July 13, 2015 | Black & Kletz Allergy
There are many cause of a cough. Coughing is usually caused by a viral upper respiratory infection (URI), asthma, post-nasal drip, and/or gastroesophageal reflux disease (GERD). There are however many other conditions which may cause a cough, some of which include other infectious types of upper respiratory infections (i.e., bacterial, fungal, parasitic), occult sinus infection, vocal cord dysfunction, cystic fibrosis, laryngopharyngeal reflux, pneumonia, bronchitis, bronchiectasis, pertussis (whooping cough), croup, foreign body (which can get stuck in one’s airways), pulmonary embolism, neurogenic cough, post-infectious cough, hypersensitivity pneumonitis, sarcoidosis, psychogenic cough (due to a habit or tic), Tourette’s Syndrome, aspiration, cigarette smoking, chronic obstructive pulmonary disease (COPD) (i.e., chronic bronchitis, and/or emphysema), interstitial lung disease, tumors, congestive heart failure, exposure to air pollutants, and the side effects of certain medications such as angiotensin-converting enzyme inhibitors [(i.e., lisinopril (Zestril, Prinivil), enalapril (Vasotec), ramipril (Altace), benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), quinapril (Accupril), trandolapril (Mavik), moexipril (Univasc), and perindopril (Aceon)].
So can allergies play a role in causing a cough? Yes. Since asthma is a leading cause of cough and about 80% of individuals with asthma also have allergies, one can see right away that allergies play a large role in causing a cough. In addition, there is a sub-group of asthmatics who have a condition called cough-variant asthma where sufferers only cough as a result of their asthma. They do not have the accompanying wheezing, shortness of breath or chest tightness that most other asthmatics experience. As if this wasn’t bad enough, it is estimated that 75-80% of asthmatics have gastroesophageal reflux disease (GERD), which is also one of the most common causes of a cough. Allergies also play a major role in predisposing a person to develop a sinus infection (sinusitis) which again often causes a cough. Immunodeficiency disorders (which are diagnosed and treated by allergists/immunologists) such as hypogammaglobulinemia also predispose people with these disorders to acute sinus infections. Hypersensitivity pneumonitis is a condition where there is an inflammation of the air sacs (alveoli) of the lungs caused by an allergic reaction to inhaled antigens such as dusts, molds, and chemicals. Individuals with this condition commonly have certain hobbies and/or occupations that expose them to these antigens. Once again, cough is a primary symptom of this disease.
In individuals with a persistent cough, many tests can be done in order to diagnose the reason behind the cough. Some of these tests include blood work, chest X-rays, CT scans of the chest and/or sinuses, allergy testing, pulmonary function tests (PFT’s; breathing tests), rhinoscopy, upper endoscopy (with or without biopsy), esophageal manometry (assesses the function of the lower esophageal sphincter and esophagus), barium swallow, pH monitoring (measures the acidity in the stomach), and bronchoscopy (with or without lung biopsy). In most cases, the workup usually does not require the last six tests listed above which are generally reserved for difficult cases. After diagnosing the problem, there are a variety of medications that can be used to treat an individual’s cough.
The board certified allergists at Black & Kletz Allergy have been diagnosing the underlying conditions of coughs and treating individuals with coughs for more than 50 years in the Washington, DC, Northern Virginia, and Maryland metropolitan area. We treat both adult and pediatric patients and have 3 convenient locations in the DC metro area. We have offices in Washington, DC, McLean, VA (Tysons Corner, VA) and Manassas, VA, each with on-site parking. The Washington, DC and McLean, VA offices are Metro accessible. Black and Kletz Allergy is committed to providing excellent allergy, asthma, and immunology care to the greater Washington, DC and Northern Virginia community.
