What are the common causes of post-nasal drip. How can you effectively treat post-nasal drip at home. When should you seek medical attention for persistent post-nasal drip. What prescription treatments are available for severe cases of post-nasal drip. How does post-nasal drip relate to other respiratory conditions.

Understanding Post-Nasal Drip: Symptoms and Causes

Post-nasal drip is a common condition characterized by a persistent trickle of mucus from the back of the sinuses, often leading to an irritating cough and throat discomfort. This nagging symptom can persist for months, causing significant discomfort and affecting daily life.

Common causes of post-nasal drip include:

• Allergies
• Viral infections (including the common cold)
• Sinus infections
• Environmental irritants (such as fumes or dust)
• Weather conditions (especially cold, dry air)
• Spicy foods

Less frequent causes may include:

• Foreign objects in the nose (particularly in children)
• Pregnancy
• Certain medications

Is post-nasal drip dangerous. While typically more annoying than dangerous, persistent post-nasal drip can significantly impact quality of life and may indicate underlying health issues that require attention.

Home Remedies and Over-the-Counter Treatments for Post-Nasal Drip

Fortunately, several home remedies and over-the-counter treatments can provide relief from post-nasal drip symptoms:

Humidity and Hydration

• Use a humidifier or practice steam inhalation (e.g., during a hot shower)
• Stay well-hydrated to thin mucus
• Elevate your head while sleeping using extra pillows

Nasal Irrigation and Decongestants

• Try nasal irrigation with saline solution
• Use oral decongestants like pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE)
• Apply nasal decongestant sprays like oxymetazoline (Afrin) for short-term relief

Antihistamines and Mucus Thinners

• Take antihistamines such as diphenhydramine (Benadryl) or loratadine (Claritin)
• Use guaifenesin (Mucinex) to thin mucus

Can combining over-the-counter medications be effective for post-nasal drip. While combination products can offer relief, it’s crucial to read labels carefully and avoid excessive intake of any active ingredient.

Prescription Treatments for Persistent Post-Nasal Drip

When over-the-counter remedies prove insufficient, healthcare providers may recommend prescription treatments:

• Nasal steroid sprays (e.g., beclomethasone/Beconase or triamcinolone/Nasacort)
• Ipratropium (Atrovent) nasal spray to inhibit mucus secretion

Are antibiotics effective for post-nasal drip. Antibiotics are generally not prescribed for post-nasal drip unless there’s a confirmed bacterial sinus infection.

The Surprising Benefits of Hot Liquids for Post-Nasal Drip

You may have heard that chicken soup can help alleviate post-nasal drip symptoms. This folk remedy has some scientific backing, but it’s not limited to chicken soup alone. Any hot liquid can help thin mucus and promote hydration, providing relief from post-nasal drip symptoms.

Why do hot liquids help with post-nasal drip. The heat and steam from hot liquids can help:

• Thin mucus, making it easier to expel
• Soothe irritated throat tissues
• Provide necessary hydration
• Temporarily relieve nasal congestion

When to Seek Medical Attention for Post-Nasal Drip

While post-nasal drip is often manageable with home remedies and over-the-counter treatments, certain symptoms warrant medical attention:

• Unexplained fever
• Bloody mucus
• Wheezing or shortness of breath
• Foul-smelling drainage
• Persistent symptoms despite treatment

Should you see a doctor for chronic post-nasal drip. If symptoms persist for several weeks or significantly impact your quality of life, consult a healthcare provider to rule out underlying conditions and explore additional treatment options.

The Connection Between Post-Nasal Drip and Other Respiratory Conditions

Post-nasal drip often coexists with or mimics other respiratory conditions, making accurate diagnosis crucial for effective treatment. Understanding these relationships can help in managing symptoms more effectively.

Post-Nasal Drip and Chronic Cough

Post-nasal drip is a leading cause of persistent cough. The constant trickle of mucus can irritate nerve endings in the throat, triggering the cough reflex. This “upper airway cough syndrome” can be mistaken for other conditions like asthma or bronchitis.

Allergies and Post-Nasal Drip

Allergic rhinitis, or hay fever, frequently leads to post-nasal drip. When allergens trigger an immune response, the body produces excess mucus, which can accumulate in the back of the throat.

