…But Why am I Coughing and They’re Not?

“There’s something happening here.  But what it is ain’t exactly clear,” sang Buffalo Springfield in 1966.  And so it is with an evolving understanding of what causes some people to have Chronic Cough and others not.

Asthma, gastroesophogeal reflux (GERD), and postnasal drip are commonly considered to be the major causes of Chronic Cough.  Then, why do the majority of patients with these 3 conditions NOT report coughing excessively? Something else is going on…

It’s Cough Hypersensitivity Syndrome!  People who have Cough Hypersensitivity Syndrome are hard-wired and hot-wired to cough.  It is the presence of this underlying condition in some people that causes asthma, GERD, and postnasal drip to act as triggers that produce cough.

Dr. Sher’s esteemed cough colleagues, Doctors Jaclyn A. Smith and Ashley Woodcock of the University of Manchester in the United Kingdom, addressed this paradox in “Chronic Cough” in The New England Journal of Medicine.   

The authors report:  ” An alternative theory is that an abnormality of the neuronal pathways controlling cough is likely to be the primary disorder in these patients, with identified causes (including asthma, reflux, and postnasal drip) acting as triggers only in the context of neuronal cough hyperresponsiveness.”

In other words, this medical paradox can be explained this way:    Abnormalities in the nervous system are the primary and underlying reason for some people having Chronic Cough.  These abnormalities create an environment for conditions such as asthma, GERD, and postnasal drip to act as irritants that trigger Chronic Cough.   These 3 common conditions and others act as Chronic Cough triggers when Cough Hypersensitivity Syndrome is present.  The illustration of “Neuronal Pathways Controlling Cough…” presented here comes directly from the NEJM article cited.

Cough Hypersensitivity Syndrome is the underlying cause of Chronic Cough. When it is present, common conditions such as asthma, GERD, and postnasal drip can result in Chronic Cough.

Cough Hypersensitivity Syndrome is the underlying cause of Chronic Cough. When it is present, common conditions such as asthma, GERD, and postnasal drip can result in Chronic Cough.

Dr. Mandel Sher of Center for Cough coaches cough patients on the difference between cough causes and cough triggers.  Very often, there is more than one cause and one trigger of Chronic Cough.  In fact, one of Dr. Sher’s patients refers to her cough as being “trigger happy.”

A comprehensive cough treatment approach begins with precisely identifying the underlying cause(s) and trigger(s) of each unique cough.  Dr. Sher will have an effective and lasting solution to your cough. Treat your cough cause(s) and cough trigger(s)!

Over 8 out of 10 Center for Cough patients demonstrate a measurable reduction in cough frequency.  Many of Dr. Sher’s patients have seen other doctors for their cough and tried other cough treatment that have failed.  Call Dr. Mandel Sher to learn how he can help you:  727-393-8067.