Coughing Again? It Could be More Than a Cold

When it seems like your constant cough has no cause, Brian Rotskoff, MD, suggests thinking outside the cold medication box


Chicago, IL, Jan. 8, 2014 (GLOBE NEWSWIRE) -- It's that time of year again. Right after New Year's when the temperature seems to drop as low as it can go, like clockwork, your annual winter cough returns. Each year you suffer through the cough spells, sore throat, and chronic throat clearing, futilely treating your "winter cold" with cough syrup and endless throat lozenges.

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According to Chicago allergist and chronic cough specialist, Brian Rotskoff, MD, there may be a very simple reason why your cold medicine isn't making a dent in your cough. As an expert in chronic cough, he knows that a chronic cough is rarely caused by a simple cold. With increasing prevalence, Dr. Rotskoff is seeing patients from around the country who are suffering from more complex cough conditions such as cough receptor hypersensitivity syndrome, or laryngeal sensory neuropathy (LSN).

"Rarely is a cough just a cough," explains Dr. Rotskoff. "It's usually indicative of something else going on in the body. We all have a cough threshold that, if crossed, will trigger a cough. People with cough receptor hypersensitivity syndrome [or LSN] have a significantly lower cough threshold."

A 3-in-1 approach to chronic cough

The three most common causes of chronic cough are acid reflux, asthma, and post-nasal drip. When diagnosing the cause of your symptoms, these three factors need to be taken into account. "It's sort of a 3-in-1 approach," explains Dr. Rotskoff.

When a patient comes to Clarity Allergy Center in Chicago complaining of chronic cough, chronic throat clearing, or hoarseness, Dr. Rotskoff examines the overall health of that patient. Taking on the perspective of a gastroenterologist looking for acid reflux, an ENT doctor examining the affected larynx and voice box, an allergist diagnosing allergies, or a pulmonologist treating asthma, Dr. Rotskoff explores all the possible triggers of cough.        

"As a doctor, my number one focus is the health of my patients," says Dr. Rotskoff. "Even though I specialize in treating breathing, sinus, and allergy conditions, I examine my patients as a whole. Everything in the human body is interrelated, like a cause-and-effect puzzle. My job is to connect the two."  

Which symptom first?

"You can have a combination of things that could be triggering the cough at one time," explains Dr. Rotskoff. "For example, asthma may trigger the cough during one episode. Another episode could be mainly acid reflux. But until you treat the cough hypersensitivity disorder, no other treatments will work."

Because cough is the primary condition, Dr. Rotskoff will prescribe a neuropathic medication to "turn off" the cough reflex. From there, he can isolate each cough trigger and tailor treatment.

If it's not post-nasal drip, asthma, or acid reflux...

Acid reflux is a major contributor to cough receptor hypersensitivity syndrome, even though it is sometimes harder to find. Silent reflux, or laryngopharyngeal reflux (LPR), is a condition in which stomach acid backs up into the throat (pharynx) or voice box (larynx) and pools in the nasal airways. For those with silent reflux, the signs of acid are almost undetectable, but chronic cough, hoarseness, chronic throat clearing, post-nasal drip, sore throat, and trouble swallowing are all symptoms of the disorder.

You may not have realized it over the holidays, but indulging in the rich foods and drinks aggravates your stomach acid and pushes you to the edge of your cough threshold.

How to treat silent reflux

If stomach acid is the cause of your chronic cough, you may already be on the right track for treatment. Dr. Rotskoff advises certain New Year's resolution-esque changes, such as losing weight, quitting smoking, avoiding alcohol, and removing certain foods from your diet to minimize acid.

Add seeing Dr. Rotskoff to your list of New Year's resolutions. Getting to the bottom of what is making you cough, can change your whole outlook for 2014.  



            

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