Hot-Wired to Cough: Your Throat’s Nerve Endings are on Fire!

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If you think of your body like a map of a city, you may visualize cough living in the following neighborhoods:  lungs, chest, and upper respiratory system.  But some coughs have a different address: some coughs live in the nerve endings in the back of the throat. Neighborhoods are all different. They dress different. Have different slang. Perhaps they have different shops and restaurants. And all these differences create a unique environment.  Let’s take Jane Smith, for example. Read more

Did you know chronic cough could be asthma?

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Did You Know?

Persistent cough is an often overlooked sign of asthma according to a study by National Jewish Health in Denver, Colorado.  Persistent, or better known as chronic cough, affects approximately 10% of the population and can be a symptom of many underlying causes, some of which are unexplained. Patients who are treated for their symptoms rather than their root cause often become frustrated and feel hopeless because they just can’t seem to get better. In reality, these root causes are not always obvious. Read more

Dr. Mandel Sher Had A Fit!

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Dr. Mandel Sher had a fit! – A coughing fit similar to the experience of people with Chronic Cough and patients at Center for Cough.  He had an upper respiratory infection five weeks ago and is experiencing residual cough.  Since his is related to a post-viral acute cough, Dr. Sher quieted his cough by slowly dissolving a menthol lozenge in his mouth. A chronic cough, on the other hand, is soothed by lozenges with pectin as the main ingredient because they are lubricating.  Different cough causes and triggers have different treatments.  It is important to know your specific cough profile.

Chronic Cough is a Gender Issue

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Did you know that the debilitating medical condition of Chronic Cough is a gender issue?  Chronic Cough is not gender neutral.  In fact, Chronic Cough favors women.  While Chronic Cough does affect both men and women, just being a woman sets you up for Chronic Cough.  Chronic Cough affects women more often than men.  And it particularly affects women as they age.   Dr. Mandel Sher’s vast experience diagnosing people who suffer with Chronic Cough and recommending cough treatment confirms the higher incidence of Chronic Cough among women.

“Chronic Cough as a Female Gender Issue,” a review article by Kavalcikova-Bogdanova, Buday, Plevkova, and Song published in the January 9, 2016 issue of Advances in Experimental Medicine and Biology, addresses this phenomenon.  The authors suggest the role of hormones in excessive cough.

According to Dr. Sher, women are hard-wired to cough.  That means that women organically have a more sensitive cough mechanism.  The higher sensitivity of the cough mechanism means that it takes a lower level of irritants or stimuli to trigger coughing spells.  And since cough begets cough, Chronic Cough can become the result.

Dr. Sher emphasizes that cough is an important mechanism in all children and adults.  But in 12 to 15% of the population, a persistent cough that won’t go away becomes disruptive.  Chronic Cough has negative physical, mental, professional and social consequences.  Dr. Sher goes on to say that the goal of cough treatment is to normalize cough – not to suppress cough. 

Sometimes, cough is an indication of a more serious underlying medical condition.  In people suffering with Chronic Cough, cough is often THE problem.  A lingering cough is not normal and should not be ignored.  If you or someone you love has a Chronic Cough, contact Dr. Mandel Sher at Center for Cough:  727-393-8067.


Dr. Mandel Sher In North Carolina: New Concepts in Chronic Cough

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Dr. Sher in North Carolina: Emerging Concepts in Chronic Cough “New Concepts in Chronic Cough”  presented by Dr. Sher to his North Carolina colleagues was just the invitation he needed to return to beautiful North Carolina.  Dr. Sher began his specialty training at Duke Health System in Durham, North Carolina, after graduating from Northwestern University’s medical school in Chicago, Illinois.  The scientific and medical community’s understanding of Chronic Cough causes and treatments are evolving rapidly and it was Dr. Sher’s pleasure to share these new concepts.     

Mandel Sher, MD, Medical Director of Center for Cough, spoke to the North Carolina Allergy, Asthma and Immunology Society’s annual meeting on Saturday, February 6, 2016 on “New Concepts in Chronic Cough”.  Dr. Sher is one of the nation’s leading investigators studying new scientific and clinical findings about the causes of Chronic Cough and effective cough treatments.  These new concepts in Chronic Cough have the promise of expanding our understanding of this debilitating medical condition and treating it effectively.

Chronic cough affects 12 to 15% of the population and has debilitating consequences:  Depression, Social Isolation, Fatigue, and Urinary Incontinence to name a few.  Dr. Sher spoke about the current unmet need in cough treatment and the promising cough treatments in the future.  Dr. Sher addressed the paradigm shift in the diagnostic and cough treatment approach to now focus on overly sensitive cough mechanism particularly in people who are hard-wired to cough. 

