Urge to cough

For about 1 year now, I have almost a constant URGE to cough with no resulting actual cough. When I have actually forced myself to voluntarily cough during these urges, the cough does not  seem "connected" at all to to the urge - the resultant cough feels superfluous.

I have been to a pulmonologist 3 times, my internist once and all have said that my lungs are clear and they have no cause for concern in ordering tests.

I am not wheezing, nor coughing up blood.

I am 42, in good health. I was a social smoker in my 20s (less than a pack a week), but have not touched a cigarette in over 10 years.

should I be concerned - what could this be?

[National Jewish Health]

The disconnect between a constant urge to cough with no resulting actual cough illustrates the complexity of the cough reflex and suggests that, for unknown reasons, there is an anatomical or functional break in the reflex.  There is some, but not always complete, degree of control of the urge and usually the urge is relieved by the cough be it reflex or volitional.  Much progress has been made in our understanding of cough, during the past decades, and many academic institutions now have cough clinics.  The most common causes of chronic cough, or even the urge, are asthma, gastroesophageal reflux disease (GERD) and postnasal drip.

Should you be concerned?  Yes, to the degree that the urge may be a sign of underlying disease and not just heightened sensitivity of the sensory nerves that initiate the cough.  It would be appropriate to rule out the 3 common causes of cough listed above and be further evaluated with auto-fluorescent bronchoscopy.  Once worrisome causes of cough or the urge have been ruled out, you should not be concerned and consider this a nuisance rather than a disease to be diagnosed.