Sneezing, a runny nose, and itchy, watery eyes are classic allergy symptoms. But did you know that allergies can also cause a troublesome cough?
As a pulmonologist at the Temple Lung Center, I often see patients who’ve been coping with a lingering cough. Discovering that their symptoms are triggered by seasonal allergies can ease their minds. And treatment can help relieve their cough and other allergy symptoms.
But while an allergy may be one cause of a nagging cough, it’s far from the only explanation. And when a cough lingers — especially for weeks at a time — it’s important to seek answers.
Here’s what I tell my patients about allergy-related coughs and how to know when it’s time to seek expert advice.
Coughing protects the lungs
As I share with my patients, coughing serves a useful purpose. It’s your body’s automatic response to mucus, dust, pollutants, and other irritants in the throat and lungs.
Think of it as a reflex, like sneezing. Nerves in your lungs and airway detect irritants and send messages to your brain, which triggers your chest and abdominal muscles to cough out the irritating particles or mucus. In this way, coughing helps protect the lungs.
But though an occasional cough is normal — as is a cough that lasts while you have a cold — a cough that won’t quit is not. If a cough lasts longer than eight weeks, it’s what we call a chronic cough. I recommend that everyone with a chronic cough see a doctor and have it evaluated.
Signs your cough is from allergies
90% of chronic coughs are caused by three things: asthma, acid reflux, and postnasal drip. Postnasal drip is when mucus constantly drips from the back of the nose down the throat, triggering a cough. It can occur in people who have allergies to dust, pet dander, mold, and plant pollen since they can irritate the nose, causing more and thicker mucus to be produced. Many people notice their postnasal drip, but some do not. They just have a chronic cough and perhaps a need to clear their throat a lot.
In addition to postnasal drip, here are some other clues that a cough may be related to allergies:
- Other allergy symptoms are present. A cough caused by allergies usually goes hand in hand with other allergy symptoms, such as sneezing; a runny or stuffy nose; itchy eyes, mouth or skin; and dark circles under the eyes.
- The cough is dry. An allergy-related cough usually doesn’t bring up mucus. A dry cough is sometimes called a nonproductive cough.
- It’s allergy season. If your cough is caused by seasonal allergies, also known as hay fever or seasonal allergic rhinitis, you might cough more at certain times of year, when pollen is in the air. Depending on what you are allergic to — for instance, tree, grass, or weed pollen — your cough and other symptoms may occur more during spring, summer, or fall. (Though allergy-related coughing can occur year-round in patients allergic to dust, pets, or cockroaches.)
- You cough when you come in contact with certain things. An allergy-related cough may be worse when you’re around potential allergy triggers, like pets, pollen, dust, or mold.
Signs your cough isn't from allergies
If your cough lingers beyond allergy season, that’s a sign it may be caused by another condition, such as:
Asthma
As I said before, asthma is one of the top three causes of a chronic cough. Some of my patients are surprised when I evaluate them for the condition, because asthma is often diagnosed in childhood. But people can develop asthma at any age.
Patients whose cough is caused by asthma often have additional symptoms of the condition. They may wheeze (make a whistling sound when they breathe), have a tight feeling in their chest, and sometimes get short of breath. An asthma cough often gets worse during exercise; when a person is exposed to cold air, pollutants or perfume; or when they have a cold. Some people have a specific type of asthma, called cough-variant asthma, in which coughing is the main sign.
Acid reflux, including gastroesophageal reflux disease (GERD)
This condition occurs when stomach acids flow back up into the esophagus, causing acid reflux or heartburn. That acid may irritate the throat, causing a cough. Many people with acid reflux notice a burning sensation in their upper chest or throat, often accompanied by a sour taste in the mouth. But some people have acid reflux without heartburn. They might have a hoarse voice and cough and clear their throat a lot.
Less common causes of cough
Coughing can also be caused by infections or by conditions like chronic obstructive pulmonary disease or lung cancer. That’s why it’s important to get a chronic cough evaluated sooner rather than later.
When should you see a doctor for your chronic cough?
If you have a cough that’s lasted for a few weeks, you should see your primary care doctor. You should also see your doctor if:
- Your cough occurs with fever, wheezing, or shortness of breath
- Coughing brings up yellow-green or bloody mucus
- You have ankle swelling or unexplained weight loss
These can be signs of a serious medical problem.
Finding the cause of a cough
The team at Temple Lung Center’s Chronic Cough Program specializes in finding the cause of persistent coughing. Typically, that starts with a physical exam. In addition, I take a close look at my patients’ medical histories to find potential clues to underlying explanations for their constant cough.
When I discuss my patients’ symptoms, I take time to understand their experience and what they believe may trigger coughing episodes. I ask questions to help identify possible underlying conditions. For example, I may ask:
- Do you have a productive cough that brings up mucus?
- Are you coughing in the morning or at night?
- Do you have heartburn?
I also review my patients’ medications. Some, such as a group of blood pressure medications called ACE inhibitors, can cause a chronic cough.
Finding out what’s causing your cough may involve one or more tests. For example, tests may be needed to rule out asthma, other lung conditions, or acid reflux.
I often work with other specialists at Temple to help diagnose and treat conditions that cause coughing. If your symptoms and medical history point to allergies as a possible cause of your cough, I may refer you to an allergy specialist for testing. Patients with a chronic cough caused by GERD may benefit from seeing a gastroenterologist.
Calming your cough
Treating a cough often depends on addressing the underlying condition that triggers it.
For patients with asthma, that might include inhaled medications called glucocorticoids and bronchodilators. These medicines work by decreasing inflammation in the airways of the lungs, which helps keep them open.
Patients with acid reflux may also need medications, such as proton pump inhibitors that help decrease stomach acids. Lifestyle changes can also help people control acid reflux. Surgery is another treatment option for severe GERD that isn’t well-controlled with medicines and lifestyle changes.
If your cough is related to allergies, managing them may help get the cough under control. I encourage patients to work with an allergist, who can tailor a treatment plan for them that includes avoiding or reducing exposure to their specific allergy triggers.
In addition, medicines help treat the allergies and postnasal drip that may be causing your cough. Options include antihistamines, which are available as pills or nasal sprays. Other medicines that can help with postnasal drip and cough are inhaled corticosteroids.
Schedule an appointment for your chronic cough
The clinicians at the Temple Lung Center are experts at diagnosing and treating chronic cough and helping people with lung conditions breathe their best.
If you have a cough that won’t go away, make an appointment with a Temple lung specialist. Call 800-TEMPLE-MED (800-836-7536) or request an appointment online.
Helpful Resources
Looking for more information?
- Learn about the different types of cough and how we treat chronic cough
- Read more about our Chronic Cough Program
- Meet our specialists