Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
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The Persistent Dry Cough....What the heck is it?
Posted in Asthma by Dr. Sharon Orrange on Oct 08, 2008
A complaint of a dry cough that won't go away brings many of you in to the physician's office. The 3 most common causes of cough lasting more than 3 weeks in adults are: gastro esophageal reflux disease (GERD), post-nasal drip from allergies, and reactive airway disease (asthma). Many of us, however, worry that it could be something more sinister. Let me try and talk you out of worrying that your cough is really caused by one of the following illnesses:

1) Pneumonia: People in my office worry about viral, bacterial and fungal causes all of which are unlikely in the absence of other symptoms like fever, body aches, fatigue, and shortness of breath....in other words you should feel SICK.


Is it a Cold, Flu, or Allergies?
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2) Tuberculosis: Unlikely unless you also have night sweats, weight loss and fatigue but it's a good thought especially if you were just travelling in a less developed country or where I work in East Los Angeles.

3) Lung Cancer: Could be, but you should also have a history of smoking, blood tinged sputum, pain in the chest, or weight loss. Asbestos exposure would make your concerns even more valid.

4) Blood clot in the lung (pulmonary emboli): Unlikely unless you also have swelling in one of your legs (a deep venous thrombosis which would be the source of your lung clot), blood tinged sputum, or you get winded easily. A sharp pain in the chest that's worse when you take a breath in (pleuritic chest pain) would also be a good thing to worry about.

5) Pulmonary fibrosis/ Interstitial Lung Disease: Unlikely unless you have shortness of breath when you exert yourself and when you lie down at night or unexplained weight loss.

6) Mass in the upper airway: It could be, since a lesion that compresses the upper airway could give you a cough but that would be so unlucky and possibly reportable in the medical literature.

7) Foreign body in the ear: The "ear-cough" could be the cause of your cough if you have a foreign body or wax irritating the external auditory canal which leads to your cough by stimulation of the vagus nerve.

8) Sarcoidosis: Before you worry about this you should look out for chest pain, shortness of breath, skin or eye lesions and maybe even joint pain.

9) Medication side effect: This could be your issue particularly if you are on an Ace Inhibitor (Lisinopril, Enalapril, Ramipril, etc). An annoying dry cough is a very common side effect of Ace Inhibitors so ask your doctor about this.

As someone who has waves of hypochondriasis I have talked myself in to a few of these..... but kidding aside, the symptom of cough is responsible for 30 million physician visits a year in the United States, so we don't mind if you come in to see us to check it out.

- Dr O.

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28
This dry persistent cough sometimes accompanied by a slight fever which lasts "forever" could also be a symptom of exposure to so-called chemtrails. Google and Youtube this term "chemtrails" to find out more about it.
By Osiyo  Sep 20, 2013
27
At the top of this list should be PERTUSSIS. After three weeks of mis-diagnosis, I was tested positive for pertussis. My symptoms were: heavy chest and uncontrollable coughing every 1 - 5 minutes. The first week they told me it was "just" bronchitis and that the cough would go away; I was not contagious. Week two, it turned into pneumonia, so I was given a z pack to treat the pneumonia. Week three, I finally got a woman Dr who thought I should be tested for pertussis. After almost a week of waiting, the test came back POSITIVE.
Let me tell you what DOES NOT work. Cough medicine, either over the counter or prescription, it only makes you cough more and harder, cough drops, MusinexDM. Prescription strength ibuprofen is the only thing that will give you respite from the cough for up to four hours. After I was diagnosed positive, they also gave me a two-day prescription for Dexamethasone, which really helps supress the cough.
If you experience these symptoms, strongly urge your Dr to run this test for you, before you infect everyone you know, like I did.
By lesbeck  Jul 05, 2009
26
1-02-09
Dear Dr. O. Thank you for your articles. Very interesting and helpful.
Your thoughts on mold and fungi infections. I was exposed to serious mold and didn't handle it properly. Soon after I started to get white foam in my mouth. Pure white and sometimes thick white like beaten egg whites.

