What could be causing your cough...

Most coughs are benign and temporary, lasting a week to several months, but some are chronic and may portend a more serious condition, The following is a list of the more common causes of cough:​​

1. A cold virus (usually due to a rhinovirus or adenovirus)- These viruses cause the common cold and can last from weeks to months. They are associated with nasal congestion and the production of clear mucus. Treatment is symptomatic. 
2. Postnasal drip- A condition that is associated with chronic cough that is due to mucus that accumulates in the sinuses and drips down the back of the throat creating a tickly sensation that triggers a cough. It is often associated with a runny nose and nasal congestion, Treatment includes nasal saline rinse, nasal steroids and antihistamines. If mucus is purulent (yellow/green) a bacterial infection is suspected and treatment includes a broad spectrum antibiotic such as amoxicillin. 
3. Asthma- Asthma usually manifests itself as wheezing and shortness of breath, but some patients have a cough-variant asthma, the presenting symptom being a persistent cough. Cough can also be precipitated by cold, exercise and allergens such as pollens, animal dander and aromatic perfumes. Treatment ranges from nasal/oral steroids to bronchodilators (albuterol) to desensitization (allergy shots) by an immunologist.
4. Acid reflux- 25% of cases of chronic cough are due to GERD (gastric reflux disease). When gastric acid refluxes back up into the esophagus it eventually reaches the larynx and trachea causing hoarseness and chronic cough. The cough usually occurs right after a meal, at night when one is in the recumbent position in bed, and upon arising in the morning. Treatment consists of: a) Drinking milk. b) Two 500 mg Tums c) An antihistamine (Zantac)  d) Proton pump inhibitor (Prilosec) e) Elevate head of bed on 6 inch blocks  f) Lose weight- excess abdominal fat squeezes stomach and propels gastric acid back up into the esophagus causing 'heartburn'. 
   
5. Pneumonia-​Cough productive of green/yellow/bloody sputum, fever and chills           common. Treatment consists of antibiotics. 
   
6. Whooping Cough- A highly contagious bacterial laryngotracheitis caused by the       bacterium Bordetella Pertussis. The name originates from the characteristic inspiratory 'whoop' the patient makes as he/she gasps for breath. After a long intensive fit of coughing, Most younger people are immune due to the effect of  vaccination as a child. Older patients may have an aborted infection due to partial protective immunity and present with the primary symptom being chronic cough. Antibiotics are effective during the first three weeks of infection. 
   
7. Ace-inhibitors- Up to 20% of persons being treated with an ace-inhibitor (Lisinopril etc) for hypertension will experience a chronic cough. If the cough is of significant severity, substitution of a different class of anti-hypertensive medication is indicated.
   
8. Allergens- A subset of asthmatics will have symptoms after exposure to molds, various pollens, smoke and other air pollutants. Avoidance is the best treatment.
   
9. Emphysema and COPD (chronic obstructive pulmonary disease)- These diseases are most often associated with smoking cigarettes/cigars. Other causes are an anti-trypsin deficiency and rare conditions causing lung damage. (silo-filler's disease, inhalation of poison gas, etc).
   
10.  Lung and Throat cancer- Diagnosis often utilizes the services of an ear, nose and throat specialist and the modalities of laryngoscopy, chest x-ray, catscan and MRI.

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