Cough



Cough is a common symptom, and what causes it can be hard to get. Most of the time, coughs come and go. Often, cough is a very good “physiological” response to something disturbing the throat – specifically something about to pass the “voice box” on the way into the lungs. In other words, it has a protective, healthy effect. Some people cough for effect – to get someone’s attention. This blog is about involuntary coughing.


People describe dry cough, wet cough, annoying coughs, spasms and more. The majority of cough that lasts less than three weeks are due to [upper OR lower] respiratory infections, specifically viral ones. The current Co-ViD-19 viral illness pandemic has cough as one of the top three symptoms. The type of cough often helps in making the diagnosis.


When cough persists, people seek medical care. A [primary] medical provider takes a history and performs a type of physical exam. Primary care workers listen to the heart and lungs. The chest X-ray (CXR) is still a very valuable tool in the work up. The answer to the question “why do I have this cough” is very often found by the primary care team. However, If no clear explanation is found, specialists are often consulted.


The pulmonologist is a lung specialist that can perform tests of how the lungs work. It makes sense that this specialist is seen next, since the majority of the listed diagnoses that cause cough are lung diseases. Many people who used to smoke [cigarettes] have a diagnosis of COPD – this is the very likely cause of that person’s involuntary chronic cough.


The gastroenterologist is a specialist who can find and diagnose causes for cough that are below the throat but not in the lungs. People point to the spot above where their collarbones meet. This is BY FAR the most common area of diagnoses that cause cough AFTER the person has had cough for a long time, had the primary doctor evaluate, had a negative SARS-CoV-2 test, normal CXR, and negative work-up by the lung doctor. They should look into the swallowing area (esophagus) and lower, usually under sedation where a cause for cough might find the cause (c.f. https://www.hudsonent.com/post/2017/10/11/why-do-i-clear-my-throat-and-cough)


When no one can find out the cause, the ear-nose-throat worker (otolaryngologist, PA, etc.) will need to look at the nose, sinuses, ears and throat to rule out other diseases. Sinusitis and post-nasal drip are NOT listed as major contributors of cough in adults. Allergies may cause cough. In children, cough could be from sinusitis, but not in adults. Postnasal drip is not usually dripping nor from the nose (c.f. https://www.hudsonent.com/post/2019/07/15/post-nasal-drip)


Ear wax is a rare cause of cough. Heart failure or heart / blood pressure medicines may cause cough. Some people have a nervous tic that creates cough. Whatever it is – the cause should be sought after, since coughing may be a sign that something else needs medical attention.

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Do you need an ear, nose and throat check? Remember, Hudson ENT. We are at the forefront of keeping your medical visit safe – see our blog about what we do to protect you here https://www.hudsonent.com/post/hudson-ent-a-covid-free-practice-perspectives-on-coronavirus-may-2020.

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