Eh-eh, eh-eh, eh-eh...You have had a cough for 3 months. What type of doctor should you see? Your primary care doctor, a pulmonologist, an allergist or...? Perhaps you have already tried over-the-counter cough medicine. It's time you need a diagnosis! What is a cough? There is no simple answer. Experts still debate the difference between a true "cough" and "throat-clearing" to clear secretions that are dripping down the back of the throat or refluxing up from the stomach. I work closely with my associate, an ENT (otolaryngologist) to address all aspects of this problem. We both start by taking a full history and physical examination to try and find out the origin of your cough. If it is thought to be caused by fluid dripping down the back of your throat or reflux, a quick endoscopic assessment by the ENT with a flexible telescope can often demonstrate signs that lead to specific treatment. If the cough is coming from your lungs, I will give you a pulmonary function (breathing) test to measure lung function. If there are signs of infection you may need to have a chest radiograph (X-ray), sputum cultures, or a TB test. I may recommend that you see a lung expert (pulmonologist). Both lung infections and asthma can present with cough, and allergy testing may help differentiate between the two. Cough can persist for several months after a viral infection such as bronchitis. Also in the last few months, I have seen 8 patients with cough as a side effect of blood pressure medication. Please remember to bring a complete list of your medications, including vitamins, supplements and herbal medicines when you vist the doctor.
Howard M. Druce MD, FACP is a board-certified physician in allergy/immunology who is in private practice in Somerville, New Jersey. My practice is for both children and adults. I am Clinical Professor of Medicine at UMDNJ-New Jersey Medical School in Newark, NJ and a fellow of both the American Academy and College of Allergy, Asthma and Immunology. I am an active member of scientific committees of both professional societies.