Chronic cough

Diagnosis

Your physician will inquire about your medical background and conduct a comprehensive physical assessment to gather crucial insights into the origin of your chronic cough. To identify the underlying cause, they might request specific tests, including:

• Imaging tests: such as chest X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasounds, and nuclear testing.
• Lung function tests: Utilized for diagnosing asthma and COPD, these uncomplicated and noninvasive tests, such as spirometry, gauge your lung’s air capacity and your exhalation speed. Additionally, your physician might recommend an asthma challenge test, assessing your pre- and post-inhalation breath performance after administering the methacholine drug.
• Lab tests: If the mucus you cough up has color, your doctor might want to test a sample of it to check for bacteria.
• Scope tests: Specialized scope examinations may be recommended to investigate potential causes if other tests fail to identify the underlying reason for the cough.
  • Bronchoscopy: This procedure involves examining the lungs and airways using a thin, flexible tube equipped with a light and camera, known as a bronchoscope. Biopsy of the mucosa may also be performed during this procedure to check for any abnormalities.
  • Rhinoscopy: In this procedure, the sinuses, upper airway, and nasal passages are examined using a rhinoscope.

Treatment

Identifying the root cause of a chronic cough is essential for successful treatment, often involving multiple underlying factors. If smoking, your doctor will assess your readiness to quit and support your cessation efforts. Similarly, if you’re using an ACE inhibitor, your doctor might recommend an alternative medication without the side effect of coughing. Medications used to treat chronic cough may include:

• Antihistamines, Corticosteroids, and Decongestants: These medications are commonly employed to manage allergies and postnasal drip, which are frequent causes of chronic cough.
• Inhaled Asthma Medications: Effective options for a cough linked to asthma involve corticosteroids and bronchodilators. These drugs work to reduce inflammation and widen the airways.
• Antibiotics: If the underlying cause of the chronic cough is traced back to a bacterial, fungal, or mycobacterial infection, the medical practitioner might prescribe suitable medications to fight the infection.
• Acid Blockers: In situations where lifestyle adjustments prove insufficient to alleviate acid reflux, medications that hinder acid production might be recommended. Surgical intervention could be considered for some individuals to address this concern.

Cough suppressants

While your doctor works on diagnosing the cause of your cough and initiating treatment, they might prescribe a cough suppressant to provide quick relief from symptoms. It’s important to note that over-the-counter cough and cold medications target symptom alleviation rather than treating the underlying condition. Research indicates that these medicines are not significantly more effective than placebos. Additionally, these medications can have serious side effects, particularly the risk of fatal overdoses in children under 2 years old. It is advised to avoid using over-the-counter medications, except for fever and pain reducers, for treating coughs and colds in children under 6 years old, and possibly those under 12 years old.