Rakesh V. Alva, MD

The major causes of chronic cough include upper airwaycough syndrome (UACS, formerly known as postnasal dripsyndrome), asthma, nonasthmatic eosinophilic bronchitis, andgastroesophageal reflux disease. In fact, one or more of these isthe cause of cough in the vast majority of nonsmokers who arenot receiving angiotensin-converting enzyme inhibitors andwho have no evidence of active disease on chest radiographs. Ahigh index of suspicion is required, because each of these conditionsmay present with cough as the sole symptom. BecauseUACS may be the most common cause, it appears reasonableto try empiric UACS therapy in patients in whom other causesare not evident at initial evaluation. In many cases, the combinationof a first-generation antihistamine and a decongestantmay be most effective. (J Respir Dis. 2008;29(3):113-122)

In the vast majority of nonsmokers who are not receiving angiotensin converting-enzyme inhibitors and who have no evidence of active disease on chest radiographs, chronic cough is caused by postnasal drip syndrome (recently renamed upper airway cough syndrome [UACS]), asthma, non-asthmatic eosinophilic bronchitis, or gastroesophageal reflux disease (GERD), alone or in combination.