Chronic Cough

Chronic cough is a condition that concerns many patients. Fortunately, although a chronic cough can be associated with serious conditions such as cancer, most coughs are due to more benign causes that are amenable to treatment. Since there are many possible causes of chronic cough, proper diagnosis depends on a good patient history, supported by a variety of tests. In many cases, empirical trials are the most cost-effective, although time consuming, approach.

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complimentary and Alternative treatments that may be considered include:

• Complete Blood Count (CBC) and Erythrocyte Sedimentation Rate (ESR).
• Chest X-ray.
• Tuberculin, histoplasmin, coccidiodin, and blastomycin skin tests.
• Sputum smear and culture or (pneumonia, fungus, TB).
• Sputum eosinophils (asthma).
• Bronchial lavage for eosinophils and culture.
• Sweat Chloride Test (cystic fibrosis).
• alpha-1 antitrypsin assay.
• Pulmonary Function Testing (spirometry).
• Arterial blood gas
• Barium swallow (hiatal hernia).
• Sputum cytology (cancer).

• Smoking.
• Angiotensin Converting Enzyme Inhibitor (ACE-I) syndrome.
• Upper Airway Cough Syndrome (post-nasal drip) due to inhaled allergens or chronic sinusitis.
•  >   
  Gastroesophageal Reflux Disease
•  >   
  Asthma ,
•  >   
  Chronic Obstructive Pulmonary Disease (COPD),
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  Bronchiectasis
• Interstitial, Restrictive, or other lung disease.
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  Cystic fibrosis .
• Non-asthmatic eosinophilic bronchitis.
• Foreign-object aspiration.
• Enlarged tonsils or adenoids
• Esophageal or laryngeal anomalies.
• Hiatal hernia.
• Pharyngitis (pertussis, virus, strep, diphtheria).
• Tuberculosis (TB), atypical mycobacterium infection, fungi, parasites, or other lung infection.
• Lung alpha-1 Antitrypsin deficiency.
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  Congestive Heart Failure, pericarditis, aortic aneurysm,
• Lung, laryngeal or esophageal cancer.
• Psychogenic (hysterical cough).
• Autoimmune disorders such as Wegener's granuloma.

• Screening TB-skin test and Chest X-ray are recommended.
• Smoking cessation.
• Change prescription ACE-I drug usage to ARB, or seek other method of controlling hypertension.
• Treat possible underlying allergies.
• Treat possible underlying Gastroesophageal Reflux Disease (GERD)
• Referral for spirometry if asthma or other lung disease is suspected.
• Referral for upper GI endoscopy if esophageal or laryngeal anomalies are suspected.
• Referral for cardiovascular evaluation if other common causes have been ruled out.