It wakes you up in the middle of the night. It disrupts your day. And, it leaves you gasping for air – and grasping for answers.
Why won’t that nagging cough go away?
If you have a chronic cough, you’re not alone. Last year, coughing accounted for 30-million doctors’ visits in the United States, and was the fourth leading reason for patients to go to their doctor. And, there are many Americans with “chronic coughs” lasting for years.
“Coughs affect your quality of life and are something you just cannot ignore. While some coughs are relatively benign, others could be the sign of something much worse, such as cancer,” said Bayhealth Pulmonologist Hakim Azfar Ali, MBBS, MD, FCCP.
Unlike a broken foot or a simple virus, coughs are far more difficult to diagnose, which is one reason why some patients cough for years, or even their entire lifetime.
“There are so many possible causes for a cough. It starts with cough receptors in your brain, and then there could be issues with your stomach, your lungs, your throat or even your heart.
It could even stem from other medications such as ACE inhibitors,” Ali said.
Ali notes that upper airway problems in the nose, throat and sinuses cause up to 40 percent of coughs. Asthma is responsible for about 20 percent of coughs. Stomach acid reflux accounts for about 15 percent of cases. Then, there are the less common instances when chronic coughing is the symptom for a far more serious condition such as cancer. In some rare instances, an enlarged atrium in the heart may press against nerves, which trigger the cough reflex. However, smoking is by far the largest, most controllable cause of coughing.
“Smoking can cause bronchitis or emphysema, which triggers constant coughing. The shame is there are patients who cough their entire lives because they keep smoking,” Ali said.
He says doctors are medical detectives when it comes to diagnosing coughs. They must get the patient’s history, find out if there are lifestyle issues or medication that can be causing the cough. Like detectives at a crime scene, doctors can develop clues through an exam. If there are still no definitive answers, diagnostics such as X-Rays, CT-Scans, and bronchoscopies may provide additional clues to the doctor. After a diagnosis, treatment can be a slow process.
“Doctors and patients have to exercise patience. Treatment may take months or years. And, patients have to be compliant and not stop their medication just because they don’t see results in the first few days,” Ali said.
Hakim Azfar Ali, MBBS, MD, FCCP, is a pulmonologist at Bayhealth Medical Center. To schedule an appointment, please call 302-674-7155.
