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How a Doctor Can Diagnose the Cause of Your Cough

January 12, 2023

Pulmonologists can tell a lot by listening to your cough.

Dry and raspy? Maybe your heating system.

Coupled with watery eyes? Probably allergies.

Wet sounding, whether or not it produces phlegm? Likely a viral infection.

“But, viruses don’t last forever. Understand that, 99% of the time, coughs are underlying symptoms of another problem. If a cough lingers for months, there’s something that needs to be addressed,” says Steven Thau, MD, a Hartford HealthCare pulmonary and sleep specialist.

So how exactly do doctors use this information to diagnose the cause of your cough? Dr. Thau breaks down the factors and treatments for various types of coughs.

> Worried about your cough? Connect with an expert

Dr. Detective

“Every cough has distinct qualities experts can use to determine the cause,” Dr. Thau notes.

He’ll use what he hears and medical history to determine if the cough is a “precipitating” factor, or causing an ailment, or “perpetuating” factor creating inflammation in the airways that keeps itself going.

The top cough causes, he says, are:

To pinpoint the cause, he’ll ask about other symptoms and timing of coughing spells. He wants to know:

  • Do you cough after eating? It could be related to reflux.
  • Is there shortness of breath? That might indicate asthma, which can get worse at night.
  • Does coughing occur after taking medication? The medication can be the culprit. If you’ve taken it for a while, another change, combined with the medication, might trigger coughing.
  • Are other inflammatory disorders – Crohn’s disease or rheumatoid arthritis – flaring at the same time? They often coexist.
  • Do you have forced hot air heat? It’s very drying for nasal passages, sinuses and airways.
  • Do you wake up parched? If you have sleep apnea or breath through your mouth, your airways can be dry and cause coughing.

“Dry air and mouth breathing create airway dryness and airway trauma much like chapping of the lips,” Dr. Thau says.

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Help is available

While anyone with a history of heart trouble should talk to a care provider whenever they develop a cough as it could indicate a cardiac condition needing attention, Dr. Thau says most people can try simple home remedies first. One, he stresses, is not a humidifier.

“All that does is create a greenhouse in your bedroom for mold and mildew,” he says.

Instead, try:

  • Saline spray
  • Sinus rinses
  • Sinus irrigation systems (use distilled water to avoid deposits of minerals and other substances in tap or bottled water)

Coughs stemming from a virus should last two to four weeks. For anything lingering longer, Dr. Thau suggests speaking to your primary care provider to address other causes.

“People are allowed to have more than one condition. We want to create a defensive strategy to protect our airways from top to bottom and both inside and out,” he says.