Your doctor will ask about your medical history and perform a physical exam. Your doctor may also order tests to look for the cause of your chronic cough.
However, many doctors opt to start treatment for one of the common causes of chronic cough rather than ordering expensive tests. If the treatment doesn't work, however, you may undergo testing for less common causes.
- X-rays. Although a routine chest X-ray won't reveal the most common reasons for a cough — postnasal drip, acid reflux or asthma — it may be used to check for lung cancer, pneumonia and other lung diseases. An X-ray of your sinuses may reveal evidence of a sinus infection.
- Computerized tomography (CT) scans. CT scans also may be used to check your lungs for conditions that may produce cough or your sinus cavities for pockets of infection.
Lung function tests
These simple, noninvasive tests are used to diagnose asthma and COPD. They measure how much air your lungs can hold and how fast you can exhale.
Your doctor may request an asthma challenge test, which checks how well you can breathe before and after inhaling the drug methacholine (Provocholine).
If the mucus that you cough up is colored, your doctor may want to test a sample of it for bacteria.
If your doctor isn't able to find an explanation for your cough, special scope tests may be considered to look for possible causes.
These tests use a thin, flexible tube equipped with a light and camera. With a bronchoscope, your doctor can look at your lungs and air passages. A biopsy can also be taken from the inside lining of your airway (mucosa) to look for abnormalities.
With a rhinoscope, your doctor can view your nasal passages to look for upper airway causes of cough.
A chest X-ray and spirometry, at a minimum, are typically ordered to find the cause of a chronic cough in a child.
Determining the cause of chronic cough is crucial to effective treatment. In many cases, more than one underlying condition may be causing your chronic cough.
If you're taking an ACE inhibitor medication, your doctor may switch you to another medicine that doesn't have a cough as a side effect.
Medications used to treat chronic cough may include:
- Antihistamines, glucocorticoids and decongestants. These drugs are standard treatment for allergies and postnasal drip.
- Inhaled asthma drugs. The most effective treatments for asthma-related cough are glucocorticoids and bronchodilators, which reduce inflammation and open up your airways.
- Antibiotics. If a bacterial infection is causing your chronic cough, your doctor may prescribe antibiotics.
- Acid blockers. When lifestyle changes don't take care of acid reflux, you may be treated with medications that block acid production. Some people need surgery to resolve the problem.
- Cough suppressants. If the reason for your cough can't be determined and it's causing serious problems for you, such as keeping you from sleeping, your doctor may prescribe a cough suppressant. However, there's no evidence that over-the-counter cough medicines are effective.
You should never give children under 4 years of age over-the-counter cough and cold products without checking with your child's doctor. These medicines may harm young children.
Lifestyle and home remedies
Follow the plan your doctor gives you for treating the cause of your cough. In the meantime, you can also try these tips to ease your cough:
- Drink fluids. Liquid helps thin the mucus in your throat. Warm liquids, such as broth, tea or juice, can soothe your throat.
- Suck on cough drops or hard candies. They may ease a dry cough and soothe an irritated throat.
- Moisturize the air. Use a humidifier or take a steamy shower.
- Avoid tobacco smoke. Smoking or breathing second-hand smoke irritates your lungs and can worsen coughs caused by other factors. If you smoke, talk with your doctor about programs and products that can help you quit.
Preparing for your appointment
While you may initially see your family doctor, he or she may refer you to a doctor who specializes in lung disorders (pulmonologist).
What you can do
It's a good idea to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you've had
- Information about the medical problems of your parents or siblings
- All the medications, including over-the-counter drugs, and dietary supplements you take
- Questions you want to ask the doctor
What to expect from your doctor
A thorough medical history and physical exam can provide important clues about a chronic cough. Your doctor may ask some of the following questions:
- What are your symptoms and when did they begin?
- Did you recently have the flu or a cold?
- Do you now or have you ever smoked tobacco?
- Does anyone in your family or workplace smoke?
- Are you exposed to dust or chemicals at home or at work?
- Do you have heartburn?
- Do you cough up anything? If so, what does it look like?
- Do you take blood pressure medicine? If so, what type do you take?
- When does your cough occur?
- Does anything relieve your cough? What treatments have you tried?
- Do you get more short of breath with exertion? Or on exposure to cold air?
- What is your travel history?