Allercy and Asthma Health
The Official Publication of AAN - MA

Does My Chronic Cough Mean I Have Asthma?

By Jakki Grimball, RRT, AE-C, PAHM

Having a chronic cough can be annoying and exhausting. It disturbs sleep, makes public speaking difficult, and wears you out.

A cough that lasts more than three weeks is known as a chronic cough or persistent (continuous) cough. Often, a chronic cough is a sign of bigger problems than a cold. The cough could be related to smoking, postnasal drip, allergies, asthma, chronic bronchitis (a component of chronic obstructive pulmonary disease, or COPD), or gastro esophageal reflux (GERD). Fortunately, chronic or persistent cough often disappears once the proper diagnosis is made and treated.

Most common cause

GERD, with or without heartburn, is most often the cause of chronic cough. GERD, also known as acid reflux, results from stomach acid flowing back up the esophagus. This causes a “burn” that turns on mucus in the back of the throat. This mucus then flows over the vocal cords, causing coughing.

If your doctor suspects GERD, diagnostic testing will be ordered, and if you are diagnosed with the condition, medication treatment options for GERD will be ordered by your doctor or a gastroenterology (GI) specialist. Your doctor may have you try over-the-counter medications prior to testing. Young children can also have GERD.

Postnasal drip is most often caused by allergies. When your nose or sinuses produce a lot of mucus it drips down your throat and triggers the cough reflex. Untreated allergies and postnasal drip can also make diagnosed asthma worse. Antihistamines, nasal sprays, and decongestants are often prescribed to treat allergies and postnasal drip. Allergy testing by a specialist may be necessary for an accurate diagnosis and treatment.

Other reasons for chronic cough

An asthma-related cough may come and go with the seasons. However, in cough-variant asthma, the persistent dry cough may be the only symptom. People with cough-variant asthma may have no other asthma symptoms, except the cough is often noticed at night.

Diagnosing cough-variant asthma is often accomplished with spirometry testing. Some physicians prescribe asthma medications to check for this type of asthma. If the cough improves with the medication, you may be diagnosed with cough-variant asthma.

Chronic bronchitis, or COPD, is most often caused by cigarette smoking over time. It causes chronic inflammation in your airways, which causes the persistent cough. Spirometry testing is the best way to diagnose COPD, along with a medical examination and past medical history. Secondhand smoke exposure over a prolonged period of time can also cause chronic bronchitis.

Some medications used to control high blood pressure can also cause chronic cough. ACE inhibitors and beta blockers are the most common blood pressure or heart medications that cause persistent coughing. Talk to your doctor if the chronic cough you are experiencing started after you were prescribed these medications. There are many alternative medications that can be used.

When to see a doctor

If you or your child has been coughing continuously for over three weeks, it is time to see a doctor. Not all chronic coughs are related to asthma. Your physician can order the appropriate tests for an accurate diagnosis and treatment. You should never give children under four years of age over-the-counter cough and cold medications without first checking with the doctor.

Respiratory therapist Jakki Grimball is a member of the American Association for Respiratory Care who is a disease management supervisor for BlueChoice HealthPlan in Columbia, SC.
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