Senior Health Help for That Nagging Cough 12/5/2023 | By Howard LeWine, M.D. Q: I can’t shake this dry nagging cough. It’s been hanging on for more than one month. Otherwise, I feel OK. Do I need to worry, and what can I do to help relieve it? A: First, I want to know if you were ever a smoker and whether you had cold symptoms or COVID-19 before the cough began . When someone has a cough lasting longer than five to six weeks and perhaps even sooner for smokers, I usually order a chest X-ray or CT scan to check for an underlying lung problem. It’s common to still have a cough for weeks after a viral upper respiratory infection. After the infection is long gone, inflamed tissues and hypersensitive nerves can persist in the larynx (voice box), trachea (windpipe), or bronchi (airways). These changes can last for much longer than people realize. In addition to a nagging cough, many people also develop wheezing. In these cases, I usually prescribe an albuterol inhaler (Proventil, Ventolin, generic versions) to use as needed. Adults can take up to two puffs every four to six hours. If this does not control the cough, sometimes an inhaler that contains a corticosteroid can be added. Coughing also can be a side effect of medications, particularly ACE inhibitors, such as lisinopril (Prinivil, Zestril, others) or enalapril (Vasotec), that are used to treat high blood pressure and heart disease. The other common causes of a persistent cough in a nonsmoker with clear lungs and a normal chest x-ray are postnasal drip, acid reflux, and undiagnosed asthma. Sometimes people don’t have typical symptoms associated with these conditions. For example, a person might not have nasal congestion yet still have postnasal drip. Acid reflux can cause a cough without heartburn. And sometimes people with asthma don’t notice wheezing. When there are no clues to the possible cause of a chronic cough, I often first recommend a decongestant, with or without an antihistamine, to treat possible postnasal drip. If that doesn’t help, my next advice addresses the possibility of acid reflux. This includes not lying down for three hours after eating, eating smaller meals and taking a short course of a proton-pump inhibitor like omeprazole (Prilosec). If these approaches don’t help, additional diagnostic tests may be needed. These could include breathing tests to detect undiagnosed asthma or checking for acid in the upper esophagus. Many over-the-counter cold products claim to reduce cough. If you try a cough suppressant, look for one that contains the ingredient dextromethorphan. While clinical study results are mixed, most studies suggest it decreases cough compared with a placebo. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu. ©2023 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC. Read similar articles on Seniors Guide: Relief From a Cough Without Antibiotics Related: A common decongestant that does not work after all Read More Howard LeWine, M.D. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.