Chicago Health | Homepage
Novel treatments for unexplained persistent coughing

Novel treatments for unexplained persistent coughing

The Medicine Cabinet: Ask the Harvard Experts

By Howard LeWine, M.D.

Q: I cannot get rid of this cough. I don’t smoke. My lung tests and chest X-ray are normal. I tried inhalers, acid blockers and nasal decongestants without any improvement. What else can I do?

A: Based on your question, your doctor has considered the most common causes of a persistent cough: reactive airways disease such as asthma, post nasal drip and acid reflux.

A less common condition that can cause a persistent cough is nonasthmatic eosinophilic bronchitis. The diagnosis is made by looking at a sputum sample under the microscope. It shows a lot of white blood cells called eosinophils.

You mention that you have tried inhalers. I suspect that one of them contained a corticosteroid. If not, that is something you should consider as a treatment for eosinophilic bronchitis.

Some medicines can cause a constant throat tickle and cough. It’s a common side effect of the blood pressure drugs known as ACE inhibitors like lisinopril and enalapril.

Most likely you have what doctors now call “unexplained chronic cough” — the term used to describe the 5 percent to 10 percent of people with no specific reason found for their ailment.

In the January 2016 journal Chest, a panel of experts published recommendations on the treatment of unexplained chronic cough. The experts reviewed prior medical studies to look for evidence-based therapies. They found two. One is a drug called gabapentin. The other is speech therapy.

Gabapentin was originally developed as an anti-seizure drug. However, now it is used primarily to help treat chronic pain, especially nerve pain. It’s not known how gabapentin helps decrease coughing. Most likely it acts by calming nerves that trigger coughing in some people.

The main side effect of gabapentin is sleepiness. So the drug should be started at a low dose at night and increased gradually.

If you wish to pursue speech therapy, be sure the person has experience in treating chronic cough.

(Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)

(c) 2016 PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.

Similar Articles

Can you be held responsible for your parents’ long-term-care costs?

Can you be held responsible for your parents’ long-term-care costs?

By Eleanor Laise, Kiplinger Retirement Report When an older adult racks up unpaid long-term-care bills, who's

Rare syndrome causes overly flexible joints, fragile skin

Rare syndrome causes overly flexible joints, fragile skin

Mayo Clinic Q&A DEAR MAYO CLINIC: I was recently diagnosed with vascular Ehlers-Danlos syndrome. My doctor

Low risk of staph infection from pets

Low risk of staph infection from pets

The Medicine Cabinet: Ask the Harvard Experts By Howard LeWine, M.D. Q: I have been taking care

When a cough just won’t go away

When a cough just won’t go away

By Monique Tello, M.D., M.P.H. Harvard Health Blog Who has never had a cough? I bet no

Eating resolutions to keep, ditch

Eating resolutions to keep, ditch

By Breana Lai, M.P.H., R.D. Many of us vow to get healthier as a New Year's

Articles By Category

Family Health

In The Know

CH Lifestyle

January 2017
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
December 25, 2016 December 26, 2016 December 27, 2016 December 28, 2016 December 29, 2016 December 30, 2016 December 31, 2016
January 1, 2017 January 2, 2017 January 3, 2017 January 4, 2017 January 5, 2017 January 6, 2017 January 7, 2017
January 8, 2017 January 9, 2017 January 10, 2017 January 11, 2017 January 12, 2017 January 13, 2017 January 14, 2017
January 15, 2017 January 16, 2017 January 17, 2017 January 18, 2017 January 19, 2017 January 20, 2017 January 21, 2017
January 22, 2017 January 23, 2017 January 24, 2017 January 25, 2017 January 26, 2017 January 27, 2017 January 28, 2017
January 29, 2017 January 30, 2017 January 31, 2017 February 1, 2017 February 2, 2017 February 3, 2017 February 4, 2017

Categories

Recent Comments

Swing for the fences in the fight to Sideline Pancreatic Cancer

Swing for the fences in the fight to Sideline Pancreatic Cancer

Enjoy a great night of baseball at Peoples Natural

VIEW ARTICLE
Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

A Hazy Shade of Healthcare: What does tort reform

VIEW ARTICLE

Archives