Sinusitis and Post-Nasal Drip

Sinus infections, both acute and chronic, often result in post-nasal drip. The inflamed sinus tissues produce excess mucus, which drains down the back of the throat.

How can you differentiate between post-nasal drip and other respiratory conditions. While symptoms may overlap, a thorough medical evaluation, including physical examination and possibly imaging studies, can help determine the underlying cause and guide appropriate treatment.

Long-Term Management of Post-Nasal Drip

For individuals prone to recurrent post-nasal drip, developing a long-term management strategy is essential. This approach may include:

• Identifying and avoiding triggers (e.g., allergens, irritants)
• Maintaining good indoor air quality
• Regular use of nasal irrigation
• Adhering to prescribed medication regimens
• Lifestyle modifications (e.g., dietary changes, stress reduction)

Can post-nasal drip be completely cured. While some cases resolve entirely with treatment, others may require ongoing management. The goal is to minimize symptoms and improve quality of life.

Emerging Treatments and Research in Post-Nasal Drip Management

As our understanding of post-nasal drip and related conditions evolves, new treatment approaches are being explored:

Immunotherapy for Allergic Post-Nasal Drip

For individuals with allergy-induced post-nasal drip, immunotherapy (allergy shots or sublingual tablets) may offer long-term relief by modulating the immune response to specific allergens.

Probiotics and Nasal Health

Emerging research suggests that probiotics may play a role in maintaining a healthy nasal microbiome, potentially reducing the incidence of post-nasal drip and related conditions.

Advanced Nasal Delivery Systems

Innovations in nasal drug delivery systems aim to improve the efficacy of topical treatments by ensuring better distribution and retention of medications in the nasal passages.

What future developments can we expect in post-nasal drip treatment. Ongoing research focuses on targeted therapies, personalized treatment approaches, and novel drug delivery methods to enhance the management of post-nasal drip and related upper respiratory conditions.

In conclusion, while post-nasal drip can be a persistent and frustrating condition, a range of treatment options exists to manage symptoms effectively. From simple home remedies to advanced medical interventions, individuals suffering from post-nasal drip have numerous avenues to explore for relief. By understanding the underlying causes, recognizing when to seek medical attention, and staying informed about emerging treatments, those affected by post-nasal drip can work towards achieving better respiratory health and improved quality of life.

Treatments for post-nasal drip – Harvard Health

You thought it would never end: that tickle in the back of your throat that made you cough or have to clear your throat. It’s been going on for months. And now you know why: post-nasal drip. It’s a common diagnosis. It can happen for a number of reasons: allergies, viral infections (including the common cold), sinus infections, irritants in the air (such as fumes or dust). Less common causes include something stuck inside the nose (common in small children), pregnancy, and certain medications. Temporary – and normal – causes of post-nasal drip includes certain weather conditions (especially cold, dry air) and spicy foods.

Whatever the cause, the problem is a steady trickle of mucus from the back of the sinuses that irritates the throat and nagging cough or other symptoms.

Now what?

Now that you have an official diagnosis, what can you do for it? There are a number of treatment options, including home remedies and over-the-counter medications:

• A humidifier or steam inhalation (as during a hot shower)
• Keeping well-hydrated (to keep the mucus thinner)
• Sleep on propped up pillows, to keep the mucus from collecting at the back of your throat
• Nasal irrigation (available over-the-counter)
• An oral decongestant, such as pseudoephedrine (as in Sudafed) or phenylephrine (as in Sudafed PE or Neo-Synephrine)
• Guaifenesin (as in Mucinex), a medication that can thin the mucus
• An antihistamine, such as
  • diphenhydramine, as in Benadryl
  • chlorpheniramine, as in Chlor-Trimeton
  • loratadine, as in Claritin or Alavert
  • fexofenadine (Allegra)
  • cetirizine (Zyrtec)
  • levocetirizine (Xyzal)
  • desloratadine (Clarinex)
• A nasal decongestant such as oxymetazoline (contained in Afrin) which constricts blood vessels in the nasal passages; this leads to less secretions. Such medications should only be taken for a day or two; longer-term use can cause more harm than good)

Keep in mind that many of these medications are combined in over-the-counter products. For example, there are several formulations of “Sudafed” containing pseudoephedrine or phenylephrine along with additional drugs including acetaminophen, dextromethorphan, and guaifenesin. While these combinations can be effective, it’s important to read the label and avoid taking too much of any active ingredient.

