Chronic Cough and Allergic Rhinitis: the Connection

Chronic cough with allergic rhinitis?

Hello doctor, my brother has been coughing since he recovered from a cold six months ago.
Recently, I saw a news report about a high school student in Kaohsiung whose persistent cough was caused by allergic rhinitis, which bothered his classmates.
Our family is wondering if my brother might be experiencing the same issue (the cough in the news report sounded quite similar).
However, he needs to go outside for work delivering goods, and the air quality is poor right now.
Could this also be a reason why he hasn't recovered? He mentioned that he feels better whenever the weather is stable (this same situation occurred early last year).
Should he go to a regional hospital for an examination? His condition is affecting the whole family's sleep quality, and he is also feeling uncomfortable.

Niming, 20~29 year old female. Ask Date: 2017/01/10

Dr. Chen Taicheng reply Family Medicine

Chronic cough has many causes.
The most common causes include post-nasal drip, gastroesophageal reflux disease (GERD), asthma, or certain medications (such as antihypertensives).
Smoking can also lead to bronchial inflammation, resulting in chronic cough.
Allergic rhinitis, having pets, and exposure to environmental or occupational allergens are also common causes.
Other less common causes are primarily pulmonary or cardiac diseases, or infections (such as certain viruses or bacteria like tuberculosis or whooping cough).
It is uncertain whether your brother has a history of allergic rhinitis, but allergic rhinitis and asthma (cough-variant asthma) are considered manifestations of the same respiratory tract disease in different locations.
If the cough occurs less frequently when the weather improves, it is still important to consider that after a cold, the respiratory tract may be more sensitive to potential allergic triggers (such as air pollution), leading to symptoms similar to allergic rhinitis or asthma.
Nighttime coughing that disturbs family members should prompt consideration of asthma, gastroesophageal reflux, or post-nasal drip.
It is recommended to reduce potential irritants (such as wearing a mask when going out and minimizing exposure to tobacco products, including secondhand smoke) and to consult with specialists in pulmonology, family medicine, otolaryngology, or gastroenterology for further evaluation and examination.
Sincerely, Dr.
Chen Tai-Cheng, Family Medicine, Taoyuan Hospital.

Reply Date: 2017/01/10

More Info

Chronic cough can be a frustrating and debilitating condition, particularly when it is linked to allergic rhinitis. In your brother's case, it seems that his persistent cough may be a result of postnasal drip, which is a common complication of allergic rhinitis. When the nasal passages are inflamed due to allergies, mucus production increases, and this excess mucus can drip down the back of the throat, triggering a cough reflex. This is often exacerbated by environmental factors, such as poor air quality, which can irritate the respiratory tract further.

Allergic rhinitis is characterized by symptoms such as sneezing, nasal congestion, runny nose, and itchy eyes. In some individuals, it can also lead to chronic cough, especially if the nasal congestion is significant enough to cause postnasal drip. The cough may worsen in certain conditions, such as during changes in weather or exposure to allergens like pollen, dust, or mold. Given that your brother's cough improves when the weather is stable, it suggests that environmental factors play a significant role in his symptoms.

In terms of management, it is essential to address both the allergic rhinitis and the chronic cough. Over-the-counter antihistamines can help alleviate the symptoms of allergic rhinitis, while nasal corticosteroids can reduce inflammation in the nasal passages, thereby decreasing mucus production and postnasal drip. Additionally, saline nasal sprays can help keep the nasal passages moist and clear of irritants.

If your brother's symptoms persist despite these measures, it may be beneficial for him to see an allergist or an ENT specialist. They can perform specific tests, such as skin prick tests or blood tests, to identify the allergens triggering his symptoms. Furthermore, they may recommend a more tailored treatment plan, which could include allergy shots (immunotherapy) if appropriate.

In cases where chronic cough is present, it is also important to rule out other potential causes. For instance, conditions such as asthma, gastroesophageal reflux disease (GERD), or even chronic bronchitis could contribute to a persistent cough. A thorough evaluation, including a physical examination and possibly imaging studies or pulmonary function tests, may be warranted to ensure that there are no underlying respiratory issues.

In summary, your brother's chronic cough is likely related to his allergic rhinitis, exacerbated by environmental factors. Addressing the underlying allergies through appropriate medications and lifestyle modifications can significantly improve his symptoms. If his cough continues to be a problem, seeking further evaluation from a healthcare professional would be a prudent step to ensure comprehensive care and management.

Similar Q&A

Managing Persistent Cough and Throat Phlegm from Allergic Rhinitis

Hello Doctor: I have a history of nasal allergies, and recently I've been coughing non-stop, both in the morning and at night. I feel like there's phlegm in my throat, but when I cough it up, it's white. Occasionally, I also taste nasal mucus. I've visited the...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, the situation you described may be chronic pharyngitis. It is recommended to seek medical attention for a laryngoscopy to rule out any masses and to consider medication treatment. In addition to medication, daily lifestyle precautions include: avoiding lying down for two h...

Chronic Cough: Understanding Allergies and Treatment Options

Hello, I have been experiencing a chronic cough for over a year. I have seen an ENT specialist, a pulmonologist, and a gastroenterologist. The diagnosis indicated that I have nasal allergies (post-nasal drip), a deviated septum, and enlarged polyps (which have already been surgic...

Dr. Li Jiaxuan reply Otolaryngology
Symptoms of upper and lower respiratory sensitivity include runny nose and cough. Irritants include temperature changes, humidity, and dusty environments. It is recommended to avoid these irritants in order to improve symptoms. Thank you!

Managing Persistent Cough and Wheezing: Insights for Allergy Sufferers

Hello Doctor, I have had a tendency to have a runny nose and nasal allergies since childhood, and I have an allergic constitution. Since the end of June this year, I have been experiencing a strange cough and wheezing sounds, along with a sensation of something stuck in my throat...

Dr. Zheng Jueyi reply Otolaryngology
Hello, elevated IgE levels and allergy testing indicate an allergy to dust and dust mites, while lung function tests are normal. This suggests current upper respiratory allergic symptoms. It is recommended to enhance the management of allergic rhinitis. In addition to environment...

Understanding Coughing and Breathing Difficulties: When to See a Doctor

Hello Doctor: I have been coughing for about a week. I cough when I inhale, and sometimes I experience a bit of difficulty exhaling. I have a history of allergic rhinitis and a smoking habit. Is there a connection between these factors? I do not have a cold; should I see a doctor...

Dr. Jian Shuntian reply Pulmonology
Hello: Coughing may be associated with allergic rhinitis and smoking, but it is not necessarily the case. Therefore, it is still necessary to undergo an examination by a pulmonologist. Best regards.