“The hypersensitive cough reflex is the primary cause of chronic cough triggered by multiple factors including viral respiratory infections, allergies, asthma and acid reflux”, Dr Sher told the group of North Carolina allergists.”

 

 

 

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Chronic Cough and Upper Airway Cough Syndrome

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There are many irritants that can trigger Chronic Cough.  That is why it is so important to see a Cough Doctor who can precisely diagnose the cause(s) and trigger(s) of your Chronic Cough.  Upper Airway Cough Syndrome is a common contributor to Chronic Cough.  Examples of upper airway irritants include: Allergic rhinitis, vasomotor rhinitis, and sinusitis.

Imagine a game of dominoes.  Upper Airway Cough Syndrome and Chronic Cough can mimic a game of dominoes.  Nasal inflammation from allergies and/or infection contribute to irritating the cough mechanism.  Symptoms of Upper Airway Cough Syndrome are a sensation of post nasal drip at the back of the throat, nasal discharge, or throat clearing. Treatment often includes nasal saline, antihistamines, nasal steroids, and ipratropium bromide.

If you have a persistent cough that won’t go away, contact Dr. Mandel Sher at Center for Cough to have your cough evaluated and begin cough treatment targeted specifically to your cough:  727-393-8067.

Sometimes, cough is a symptom of an underlying and serious medical problem.  Sometimes, Chronic Cough is THE problem.  A cough that won’t go away should not be ignored.  Prompt cough evaluation and cough treatment plan minimize your and your loved ones’ concerns that something more serious can be going on.

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Chronic Cough and GERD with Symptoms or Silent

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Did you know that GERD can be a silent contributor to Chronic Cough?  While there are often classic symptoms associated with GERD, sometimes GERD is silent and there are no telltale symptoms.  That is why it is important to see a Cough Doctor who carefully reviews your medical history with you and looks for clues.  Questions about diet, reclining or lying down position, time of day, and cough while or after eating may offer you and the Cough Doctor clues about the role of GERD in Chronic Cough.

Dr. Mandel Sher, Medical Director and Founder of Center for Cough, is a Cough Doctor.  Dr. Sher offers patients a comprehensive diagnostic and cough treatment approach.  Over 8 out of 10 Center for Cough patients demonstrate a remarkable reduction in the frequency and intensity of cough.  When Chronic  Cough is normalized, patients report an overall improvement in daily living activities.  Professional performance, energy level, social engagement, and personal relationships improve when cough is normalized.

Persistent cough that won’t go away should not be ignored.  Sometimes, cough is an indication of an underlying and serious medical problem.  Sometimes, Chronic Cough is THE problem!

Cough can be triggered by gastro esophogeal reflex disease (GERD) or can be associated, but not triggered, by GERD. GERD triggered or associated coughs sometimes have symptoms of hoarseness, throat clearing, and sore throat, or is asymptomatic in others. Treatment often includes simple and effective dietary changes and Proton Pump Inhibitor (PPI) medications aimed at reducing gastric acid production.

Do not guess or make assumptions about the cause of your cough.  Do not waste time and money on cough treatments that are not targeted to your type of cough.  Contact Dr. Mandel Sher at Center for Cough for a comprehensive cough evaluation and cough treatment plan:  727-393-8067.

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Your Medicine May Be Making You Cough

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Angiotensin-Converting Enzyme (ACE) Inhibitors found in some prescription medications can be associated with Chronic Cough.  It is important to never stop a medication without first discussing the consequences with the ordering physician.  But a Cough Doctor can precisely diagnose the cause(s) of your Chronic Cough and the role of ACE Inhibitor medication in your situation.

A persistent, dry, tickling cough is a relatively common result of ACE inhibitors, such as lisinopril, which are used to treat hypertension, heart and kidney diseases. Cough may occur within hours of the first dose of medication, or its onset can be delayed for weeks to months after the initiation of therapy. Treatment with ACE inhibitors may sensitize the cough reflex, thereby potentiating other causes of chronic cough.

The mechanism of ACE inhibitor induced cough is not fully understood but probably is associated with increases in bradykinins that activate the cough reflex. Although cough usually resolves within 1 to 4 weeks of the cessation of therapy with the offending drug, in a subgroup of individuals cough may linger for up to three months. A different drug class, angiotensin receptor blockers (ARBs), do not cause cough, even in those patients with a history of ACE inhibitor-induced cough.