What about prescription treatments?

If these approaches aren’t effective, prescription treatments may be the next best steps, including:

• A nasal steroid spray (such as beclomethasone/Beconase or triamcinolone/Nasacort)
• Ipratropium (Atrovent) nasal spray which inhibits secretions (such as mucus)

Other treatments depend on the cause of the post-nasal drip. Antibiotics are not usually helpful, so they aren’t usually prescribed for post-nasal drip (unless the symptoms are due to bacterial infection of the sinuses). For allergies, dusting and vacuuming often, covering your mattresses and pillowcases, and special air filter can help reduce exposure to allergy triggers.

What about chicken soup?

If you’ve been told that chicken soup helps with post-nasal drip (or other symptoms of a cold or flu), it’s true! But it doesn’t actually have to be chicken soup – any hot liquid can help thin the mucus and help you maintain hydration.

When should I call a doctor?

In most cases, post-nasal drip is annoying but not dangerous. However, you should contact your doctor if you have:

• Unexplained fever
• Bloody mucus
• Wheezing or shortness of breath
• Foul smelling drainage
• Persistent symptoms despite treatment

The bad news/good news about post-nasal drip

Post-nasal drip is among the most common causes of persistent cough, hoarseness, sore throat and other annoying symptoms. It can be caused by a number of conditions and may linger for weeks or months. That’s the bad news. The good news is that most of the causes can be quickly identified and most will improve with treatment.

Image: Cecilie_Arcurs/Getty Images

Gastroesophageal Reflux Disease (GERD) – Harvard Health

Gastroesophageal reflux disease (GERD) is commonly called heartburn. This digestive disorder most often causes a burning and sometimes squeezing sensation in the mid-chest.

In GERD, acid and digestive enzymes from the stomach flow backwards into the esophagus, the tube that carries food from your mouth to your stomach. This backward flow of stomach juices is called “reflux”. These caustic stomach juices inflame the lining of the esophagus. If GERD is not treated, it can permanently damage the esophagus.

A muscular ring seals the esophagus from the stomach. This ring is called the esophageal sphincter. Normally, the sphincter opens when you swallow, allowing food into your stomach. The rest of the time, it squeezes tight to prevent food and acid in the stomach from backing up into the esophagus.

In most people with GERD, however, the esophageal sphincter does not seal tightly. It remains relaxed between swallows. This allows digestive juices to enter the esophagus and irritate the esophageal lining.

Many things can weaken or loosen the lower esophageal sphincter. These include:

• Certain foods
• Smoking
• Alcohol
• Pregnancy
• Many medications
• Increased abdominal pressure, because of obesity or pregnancy
• A bulge in the stomach (hiatal hernia) that protrudes above the diaphragm

Prolonged exposure to acid can cause the esophagus to:

• Become inflamed
• Narrow
• Develop an open sore

Long-term exposure to acid also can lead to a condition called Barrett’s esophagus. Barrett’s esophagus increases the risk of esophageal cancer.

For many people with GERD, heartburn is not merely an occasional discomfort. Rather, it is a frequent, even daily, ordeal.

Symptoms

Symptoms of GERD may include:

• Sharp or burning chest pain behind the breastbone. This is also known as heartburn. It is the most common symptom of GERD. Heartburn may be worse when you eat, bend over or lie down.
• Tightness in your chest or upper abdomen. The pain may wake you up in the middle of the night.
• Regurgitation, the backflow of stomach fluids into your mouth
• Nausea
• A recurring sour or bitter taste in the mouth
• Difficulty swallowing
• Hoarseness, especially in the morning
• Sore throat
• Coughing, wheezing or repeatedly needing to clear your throat

Diagnosis

Your doctor will ask you:

• How often you have heartburn or other symptoms of GERD
• Whether your symptoms are worse when you lie down or bend over
• Whether your symptoms are relieved by over-the-counter heartburn remedies

Your doctor also will review your current medications. Some medications can loosen the esophageal sphincter. These include:

• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
• Blood pressure or heart medications such as calcium channel blockers and nitroglycerin
• Osteoporosis drugs called bisphosphonates
• Progestins, such as progesterone
• Medicines that reduce the amount of saliva you produce, such as antihistamines and antidepressants

Pain that feels like heartburn also can be a symptom of coronary artery disease. Your doctor may ask whether you have any symptoms of heart problems. He or she may test for heart problems.

