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Johns Hopkins Health - Calming That Cough

Fall 2014
Issue No. 26

Calming That Cough

Date: October 9, 2014

Lingering tickles and hacks can be a nuisance, but are they cause for concern? Johns Hopkins pulmonologist Christian Merlo, M.D., explains


I have a cough I just can’t shake. At what point is it “chronic”?
A cough can last a couple of days, a couple of weeks or a couple of months. Most of the people I see for a lingering or chronic cough have had it for more than eight weeks. The majority of coughs that last that long are related to sinus problems and allergies. Sometimes they are linked to asthma, gastroesophageal reflux disease (GERD) or certain medications.

What solutions can I try at home?
I don’t know of too many over-the-counter fixes for a chronic cough. So take good care of your health with diet, exercise and plenty of rest, and if you’ve had a cough for about eight weeks, it’s time to see a doctor. The evaluation should be a stepwise process, and, if nothing else, the doctor can offer reassurance that it’s nothing serious.

How will a doctor determine what’s causing my cough?
I start with a detailed history, including a list of current medications. One of the questions I ask is, “Do you smoke?” Smoking causes lung disease and is the biggest symptom of chronic bronchitis. Coughs can also be caused by an infection, which may need to be treated with antibiotics that can clear it up in about a week. But if it’s a viral infection, remember that antibiotics won’t help. In that case, I may prescribe nasal sprays to help reduce inflammation and ease symptoms.

What if it’s something more serious?
A lot of people ask whether their cough might be cancer, but that’s unlikely. Most causes of cough aren’t life-threatening. If treating for the most common causes of a cough doesn’t resolve the issue, then we’ll do more tests to check for asthma or GERD. I don’t do more specialized tests unless a cough doesn’t go away after six months, so be patient with the process. I try to rule out causes one by one, so we can identify what’s going on. The best thing you can do is to follow your doctor’s orders and stick with the prescribed treatment to give it time to work.

For more information, appointments or consultations, call 877-546-1872.

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