After no luck with my doctor who kind of blew it off and hundreds of hours searching the internet, over a period of 2-1/2 years, I finally came across information that made sense.

www.knowthecause.com by Doug Kaufmann on FUNGI and MOLD infections.
Another site used by doctors www.drfungus.org and click on human link.

Mind blowing information.

I hope you get a chance to check it out.

I have been using a nasal spray with grapefruit seed extract in it by Nutribiotics. I will not use OTC sprays with rebound effects. It doesn't work as quickly on a stuffy nose like the OTC sprays but I think killing the fungi is more important. Be patient.

I want to kill the fungi/mold infection. I have started using Olive Leaf by a company recommended by other great doctors with terrific sites like yours. www.SeagateProducts.com I hope your readers will take the time to investigate the MOLD/FUNGI CONNECTION to Asthma, lung and a host of other medical issues.

It's taken me going on 4 years now to find a solution to my Candida Yeast Overload Infection and I do have to go on a strict diet avoiding all sugar, yeast products ect. all listed in books by Doug Kaufmann found on his Know the Cause website or Amazon.com.

I have made some changes to my diet but I have to commit to a few months of strict diet changes.

Happy New Year to you and all your readers for taking control of your own health.

Regards, LucyEbony
By lucyebony  Jan 02, 2009
25
I have had a dry cough with yellow and white phlegm for about 8 or 9 months. I live in alaska and went to the medical center nearby. First they suggested walking bronchitis, then allergies but nothing they gave me ever helped. I have been running and lately especially with the cold I have been coughing more and felt like my lungs were burning after being outside for a while. I have had some shortness of breath, and aches.
I was concerned about TB because I recently spent close to 6 months in Guyana and was exposed to it(some neighbors had it). I have not really had any fevers though so I figured it might be something else. I don't really want to go back to the med center though because they have not helped me so far. It doesn't seem like it is getting worse quickly but it is annoying! I have had pneumonia several times in the past and know it is not that. Also with my running more I would expect my lungs to improve but they don't seem to be?? Any advice or suggestions?
By amydugas  Nov 10, 2008
24
I need to submit an edit to post #23. It was not restrictive pericarditis but constrictive pericarditis.
By Drasan  Oct 24, 2008
23
I had a persistant cough when I was a teenager. My doc chalked it up to nerves. Well it persisted and one year later I was in the emergency room because I passed out. Later that day I had heart surgery for restrictive pericarditis. Now, I know this is very rare, especially for a sixteen year old girl.

Sometimes a persistant cough can be a clue and I worry that, like my doc, others may dismiss a symptom because it is so common.
By Drasan  Oct 24, 2008
22
I have had a dry cough for years now. I have gone to 6 differnt pulmonolgist and they all say I have ILD. I have just arrived at the Mayo Clinc and they are running test on me. So far they can't see what the other doctors see. They are running a battery of test. They only thing they have found so far is that my blood gas level comes back low. But nothing else. I have been to University of Michigan and the CLeveland clinic, how can one doctor say he does not see anything and others say something differnt.

Ilene
By bamababe  Oct 19, 2008
21
Been to see my Mdoc in the past 2 weeks after having a dry, tickly cough, that also felt a bit wheezy after getting over a Sinus Infection 4 weeks prior.

He added Atrovent Nasal Spray to help dry stuff up, and it helped relieve the cough from the Post Nasal Drip! Already on Zyrtec and Singulair, plus added in some Benadryl on top of it.