If your only complaint is mild heartburn and your physical examination is normal, your doctor may suggest lifestyle changes and over-the-counter medications. You may not need any special diagnostic testing or prescription treatment.

If you have more serious symptoms, or if your heartburn is not relieved by medications, you will need further testing. Serious symptoms include severe, long-lasting heartburn, difficulty swallowing or weight loss.

The best test for GERD is an endoscopy. The doctor looks directly at your esophagus with an endoscope. This is a flexible tube that can be passed through the mouth and throat. Endoscopy is usually is done by a gastroenterology specialist.

During endoscopy, your doctor may take a small sample of tissue to be examined in a laboratory. Your doctor also may look at your stomach and first part of the small intestines with the endoscope.

You also may have one or more of the following tests:

• Barium swallow — An X-ray test that outlines the esophagus.
• Cardiac evaluation — To check for heart disease.
• Esophageal manometry or motility studies — To check the squeezing motion of your esophagus when you are swallowing.
• Esophageal pH monitoring — Uses electrodes to measure the pH (acid level) in the esophagus. It is usually done over a 24-hour period.

Expected Duration

Without treatment, GERD is typically a long-term problem.

Symptoms may be relieved within days of treatment. But for many patients, several weeks of treatment are needed before symptoms lessen or resolve.

Treatment often has to continue for a long period. Even with daily medication, many people with reflux continue to have symptoms.

Prevention

There are a lot of things you can do to prevent the symptoms of GERD. Some simple lifestyle changes include:

• Elevate the head of your bed at least six inches. If possible, put wooden blocks under the legs at the head of the bed. Or, use a solid foam wedge under the head portion of the mattress. Simply using extra pillows may not help. Lying on your left side also can help reduce acid reflux.
• Avoid foods that cause the esophageal sphincter to relax during their digestion. These include:
  • Coffee
  • Chocolate
  • Fatty foods
  • Whole milk
  • Peppermint
  • Spearmint
• Limit acidic foods that make the irritation worse when they are regurgitated. These include citrus fruits and tomatoes.
• Avoid carbonated beverages. Burps of gas force the esophageal sphincter to open and can promote reflux.
• Eat smaller, more frequent meals.
• Do not lie down after eating.
• Do not eat during the three to four hours before you go to bed.
• If you smoke, quit.
• Avoid drinking alcohol. It loosens the esophageal sphincter.
• Lose weight if you are obese. Obesity can make it harder for the esophageal sphincter to stay closed.
• Avoid wearing tight-fitting garments. Increased pressure on the abdomen can open the esophageal sphincter.
• Use lozenges or gum to keep producing saliva.

Treatment

Treatment for most people with GERD includes lifestyle changes as described above and medication. If symptoms persist, surgery or endoscopy treatments are other options.

Medications

There are several medications that can be used to treat GERD. They include:

• Over-the-counter acid buffers — Buffers neutralize acid. They include Mylanta, Maalox, Tums, Rolaids, and Gaviscon. The liquid forms of these medications work faster But the tablets may be more convenient.

Antacids that contain magnesium can cause diarrhea. And antacids that contain aluminum can cause constipation. Your doctor may advise you to alternate antacids to avoid these problems. These medicines work for a short time and they do not heal the inflammation of the esophagus.

• Over-the-counter h3 blockers — These drugs cause the stomach to make less acid. They are effective in patients with mild to moderate symptoms. They include famotidine (Pepcid AC), cimetidine (Tagamet HB) and nizatidine (Axid).
• Over-the-counter proton pump inhibitors — Proton pump inhibitors shut off the stomach’s acid production.

