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Tests and diagnosis
By Mayo Clinic staff
Because the top three causes of chronic cough — postnasal drip, asthma and acid reflux — are so common, doctors can often pinpoint the underlying problem through your response to treatment rather than by tests. If your cough goes away with treatment for a particular problem, the diagnosis is confirmed. Treatments include:
- Antihistamines and decongestants for postnasal drip
- Inhalers or nasal sprays for asthma
- Acid-reducing medications for acid reflux
If this approach fails or you become frustrated with the trial-and-error process, you may need one or more of the following tests.
Imaging tests
- Chest X-ray. Although a routine chest X-ray won't reveal the most common reasons for a cough, such as postnasal drip or acid reflux or asthma, it may be used to check for lung cancer and other lung diseases.
- Computerized tomography (CT scan). A CT scan takes X-rays from many different angles and then combines them to form cross-sectional images. This technique can provide more detailed views of your lungs. CT scans also may be used to check your sinus cavities for pockets of infection.
Lung function tests
These simple, noninvasive tests measure how much air your lungs can hold and how fast you can inhale and exhale. Sometimes you may also have an asthma challenge test, which checks how well you can breathe before and after inhaling a drug called methacholine.
Scope tests
These tests use a thin, flexible tube equipped with a light and camera to visualize structures within your body. The procedure is always preceded by spraying your nose or throat with a numbing agent like lidocaine. You may be given sedatives or pain relievers to make the procedure less uncomfortable.
- Nasal endoscopy. This test involves inserting a small fiberoptic scope into your nostrils to better assess the status of the nasal mucosa and the openings to your sinuses. A sinus CT scan is usually done first.
- Upper endoscopy. In this test, the scope is passed down your throat into your esophagus to check for signs of acid reflux in your stomach and esophagus.
- Bronchoscopy. In this test, the scope is passed down your windpipe to check your bronchial tubes for signs of infection or obstruction.
- Silvestri RC, et al. Evaluation of subacute and chronic cough in adults. http://uptodate.com/home/index.html. Accessed March 9, 2009
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. March 27, 2009.
- Approach to the patient with a cough. In: Mason RJ, et al. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2005. http://www.mdconsult.com/das/book/body/124735402-3/813991400/1288/241.html. Accessed March 9, 2009.
- Hill DG. Cough. In: Rakel RE, et al. Conn's Current Therapy. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/124890287-5/814421311/1621/18.html#4-u1.0-B978-1-4160-4435-2..50010-8--cesec4_130. Accessed March 10, 2009.
- Weinberger SE, et al. Treatment of subacute and chronic cough in adults. http://www.uptodate.com/home/index.html. Accessed March 10, 2009.
- Upper endoscopy. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy. Accessed March 10, 2009.
- Bronchoscopy. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/bron/bron_whatis.html. Accessed March 10, 2009.
- Prednisone. American Society of Health-System Pharmacists. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601102.html. Accessed March 10, 2009.
- Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd. Accessed March 10, 2009.
- Natural medicines in the clinical management of cold and flu: Cough. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed March 10, 2009.
