Why am I always coughing in NYC?

“Why am I always coughing? Is it Allergy? Is it Asthma? Do I have an infection? I took 2 courses of antibiotics but it did not go away, so I had a chest X-ray, which was normal. I took allergy medication, and it still did not go away. My doctor gave me inhalers to treat asthma and the cough is still there. The only thing that helps is cough syrup, but I am tired of taking that. Some days I feel better and I think the problem has resolved, but the next day the cough is back.”

Does this history sound like you? As a physician I see patients with this complaint 3-4 times per day. They often try multiple treatment regimens for a variety of diagnosis with no resolution to the symptoms. The reason is simply that the diagnosis is wrong. Dry coughs are not typical of infection and without other allergy symptoms (congestion, itchy eyes, sneezing and runny nose) the problem is usually not allergy. Throwing medications at the symptoms does not manage the cause. The cause in most cases is acid reflux (LPR). Laryngeal reflux is usually not associated with indigestion and heart burn, thus the diagnosis is not an obvious one. When acid comes up into the back of the throat, there is a localized swelling behind the vocal cords and thick mucous often coats the area to prevent ulcers. The swelling causes a constant tickle in the throat and an annoying cough. Symptoms of post nasal drip and throat clearing may be associated, but not always.

You may try an over the counter reflux medication taken daily in the morning. Avoid eating late at night, cut down on highly acidic foods and elevate your head of bed. For some, without the medication the cough can return. You can follow up with an Ear, Nose and Throat specialist at Madison ENT & Facial Plastics in New York City for an exam and help with a treatment regimen. To request an appointment call (212) 213-3339.