Proton pump inhibitors are very effective. They can be especially helpful in patients who do not respond to h3 blockers and antacids. These drugs are more potent acid-blockers than are h3 blockers, but they take longer to begin their effect.

• Prescription medications — Prescription medications include:
  
  • h3 blockers — These are prescribed at higher doses than those available in over-the-counter forms.
  • Proton pump inhibitors — A variety of proton pump inhibitors are available by prescription.
  • Motility drugs — These medications may help to decrease esophageal reflux. But they are not usually used as the only treatment for GERD. They help the stomach to empty faster, which decreases the amount of time during which reflux can occur.
  • Mucosal protectors — These medications coat, soothe and protect the irritated esophageal lining. One example is sucralfate (Carafate).

Surgery

Surgery is an option for people with severe, difficult-to-control GERD symptoms. It may also be considered for people who have complications such as asthma or pneumonia, or scar tissue in the esophagus. Some people who do not want to take medications for a long time may choose surgery.

Surgery for GERD can be done using camera-guided instruments. This technique is called laparoscopic surgery. Laparoscopic surgery requires smaller incisions than conventional surgery.

In a procedure called Nissen fundoplication, excess stomach tissue is folded around the esophagus and sewn in place. This holds extra pressure around the weakened esophageal sphincter.

This operation appears to relieve symptoms about as much as prescription acid-blocking medicines. The success rates of surgery might be lower for people whose symptoms are not relieved by anti-acid medicines. Following surgery, some people have a lasting bothersome side effect. But most people who undergo surgery are very satisfied with the results.

Potential side effects include swallowing difficulty, diarrhea and the inability to belch or vomit to relieve bloating or nausea.

Endoscopy treatments

The lower esophageal sphincter can be sometimes be tightened using an endoscope. The procedures currently used are stitching (plication) and radiofrequency heating (the Stretta procedure). These procedures are newer and long term success still needs to be determined.

Prognosis

Most patients improve after treatment with medication. But it can take weeks of treatment before symptoms begin to improve.

Additional Info

National Digestive Diseases Information Clearinghouse

https://digestive.niddk.nih.gov/

American College of Gastroenterology (ACG)

https://www.gi.org/

Chronic cough | Symptoms, complications, diagnosis and treatment

Chronic cough is a cough that lasts eight or more weeks in adults or four weeks in children. Chronic cough is not just an irritation. Chronic cough can interfere with sleep. Severe cases of chronic cough can cause vomiting, dizziness, and even rib fractures. While it can sometimes be difficult to pinpoint the underlying problem behind a chronic cough, the most common causes are tobacco use and asthma. Fortunately, chronic cough usually goes away after the underlying problem is treated.

Chronic cough may occur with other signs and symptoms, which may include:

• Stuffy nose
• Sensation of fluid running down the back of the throat
• Frequent clearing of throat and sore throat
• Hoarseness
• Wheezing and shortness of breath
• Heartburn or sour taste in the mouth
• In rare cases, coughing up blood

The occasional cough is normal – it helps clear irritants and secretions from the lungs and prevents infection. However, a cough that persists for several weeks is usually the result of a medical problem. In many cases, multiple causes are involved. The following causes, alone or in combination, are responsible for most cases of chronic cough:

• Consequences of using nasal drops. When the nose or sinuses produce extra mucus, it can drip down the back of the throat and reflexively trigger a cough.
• Asthma. Asthma-related coughs may come and go with the seasons, appear after an upper respiratory tract infection, or get worse when you are exposed to cold air or certain chemicals or fragrances.
• Gastroesophageal reflux disease . In this general state, stomach acid flows back into the tube that connects your stomach and throat (esophagus). Constant irritation can lead to chronic coughing.
• Infections . The cough may linger after other symptoms of pneumonia, flu, colds, or other upper respiratory infections have gone. A common but underestimated cause of chronic cough in adults is whooping cough.
• Blood pressure preparations. Angiotensin-converting enzyme inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.
• Chronic bronchitis. This long-standing inflammation of the main airways (bronchi) can cause a cough that produces colored sputum. Most people with chronic bronchitis are current or former smokers. Chronic bronchitis is usually part of a spectrum of smoking-related lung diseases called chronic obstructive pulmonary disease.

