Dr. Lu Yao is Board Certified in Allergy & Asthma, Adult Internal Medicine and Pediatrics. She attends to her hospitalized patients at Banner Desert Medical Center.
Question: My 30-year-old husband, who appears otherwise vigorously well, has been coughing for almost 6 months. I’ve noticed that the dry, raspy cough usually occurs during vigorous running, or sometimes with laughter. What could be the cause of his cough?
Answer: Cough is one of the most common presenting complaints of patients attending our clinic. The most common causes of a chronic cough are post-nasal drainage, asthma, and gastro-esophageal reflux. Coughing related to post nasal drip is usually from chronic rhinitis and sinusitis. It is associated with frequent nasal discharge, a sensation of liquid dripping into the back of the throat, and frequent throat clearing. However, postnasal drip may not be noticed. Coughing due to asthma is commonly accompanied by episodic wheezing and breathlessness. However, it rarely is the sole manifestation of asthma. Coughing caused by gastro-esophageal reflux is often associated with heartburn or a sour taste in the mouth. However, these symptoms are absent in more than 40% of the patients.
Other important causes of cough include pertussis, chronic bronchitis, bronchietasis, lung cancer, medication (ACE inhibitor), vocal cord dysfunction, and congestive heart failure.
Our general approach to the patient with chronic cough is first to take a history regarding medication use and the presence of an upper respiratory infection. Second we pay attention to coexisting symptoms like wheezing and post nasal drip. My best guess is that your husband may well have “cough variant asthma”, which can be diagnosed by using spirometry pre- and post – bronchodilator or exercise challenge test. Needless to say, you should see a physician for evaluation and treatment.