Getting to the Cause of Chronic Coughing

April 03, 2014

Herbert Webb, MD, wears many hats as the medical director of the respiratory therapy department, the pulmonary rehab department, the arterial blood gas lab, and the intensive care unit at Providence Little Company of Mary Medical Center San Pedro. He is known as a master of finding the cause of chronic coughs so patients can be adequately treated.

“Chronic cough (coughing that lasts a few months) is one of the most common things we see in our office,” Dr. Webb said. “The most common cause of chronic cough in people who don’t have lung disease is post-nasal drip. About 60% of the population has it. 25 years ago, even medical professors didn’t make the connection because when an earnose-throat physician looks in the throat of a patient with a chronic cough, everything looks fine. It wasn’t until about 10 years ago that we convinced ear-nose-throat physicians of the connection.”

Dr. Webb doesn’t believe that simple post-nasal drip is allergy related. “It happens in people who have allergies and it happens in people who don’t have allergies,” he explained. “We don’t know what causes post-nasal drip but we do know many of the things that trigger it, such as irritants, ion changes and air pollution.

“We can’t cure it but we can control it to the point where people can function well again. Having chronic cough does not necessarily indicate lung disease at all—we see people who have chronic coughs from post-nasal drip syndrome who don’t have any lung disease at all.

“We treat them for the post-nasal drip syndrome and the cough goes away. We don’t give them cough suppressants; we diagnose the cause of the cough and then treat that cause. If the cough goes away, we know we have the right treatment. I have a long list of treatments for post-nasal drip, and we start with the simplest, mildest treatment and see if that works. If not, we start working progressively down the list. We strive to do the minimum necessary to treat it, to keep any side effects as weak as possible.

“GERD is another cause of chronic cough, as is adult asthma. Certain medications can cause chronic cough, including the ace-inhibitor medicines that people take for blood pressure and heart problems.” Dr. Webb and the pulmonary health team at Providence Little Company of Mary Medical Center San Pedro are available to treat your breathing issues too.