Persistent Cough for Three Months: Seeking Answers and Solutions

Persistent cough lasting for approximately three months?

In October, I visited an otolaryngologist who diagnosed me with pharyngitis and advised me to speak less.
However, due to work obligations, I couldn't avoid talking, which led to persistent coughing.
I went back for another visit and received the same advice.
Later, I consulted an internist who mentioned that my cold had not improved and prescribed medication.
After two visits with no improvement, I returned to the otolaryngologist, who suggested that it might be post-nasal drip and prescribed antihistamines for my allergies.
I felt somewhat better after taking them, but the cough persisted.
Concerned, I went to a large hospital for an X-ray, which came back normal.
I also paid out of pocket for a CT scan of my lungs, which was also normal.
Currently, I cannot find the cause of my cough, so I decided to see a traditional Chinese medicine practitioner.
The doctor said I have allergic cough and need to strengthen my constitution.
As of now, I am still confused and unsure of what to do next.

Xiao Hua, 40~49 year old female. Ask Date: 2018/12/31

Dr. Li Jiaxuan reply Otolaryngology

It seems that after undergoing many tests, if there is bronchial allergy, it is important to remember to keep warm, avoid humidity and dust mites, and take medication for about two weeks, which should lead to significant improvement.
Wishing you safety and health.

Reply Date: 2018/12/31

More Info

Persistent cough lasting for three months can be quite frustrating, especially when multiple medical evaluations have not yielded a definitive diagnosis or effective treatment. It sounds like you've been through a thorough process, including visits to both ENT and internal medicine specialists, as well as imaging studies like X-rays and CT scans, which have all come back normal. Let's explore some potential causes and management strategies for your persistent cough.

Possible Causes of Persistent Cough
1. Postnasal Drip: As your ENT specialist suggested, postnasal drip can lead to chronic cough. This occurs when mucus from the sinuses drips down the back of the throat, irritating it and triggering a cough reflex. Allergies, sinus infections, or even environmental irritants can contribute to this condition.

2. Chronic Bronchitis: If you have a history of smoking or exposure to irritants, chronic bronchitis could be a possibility. This condition is characterized by a persistent cough that produces mucus and can be exacerbated by respiratory infections.

3. Asthma: Asthma can present as a chronic cough, especially if it is triggered by allergens or irritants. Symptoms may include wheezing, shortness of breath, and chest tightness, which may not always be present.

4. Gastroesophageal Reflux Disease (GERD): GERD can cause a chronic cough due to acid irritating the throat. This is often accompanied by heartburn or a sour taste in the mouth.

5. Medication Side Effects: Certain medications, particularly ACE inhibitors used for hypertension, can cause a persistent cough as a side effect.

6. Infections: While you mentioned that you have been treated for a lingering cold, it’s possible that a lingering infection or a secondary infection could be contributing to your symptoms.

7. Allergies: Allergic rhinitis can lead to chronic cough due to inflammation and mucus production. If you have a history of allergies, this could be a significant factor.

Management Strategies
1. Follow-Up with Specialists: Since you have already seen multiple specialists, consider returning to an allergist or a pulmonologist for further evaluation. They may conduct specific tests, such as allergy testing or pulmonary function tests, to identify underlying issues.

2. Nasal Irrigation: Using a saline nasal spray or performing nasal irrigation can help clear mucus and reduce postnasal drip, potentially alleviating your cough.

3. Avoid Irritants: Identify and avoid any potential irritants in your environment, such as smoke, strong odors, or allergens. This may help reduce your symptoms.

4. Medications: Continue using antihistamines if they provide relief. Additionally, consider discussing the use of a nasal corticosteroid spray with your doctor, as it can help reduce inflammation in the nasal passages.

5. Lifestyle Modifications: If GERD is suspected, lifestyle changes such as avoiding spicy foods, eating smaller meals, and not lying down immediately after eating can be beneficial.

6. Hydration and Humidification: Staying well-hydrated and using a humidifier can help soothe the throat and reduce cough.

7. Consider Alternative Therapies: Since you mentioned seeing a traditional Chinese medicine practitioner, you might explore herbal remedies or acupuncture, which some people find helpful for respiratory issues.

Conclusion
Persistent cough can be a complex issue with multiple potential causes. It’s important to continue working with healthcare providers to explore all avenues of diagnosis and treatment. Keeping a symptom diary, noting when the cough worsens or improves, can also provide valuable information for your healthcare team. If your symptoms persist or worsen, do not hesitate to seek further medical attention. Your health and comfort are paramount, and finding the right solution may take time and persistence.

Similar Q&A

Understanding Persistent Cough: Causes, Symptoms, and Treatments

Since January of this year, I have been experiencing recurrent colds due to taking care of children, resulting in two to three episodes of illness. Although the colds have resolved, I have been suffering from a persistent cough. Before the Lunar New Year, I took antibiotics presc...

Dr. Zhou Ziguang reply Pulmonology
Hello: Based on what has been described, it is more likely to be caused by a sensitive trachea or post-nasal drip. However, since this is not an in-person consultation, please visit a pulmonologist for evaluation and treatment.

Persistent Cough for Over Two Months: Causes and Concerns

Hello, doctor. I traveled abroad in December, and during that time, I started to catch a cold, which later developed into a cough. Initially, around January, my cough became severe, and the phlegm was green. After seeing the doctor three times and taking medication towards the en...

Dr. Jian Shuntian reply Pulmonology
Hello: It may be chronic bronchitis. The primary recommendation is to quit smoking and avoid secondhand smoke and air pollution. When air quality is poor, it is advisable to wear a mask. To determine if there is lung cancer, a chest X-ray or CT scan is necessary, as a diagnosis c...

Chronic Cough: Understanding Persistent Symptoms and Seeking Solutions

Hello, Doctor: (The following content is a bit long; thank you for your patience!) This year, I have once again relapsed with my chronic issue: coughing. I remember being frequently ill since the first grade of elementary school, sometimes with a common cold, sometimes just a cou...

Dr. Yang Wenda reply Pulmonology
Hello: The chest X-ray is normal, which rules out pulmonary infections, tuberculosis, and parenchymal lung diseases such as bronchiectasis. However, it does not exclude tracheal hypersensitivity or asthma, especially since your response to bronchodilators is not significant. I am...

Persistent Cough: Seeking Answers for a Four-Month Struggle

Hello Dr. Zhou, I would like to ask you about a problem related to the thoracic cavity. Here’s the situation: my father has been coughing for almost four months now. However, he has not been able to get better despite visiting several hospitals. The condition seems to improve sig...

Dr. Zhou Ziguang reply Pulmonology
Hello: There are many causes of chronic cough that require differential diagnosis; common ones include chronic bronchitis, bronchiectasis, tuberculosis, and cancer. Additionally, non-pulmonary diseases may also be responsible, such as rhinitis with post-nasal drip, side effects f...