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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes persistent dry cough?

Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3663 Questions

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Posted on Mon, 4 May 2015 in Medicines and Side Effects
Question: HI am a 66 year old male that stopped smoking one pack a day at age 37 after 20 years. I have stopped for 28-29 years but still worry some.

I have a very mild dry tickly cough...I probably cough lightly 8-12 times per day and night. No other symptoms. I could play tennis for three hours. I have no shortness of breath, no weight loss, no chest pain, and no blood in spit or cough up.

I do suffer from long term allergies and I am guessing it's Spring and Fall allergies causing this from post nasal drip. I just started Allegra and Flonase nose spray. Do you think I have the likely issue noted? Thank you.
doctor
Answered by Dr. Panagiotis Zografakis 45 minutes later
Brief Answer:
It could be allergic

Detailed Answer:
Hello,

you haven't mentioned when your cough started but I guess it must have been there more than a few weeks. There are many potential causes. I'll comment upon the most common ones.

Chronic obstructive pulmonary disease and asthma may cause cough but you have no shortness of breath or sputum, so it's probably out of the question.

Gastroesophageal reflux disease usually causes more symptoms when lying down, but you haven't described such a pattern.

Drugs may cause cough. The angiotensin converting enzyme inhibitors is a very characteristic example. Since you've not included your medical history in the question, I suppose that there is nothing to mention.

Heart related conditions cause shortness of breath, but you can play tennis for three hours.

Now let me comment on various common or not so common causes that may be the source of your problem.
Allergic reactions to various allergens may cause cough. Postnasal drip by allergic rhinitis is one such example.
Various irritants may cause cough, but you should be able to recognize that your cough starts when you come into contact with them or when you visit certain places etc
Various parenchymal diseases may cause cough like sarcoidosis. Other symptoms may be present depending on the severity.
Cancer may cause cough and needs to be excluded whenever an investigation for cough takes place.

So I've mentioned some potential causes to help you understand your situation better. My opinion is that you'll have to do a chest X-ray to exclude parenchymal disease (either local like a tumor or widespread like sarcoidosis or fibrosis). Spirometry and bronchial challenge test may help exclude the diagnosis of asthma.

If there are no findings in the aforementioned tests then continuing your current treatment is advised. Treatment success would confirm that your problem is allergic in nature. The treatment you're taking seems appropriate to me. No improvement would mean that another cause would have to be sought.

Contact me again, if you'd like more information or clarifications.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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