I guess spring has finally arrived. The long winter season is now giving way to a rebirth of our native vegetation. With this rebirth comes the season of allergies. One of the ways that this season of allergies makes itself known is with an increase in complaints of chronic cough.
Chronic persistent cough has three main causes: postnasal drip and sinus disease, esophageal reflux, and lung disease. The most common cause is upper airway problems such as postnasal drip. Many patients with chronic postnasal drip have difficulty this time of year because of allergies. Recently, I have been prescribing a nasal rinse and gargle to help relieve
symptoms but I am recognizing that many patients have seasonal flare-ups that may be due to allergies. My work up now contains some specific investigations to try and help these long time sufferers.
Along with the sinus rinse and gargle as a first line therapy, I have been getting sinus x-rays to be sure we are not dealing with anatomic sinus disease. In addition to this, I may add a steroid nasal spray. More recently I have been getting some blood tests to see if the patient has an allergic predisposition and clearly some of these patients will need some type of allergy survey to see if they are candidates for desensitization. This last process has been made easier with more modern testing techniques and therapy that can be administered by the patient at home.