Cough while talking, no cough while silent

Someone I know (and love) coughs when she talks, but doesn't cough when she doesn't talk. What could this be? Not a smoker or anything like that.

[National Jewish]

She will need to be seen by her doctor to have testing done to figure out what is causing her cough when she talks and the best treatment.  Here are some ideas to get her started.

This could be caused by a vocal cord problem or a voice problem.  Learning specific vocal exercises from a speech therapist may be helpful.

This could be due to postnasal drip (PND).  PND is drainage from the nose and sinuses dripping down the back of the throat.  Postnasal drip can cause coughing as a result of irritation of the throat and lungs.  As long as she is not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.  This will thin the drainage so that it moves more easily.  A nasal wash helps remove the drainage from the nose and sinuses.  This can temporarily reduce the postnasal drip and lessen the cough.  A prescription nasal steroid spray decreases nasal swelling and drainage.  This may prevent the postnasal drip and coughing.  To get the most out of a nasal steroid spray use it after doing a nasal wash.  A nasal steroid spray does not provide immediate relief of symptoms.  It may require several weeks of routine use to become effective.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  She should share this information with her doctor to see if she would benefit from this daily treatment.

This cough could be a symptom of an upper airway form of asthma.  Generally testing for asthma starts with a simple breathing test called spirometry.  This test will provide detailed information about how her lungs are working.  It will show if there is obstruction in her airways.  To really test for asthma it is best to repeat this test after using a rescue inhaler, an inhaled bronchodilator.  This measures how much the bronchodilator helps her lungs by reversing the problem.  When there is a 20% increase the test is positive for asthma.  She might consider seeing a local board certified allergist for help in making the diagnosis and getting the best treatment.

[atldude]

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