Chronic cough a common problem
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| Dr. George Vraney examines Richard Jay, one of his patients. |
“As we build our homes more air-tight and energy efficient, we no longer have the air exchange we used to have,” says Dr. George Vraney, a specialist in breathing disorders with Medical Specialty Clinic, P.C. “All of the chemicals we use in our homes now environmentally stay there, and this causes serious levels of nasal damage.”
Over a period of time, as the nose is constantly being irritated, coughing develops, Dr. Vraney says.
Chronic coughing – a cough that lasts several weeks at a time and reoccurs several times a year – is one of the most common reasons that people see a primary care physician, he says. “Thousands of people go to the doctor every day complaining of coughing.” Though many different factors can lead to coughing, the most common are gastrointestinal reflux disease and upper respiratory problems and asthma.
Your nose acts as your body’s air conditioner, Dr. Vraney says. A moist, thin layer of tissue called the mucous membrane “filters, heats and humidifies the air before it reaches your lungs at 98 degrees and 100 percent humidified.” A buildup of irritants can stimulate your body’s cough reflex and cause problems if the coughing is constant. (The ability to cough, by the way, is an important part of normal lung function as it allows the body to get rid of particles and secretions.)
“We take our nose for granted,” Dr. Vraney says. “Marketing has convinced us that we need to have our house smelling clean or a favorite scent in our homes. We are bombarded with the need to purchase scented products.”
If you seem to be coughing a lot, get rid of some of those extra smells in your home environment, he says.
“You don’t need a powerful scent to tell you that your floors are clean. Get rid of the strong-smelling bleach and cleaners. Avoid burning scented candles, which probably are the single biggest offenders.”
Another common cause of chronic coughing is gastrointestinal reflux disease, Dr. Vraney says. When you lie down, small amounts of gastric juices come up the esophagus, causing an irritation or a low-grade burn to the trachea and vocal chords. The amount may be so small that it may not even wake you up.
Reasons to suspect reflux as the cause of your chronic cough are recent weight gain and heartburn or indigestion, he adds.
He suggests these steps to avoid reflux…
• Go to bed with an empty stomach; eat three to four hours before bedtime.
• Elevate the head of your bed.
• Reduce the acidity of the foods you eat. Avoid alcohol, caffeine, chocolates and mints before bedtime. (Favorite ways to end a late dinner, complete with mints and a chocolate dessert, are the very foods that contribute to reflux, Dr. Vraney points out.)
• Take medication to decrease acidity in your stomach.
If your chronic cough is caused by reflux or strong smells in your environment, it may take several months for your cough to go away.
Meanwhile, make sure any physical exam at your doctor’s office includes a look at your nasal membranes and your throat. Stop smoking, Avoid cigarette smoke and strong scents in your environment.
Nasal medications and cleaning your nose with saltwater nasal saline also help your nose recover, he says.
Besides being irritating or keeping your spouse up at night, chronic cough should be taken seriously, Dr. Vraney says. It can lead to insomnia, incontinence, hoarseness, headaches, unpleasant social situations, and other problems, he adds.
“It can disrupt your life. You won’t die from it, but it can have a huge impact on your quality of life.”