DEAR DR. DONOHUE: I have been coughing for what seems like forever. I have used every over-the-counter cough medicine I can get my hands on. No luck. I feel OK otherwise, but the coughing is getting me and those around me down. What can I do?
A cough is a protective reflex that clears the airways. A virus-caused cough lasts about three weeks. Coughs that persist for more than eight weeks are chronic coughs, and treatment for such a cough hinges on finding its cause — not always an easy task. I assume you’re not a smoker. The cure for smokers’ cough is to stop smoking.
A chest X-ray is a standard test for coughers. Sometimes bronchoscopy, a look into the airways with a scope, is necessary.
The three main causes of coughing for nonsmokers are asthma, postnasal drip and GERD, gastroesophageal reflux disease (heartburn). Asthma consists of attacks of airway narrowing, excessive mucus production, wheezing and coughing. Examples of asthma treatment are inhaled medicines like Proventil and Pulmicort. Postnasal drip is the annoying trickle of mucus from the sinuses and nose into the throat. It triggers coughing. Astelin nasal spray often can open the airways and quiet the cough. GERD is the spurting of stomach acid into the esophagus and sometimes into the throat, where it provokes coughing spells. Medicines that decrease acid production get rid of GERD coughing.
Medicines have to be considered, too. The blood pressure medicines called ACE inhibitors often are implicated as a cause of coughing.
DR. PAUL DONOHUE is a syndicated columnist with North America Syndicate Inc., P.O. Box 536475, Orlando, FL 32853-6475.