Less commonly, chronic cough may be caused by:

• Bronchiectasis (impaired airways)
• Bronchiolitis
• Cystic fibrosis
• Laryngopharyngeal reflux (stomach acid drains down the throat)
• Lung cancer
• Non-asphmatic eosinophilic bronchitis (inflammation of the airways not caused by asthma)

If you are a current or former smoker, this is one of your leading risk factors for chronic cough. Frequent exposure to secondhand smoke can also lead to coughing and lung damage. Women tend to have more sensitive cough reflexes, so they are more likely to develop a chronic cough than men.

Chronic cough in Kyiv – private clinic Oberig. Chronic Cough

Cough is a defense mechanism by which your body keeps foreign objects out of your airways and lungs and removes excess mucus and harmful particles from them. Coughing from time to time (for example, when inhaling smoke) is normal, coughing helps prevent the development of inflammation and infection of the respiratory tract. However, an obsessive cough, the presence of a large amount of sputum, a change in its color, the appearance of blood in the sputum are signs of a painful condition. Coughing can also lead to complications such as severe weakness, dizziness, vomiting, urinary incontinence, pain or discomfort in the chest or abdomen, and even broken ribs.

HOW LONG IS A NORMAL COUGH?

In medicine, it is customary to distinguish acute, subacute and chronic cough.

Acute cough lasts less than 3 weeks and is usually associated with a cold (acute respiratory viral infection). As the cold subsides, the cough decreases and gradually disappears. According to statistics, a cough due to a respiratory infection lasts an average of about 15-18 days. The presence of such a cough is a kind of “norm” for this condition.

Subacute cough lasts 3 to 8 weeks. This is usually a prolonged cough after a respiratory infection (the so-called subacute post-infectious cough). Most often, the cough is delayed due to the characteristics of the infectious agent or the properties of the patient’s body. As a rule, it is not dangerous, does not require active treatment and goes away on its own. However, in some cases, such a cough may be a sign of a specific infection, such as whooping cough, or a symptom of a “sleeping” disease. For example, very often bronchial asthma worsens and manifests itself only against the background of a viral infection.

Chronic cough lasting more than 8 weeks. A persistent, prolonged cough, or recurring episodes of it, is a sign of an illness that requires a mandatory visit to a doctor to find out the cause of the cough and prescribe the appropriate treatment. “Red flags” for chronic cough – symptoms that require immediate medical attention: profuse sputum production, purulent sputum, hemoptysis (blood in the sputum or “rusty” color), fever, severe weakness, sweating and weight loss, shortness of breath, ” whistle” in the chest. With the right approach, in the vast majority of cases, you can effectively get rid of an obsessive, exhausting chronic cough.

WHICH DISEASES ARE THE MOST COMMON CAUSES OF CHRONIC COUGH?

Contrary to expectations, the most common cause of chronic cough is not chronic bronchitis. Most often, chronic cough is associated with pathology of the upper respiratory tract (rhinitis, sinusitis), bronchial asthma and asthma-like diseases, as well as gastroesophageal reflux disease.

Cough syndrome of the upper respiratory tract is a pathology of the nose and paranasal sinuses (rhinitis, sinusitis), in which chronic cough is caused by irritation of the respiratory tract by mucus flowing down the back of the pharynx from the nasal cavity and causing inflammation. In addition, the presence of constant inflammation and accumulation of mucus in the nose “overexcites” the cough center in the brain, it becomes overly active and “works” in the form of a cough to the most insignificant stimuli. Symptoms of cough syndrome of the upper respiratory tract are: a feeling of mucus running down the back of the throat, nasal congestion, difficulty in nasal breathing and a runny nose, a sensation of “tickling” and a foreign body in the throat and nasopharynx, the need to often clear the throat.

Bronchial asthma (BA) is a chronic inflammatory disease manifested by episodic narrowing of the bronchi (bronchospasm). Typical manifestations of asthma are choking (shortness of breath, shortness of breath) and wheezing in the chest, but coughing may be the only symptom. Attacks of coughing and shortness of breath in asthma are usually seasonal (especially during grass flowering), often follow a respiratory infection, and may occur in response to exposure to “triggers” (provoking factors) – cold and dry air, strong odors, smoke, dust and various allergens (for example, hair and dander of pets). A very common is the “cough variant” of bronchial asthma, in which the patient coughs a lot and for a long time, but does not have attacks of suffocation or difficulty breathing.