Allergies are out of control in Ohio right now! My son has this dry cough now, and I added Mucinex to his regime with some results. He's on Zyrtec too. Try to give him a squirt or two of the Nasal Spray, but he doesn't like it, but he plays football, and all the dust and pollen in the field get all kicked up when he practices and plays too.
By TLCDaisy  Oct 16, 2008
20
Thank you Dr. O to your response (#16) below to my questions (#14). Doug W
By DougWeeks  Oct 15, 2008
19
My husband suffered from a dry, hacking cough for many months, until one of his doctors told him it was a side effect of one of his medications. The medication was switched to another one, and voila, the cough is gone.
By flip12flop  Oct 13, 2008
18
I have asthma and allergies I have the dry cough a lot in the morning and at night. I also have gastritis and I keep a glass of water on my nightstand at night and I try to prop my pillow up at night. I also take prilosec and if i dont take it I end up throwing up after I eat and it just burns and hurts so bad.
By meganK08  Oct 13, 2008
17
Dr. O, I have found that sometimes I have a dry cough when I am thirsty. Right now I am on 4 different meds that couse dry mouth, so I feel dehydrated, especially in my mouth and throut most of the time. I try to drink more water but don't always accomplish this. This is a side effect problem, but at least I understand that.
By dlbaker  Oct 11, 2008
16
Hey you guys
1) the Proton Pump inhibitors (omeprazole which is prilosec, nexium prevacid, protonix, etc) are used to treat the dry cough believed to be from reflux (GERD) and can be taken long term. There are studies done on elderly (over 70) patients in nursing homes that show some bone loss with long term proton pump inhibitor use.
2) For the dry cough from post nasal drip the intranasal steroid sprays are used (flonase, nasacort, nasonex) and will relieve the cough...you can also try an over the counter non sedating anti-histamine like claritin or zyrtec.
Dr O.
By DrOrrange  Oct 11, 2008
15
He smoking too much weed LOL
By Danny08  Oct 11, 2008
14
I have both GERD and post nasal drip. Is it OK to take Omeprazole daily year after year? When I take Omeprazole I don't have the tickle in the throat that makes me want to cough.

As for the post nasal drip, what can alleviate that? It really affects my voice. I love to sing, but the gunk makes my voice scratchy.
By DougWeeks  Oct 11, 2008
13
I have had a cough for over a year with phlem that gets caught in my throat that i cant cough up. The doctor keeps giving me antibotics.Please help me.
By terri1965  Oct 10, 2008
12
I have had this cough my entire life. I grew up in a house filled with smokers and I had chronic bronchitis and pneumonia a few times as a child. I have carried this cough into my adulthood and still suffer with it. I never test positive for allergies but am sensitive to many seasonal things. I believe I actually have had mild form of asthma but never diagnosed, I also have chronic post nasal drip and repeated sinus infections. I now am fighting an allergy that presents itself as patches on my face that are in my eye corner and lid. I am sure if I did nothave this exposure to breathing a smoke filled house when I was a child I would not have these problems today.
By desrtrse  Oct 10, 2008
11
I had the persistent cough for 5 months. I was treated with cough meds. a course of steroids, then was sent to a ENT man, was treated for GERD. I had no shortness of breath, no chest pain, no swelling or pain in the legs. Bottom line and the straw that broke the camel's back was flying home from a vacation overseas the pain in my chest as severe when coughing. I just thought I had gas pains and endured the 14 hour flight. Next day I spit up small amounts of blood. Immediately called my internist was took various test. Dimmler test which showed I had something going on in my lung. Xrays, scans etc. were then taken. Sure enough I had a PE and also a DVT in left calf. I believe my cough was something to do with the clot to this day. I was on Warfarin for 6 months and then retested on DVT and there is no sign of it now. I am off the Warfarin and now taking a baby aspirin daily. I am a 66 year old very active lady, a runner for 30 years, a yogi, a gym rat. Maybe all that has helped.
By tucstan  Oct 10, 2008
10
I love the straight-forwardness, but yet factual information you give along with your sense of humor! I've oftentimes wondered if I too didn't have waves of hypochondriasis while studying! I would like to know more about this "ear cough" though. I call it "itchy ear-syndrome." It's like the inner part of my ear itches all the way down to the back of my throat which causes anywhere from a minor, yet persistent cough that could last anyway from 15 seconds to five minutes, to an all out coughing fit----to the point of running eyes and coughing until you almost choke!

So exactly what kind of "foreign body" could possibly be in the ear to cause this besides ear wax???
By Shantiann  Oct 10, 2008
9
Good article. I have allergies and gerd, and have been plagued with a dry cough for years and years.
By BlazePurraCat  Oct 09, 2008

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