
There are several different types of chronic (or persistent) cough.
- A dry cough is a cough that does not produce any mucus, is irritating to the lungs and throat and may be a sign of a viral infection or sinus problems.
- A wet cough is a cough that produces mucus (sputum), and depending on the color, may indicate a bacterial infection.
- A stress cough is a reflexive spasm of the airways caused when you are under stress. It usually produces no mucus and is not generally related to infections.
- A 'barking' cough is usually found in children, and may be associated with croup or other viral illness.
- A cough that causes a 'whooping' sound after the cough may be indicative of a serious infection and should be evaluated by a doctor.
How is chronic cough treated?
The treatment of cough is directed the cause. Patients may get symptomatic relief from over-the-counter cough medicines containing guaifenesin and/or dextromethorphan, drinking lots of water, inhaling steam, and using cough lozenges. In severe cases a doctor may prescribe codeine, which is an effective cough suppressant.
- Asthma: Inhaled bronchodilators and inhaled steroids are given to decrease inflammation of the airways, and reduce wheezing. In some cases, short-term oral steroids are prescribed.
- Gastroesophageal reflux disease (GERD): Treatment includes avoiding foods that increase reflux, avoiding meals before lying down, elevating the head while sleeping, and taking medication such as famotidine (Pepcid), cimetidine (Tagamet), or ranitidine (Zantac) to decrease stomach acidity.
- Sinus problems and postnasal drip: Use of decongestants such as pseudoephedrine (Sudafed) or antihistamines such as diphenhydramine (Benadryl) may improve symptoms of post nasal drip. Inhaled nasal steroids are very effective in treating allergic rhinitis (hay fever), a common cause of cough. Additionally, other nasal inhalers like ipratropium bromide (Atrovent) can relieve post nasal drip. Antibiotics may be prescribed if the cause is determined to be sinusitis.
- Infections: Bacterial pneumonia and bronchitis is typically treated with antibiotics such as cephalosporins and azithromycin (Zithromax) and other antibiotics. If the pneumonia is close to the chest wall inflammation of the surface of the lung can cause pain, known as pleurisy and pain relievers (analgesics) can be helpful. Cough suppressants are used with caution in these situations because clearing the lung of the infected mucus by coughing helps clear the infection. Most bronchitis in adults is from viral infections. Therefore, treatment is much the same as that of the common cold including rest, fluids, pain relievers, and humidification. Some people find expectorant cough medicines containing guaifenesin helpful in alleviating their discomfort. Sometimes it is hard to differentiate a viral bronchitis from a bacterial bronchitis, and antibiotics are prescribed. In some cases, asthmatics can produce green mucus that looks infected. Your doctor can have the mucus examined to determine if an infection is present.
- Medications: Patients taking blood pressure medicines called ACE inhibitors (angiotensin converting enzyme), for example, enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril, Prinivil), etc. should talk to their doctor about switching medications. Patients should not stop taking medicine on their own because a marked elevation in blood pressure can result from discontinuation. A newer generation of ACE inhibitor like medicines called ARB's (angiotensin receptor blockers), (for example, valsartan [Diovan], losartan [Cozaar], etc.) can be alternatives that have less potential to cause chronic coughing. There are a host of other medicines available to manage blood pressure.
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