The type and timing of the cough can help identify the cause, and symptoms such as “allergies”, throat-clearing, wheezing, shortness of breath, and heartburn can help point to one of the common illnesses associated with cough.

A careful medical interview and physical exam is the key to finding the cause of chronic coughing. Allergists are especially well-suited for evaluating and treating chronic cough because of their training and areas of expertise. Postnasal drip (allergies), asthma, and gastric reflux alone or in combination are responsible for most of the cases of chronic cough, and most medical professionals first try a “therapeutic trial” of medications that treat these conditions.
 

Chronic cough treatment is tailored to the cause:

For patients with allergies, treatment can include avoidance of triggers, prescription nasal steroid sprays, antihistamines, decongestants, and allergen immunotherapy (allergy shots).
Avoiding known triggers can reduce the intensity of atopic dermatitis. Irritants, stress, heat/sweating, infections, and allergens can all cause exacerbations.

 

Those who have non-allergic nose or sinus problems may respond best to older antihistamines (those that may make you sleepy) by mouth or prescription antihistamine nasal sprays.

Asthma is usually treated with the combination of daily inhaled corticosteroids and as-needed inhaled albuterol. Medications such as Singulair® are sometimes used instead of the steroids. Patients with asthma can also benefit from identifying and avoiding any allergies, as well as allergen immunotherapy if they have significant allergies.

 

Gastroesophageal reflux (“GERD”) is treated with lifestyle changes (such as weight loss, avoidance of spicy & fatty foods, and not eating right before bed) and use of a moderate dose of a “proton pump inhibitor” such as omeprazole. It may takes weeks or sometimes months for cough due to reflux to respond to reflux therapy.