Non-asthmatic eosinophilic bronchitis is the same inflammation of the bronchi as in asthma, but without constriction of the bronchi. The main symptom of the disease is a dry cough.

Gastroesophageal reflux disease (GERD) is the reflux of gastric juice into the esophagus, larynx and even bronchi. The hydrochloric acid and digestive enzymes contained in it cause pronounced irritation and inflammation of the mucous membrane. GERD often presents with heartburn, a feeling of stomach contents back up into the esophagus (the medical term is regurgitation), and a sour taste in the mouth. However, in a significant proportion of cases, cough is almost the only symptom of the disease.

WHAT OTHER DISEASES CAN CAUSE CHRONIC COUGH?

Other possible causes of chronic cough include: smoking, taking certain drugs for the treatment of arterial hypertension (angiotensin-converting enzyme inhibitors), occupational or household hazards, chronic bronchopulmonary infections (bronchiectasis, cystic fibrosis), pulmonary tuberculosis, interstitial lung disease, tumors of the lungs and bronchi, foreign body in the respiratory tract, heart disease and heart failure, neurological pathology, psychogenic causes.

HOW ARE SMOKING AND CHRONIC COUGH RELATED?

Smoking is not only one of the most common causes of coughing, but also exacerbates the condition in the presence of other diseases that cause coughing. So-called “smoker’s cough” is usually associated with chronic bronchitis or chronic obstructive pulmonary disease.

Chronic bronchitis is an inflammation of the bronchial mucosa caused by long-term exposure to harmful factors, among which the most important is cigarette smoke. The main symptom of chronic bronchitis is a prolonged cough (for 2 years – persistent or episodes of more than 3 months) with the presence of sputum, which can be either transparent or colored – white, yellow or green. Very often, the diagnosis of chronic bronchitis is made in patients with any chronic cough. And just as often it is done wrong. If you have been diagnosed with chronic bronchitis, but you do not smoke, do not have other harmful inhalation exposures (for example, professional ones), if the cough is predominantly dry, and the duration of the disease is less than 2 years, you most likely have another cause of coughing. According to all medical canons, the correct diagnosis of chronic bronchitis is possible only when other, more common causes of cough (for example, GERD, asthma, or upper respiratory tract cough syndrome) are excluded.

Chronic obstructive pulmonary disease (COPD) is an inflammation of the airways, also predominantly associated with smoking, causing permanent narrowing of the airways (bronchial obstruction). COPD presents with cough, shortness of breath, and shortness of breath. Changes in the bronchi and lungs in this disease are irreversible and steadily progressive, but worsening of the condition can be prevented if smoking is stopped.

Smoking does not exclude the presence of other causes of chronic cough, such as bronchial asthma, GERD and others. Many smokers who have a chronic cough do not seek medical help, associating the cough with smoking, but during the examination, the doctor may identify another disease that requires treatment.

SHOULD I STOP SMOKING?

Successful treatment of diseases caused by smoking is not possible while the patient continues to smoke. After quitting smoking, the cough usually disappears after 4 weeks, but may continue for several months. If the cough persists for a long time or has changed after quitting smoking, you should consult a doctor to find and treat other causes of the cough. On the other hand, even the correct treatment of the disease that caused the cough may not completely eliminate the symptoms without stopping smoking. Smoking causes a deterioration in respiratory function in all people, and vice versa, smoking cessation leads to an improvement in respiratory function and an improvement in well-being in everyone, regardless of gender, age, smoking history and the presence of concomitant diseases.

CAN THERE BE SEVERAL CAUSES OF CHRONIC COUGH AT THE SAME TIME?

Yes, it is common for a patient to have multiple coughing conditions in the same patient. A combination of two or even three of the most common causes of cough (upper respiratory cough syndrome, bronchial asthma or eosinophilic bronchitis and GERD) is as common as a single cause.

HOW CAN YOU DETECT THE CAUSE OF CHRONIC COUGH?

