How is chronic cough treated?
How is chronic cough treated?
Your healthcare provider will discuss a treatment plan that will be based on your needs and the cause of the cough.
Possible treatments include new or different medications. If you are having chronic cough due to ACE inhibitors, your doctor might prescribe a different type of medication for your high blood pressure. It’s important to note that you shouldn’t just stop taking a medication without discussing it with your healthcare provider or pharmacist.
Drug treatments for asthma include inhaled bronchodilators and/or steroids. These drugs help reduce airway inflammation and wheezing.
For infections such as bacterial pneumonia or bronchitis, your provider might prescribe antibiotics, such as azithromycin (Azithrocin®, Zithromycin®), cefuroxime (Ceftin®) or cefprozil (Cefzil®), are prescribed.
For some conditions, like GERD, your provider might suggest a combination of non-drug treatments and prescription medications. Non-drug treatments include:
- Using pillows to prop up your head when you're lying down.
- Avoiding foods that cause acid reflux (such as chocolates, colas, red wines).
- Not eating right before bedtime.
Prescription medicines that treat GERD by reducing stomach acids include:
- Cimetidine (Tagamet®).
- Famotidine (Pepcid®).
- Ranitidine (Zantac®).
- Esomeprazole (Nexium®).
- Lansoprazole (Prevacid®).
- Omeprazole (Prilosec®).
If the cause is post-nasal drip, over-the-counter decongestants, such as diphenhydramine or pseudoephedrine, may help relieve symptoms. Antibiotics may be prescribed if the cause of the chronic cough is sinusitis. Nasal spray, such as ipratopium (Atrovent®) can relieve a runny nose, sneezing and post-nasal drip. A nasal glucocorticoid, such as fluticasone (Flonase®), can also reduce post-nasal drip.
In the case of unexplained chronic cough (UCC), your healthcare provider might suggest that you see a speech/voice pathologist. Voice therapy for coughing is called behavioral cough suppression therapy (BCST).
The therapy will start with education and by explaining cough hypersensitivity reflex — that some people just cough more easily because their body is more sensitive to things that make people cough. Many people with UCC have triggers that make them cough like talking or laughing, environmental stimuli like sprays or aerosols, and even smaller changes in air temperature or the position of the body (laying down or bending over) bother these more sensitive people. BCST teaches you how to control the urge to cough through various behavioral techniques.
In therapy, you will learn how to do other things with the muscles you use for coughing. Those are the muscles that bring your vocal cords together, along with the muscles in your throat used for swallowing and breathing.
There are other next-level treatments for UCC such as oral medications:
- Neuromodulators (amitriptyline, gabapentin) or tramadol, a pain reliever.
- A superior laryngeal nerve block with steroids.
- Laryngeal onabotulinumtoxinA (Botox®) injections.
Sometimes more holistic treatment such as acupuncture can also be helpful. If other treatments have failed and the chronic cough is severe, a cough suppressant such as codeine may be prescribed.