Persistent Cough: Diagnosis and Treatment

When to seek care

Cough-variant asthma, nasal or sinus conditions, gastroesophageal reflux and medicines can all cause a persistent cough.

Tests selected for your symptoms

• History and examination: when the cough began, sputum, timing, nasal symptoms, heartburn, medicines and smoking history.
• Oxygen saturation and listening to the chest.
• Chest X-ray; chest CT may be considered when further assessment is needed.
• Blood tests for infection, inflammation or allergy when appropriate.
• View39 measures specific IgE antibodies to 39 allergens in one blood sample. Results are explained later together with symptoms and environmental exposures; a positive test alone does not establish the cause.

Treatment depends on the cause

• Short-term cough suppressants or medicines that help clear sputum may be selected. When sputum is present, clearing it matters as well as relieving the cough.
• For cough-variant asthma, inhaled corticosteroids are central; bronchodilators or leukotriene receptor antagonists may be selected as appropriate.
• For nasal allergy or postnasal drip, allergy medicines or nasal treatments address the nasal symptoms too.
• For diagnosed gastroesophageal reflux, diet and lifestyle changes may be combined with acid-suppressing medicines.
• For refractory or unexplained chronic cough after adequate treatment of possible causes, gefapixant may be considered when indicated. Its benefit and adverse effects, including changes in taste, are monitored.

Preparing for your visit

Bring your medication record and previous test results if available. Notes about the starting date, timing, sputum, nasal symptoms and heartburn help us assess the cough.

About this summary and references

This English patient summary covers the assessment, treatment approach and precautions in our Japanese article. The Japanese article also lists representative medicine names.