To find out the cause of the cough, it is imperative to consult a doctor. In most cases, with the help of special studies and targeted treatment, the causes of chronic cough are successfully identified. Often, the effectiveness of a trial course of treatment is the main diagnostic criterion in making a diagnosis. In some cases, an advanced diagnostic program is required.

WHAT DIAGNOSTIC TESTS CAN BE USED?

The following diagnostic methods are used to diagnose the most common causes of cough: spirometry, bronchoprovocation test, chest x-ray, sputum examination, as well as x-ray of the paranasal sinuses, ambulatory monitoring of acidity in the esophagus (rarely used), esophagogastroscopy, bronchoscopy, x-ray contrast study stomach, computed tomography of the lungs and others.

Chest X-ray is a mandatory diagnostic measure for any type of cough, as it allows you to identify or exclude obvious bronchopulmonary causes, including life-threatening diseases such as tuberculosis and lung tumors in the early stages.

Spirometry is a respiratory function test that detects bronchial obstruction (bronchial constriction) in many diseases of the lungs and bronchi. With spirometry, the volume of air exhaled by the patient during forced (“enhanced”) exhalation and the air flow rate are measured. Spirometry is the “gold standard” in the diagnosis of diseases such as bronchial asthma and chronic obstructive pulmonary disease.

If asthma is suspected, but spirometry results are normal, this does not mean that the disease is not present. In this case, a bronchoprovocation test is required – a series of consecutive inhalations of a specific medicinal substance and subsequent spirometry tests. With the help of such a medicinal substance, some narrowing of the bronchi is provoked in people with asthma, but this does not happen in healthy people. If the bronchoprovocation test is negative, bronchial asthma can be ruled out with a high degree of probability. Microscopic examination of sputum allows you to assess the nature of inflammation in the bronchi. In most cases, including dry cough, the use of sputum induction is required – inhalation of a saline solution using a nebulizer inhaler to stimulate sputum discharge.

IS CHRONIC COUGH TREATABLE?

Yes, in more than 90% of cases, the cough disappears completely or is significantly reduced as a result of adequate treatment. The key is to identify the cause of the cough and apply the right treatment program. Sometimes, especially in the treatment of asthma and GERD, it takes a long time (up to several months) to achieve the full effect. Consistent and regular implementation of the doctor’s recommendations is important. Also of great importance is a persistent change in habits and lifestyle – quitting smoking, changing diet and diet, limiting contact with allergens, stopping certain drugs.

WHAT ARE THE TREATMENTS FOR THE MAIN CAUSES OF CHRONIC COUGH?

Cough syndrome of the upper respiratory tract : antihistamines and topical vasoconstrictors in the nose. A common mistake is to prescribe new non-sedating antihistamines that are ineffective for this condition (except for allergic rhinitis). Numerous clinical studies have proven antitussive efficacy only for 1st generation antihistamines.

Bronchial asthma and eosinophilic bronchitis : inhaled glucocorticosteroids are essential and main drugs for the treatment of asthma. These are hormonal anti-inflammatory substances that are administered by inhalation, that is, they are inhaled in the form of a powder or aerosol, and act directly in the bronchi. They were specifically designed to prevent “hormonal” side effects, so unlike the tablet and injectable forms of hormones, they are very safe. This has been proven by numerous clinical studies and extensive worldwide application experience over many decades.

Gastroesophageal reflux disease : antisecretory drugs are the first choice (proton pump inhibitors), prokinetics and antacids may also be added to reduce reflux and eliminate its effects. It is extremely important to follow dietary recommendations and modify habits (refusal to rest in a horizontal position after eating, raising the head of the bed, etc.).

CAN CHRONIC COUGH BE ASSOCIATED WITH PSYCHOLOGICAL PROBLEMS OR HABIT?

Yes, such cases are possible, but very rare. The diagnosis of psychogenic cough or habitual cough can only be considered after excluding all possible more frequent and more dangerous causes, if it seems justified to both the doctor and the patient himself. If the patient is concerned about coughing and the cause cannot be determined despite efforts, it can cause depression and anxiety, so these conditions may accompany the cough rather than provoke it.

IS A COUGH CONTINUOUS?

In most cases, no, unless the cough is caused by an infection.