Introduction
Most coughs are short-lived, linked to colds or seasonal infections. But when a cough lingers for 8 weeks or longer in adults (or 4 weeks in children), it’s considered a chronic cough. At this point, it’s no longer just a nuisance—it may signal an underlying health issue. While a family doctor can start the evaluation, sometimes you need to see a specialist, such as an ENT (ear, nose, and throat doctor) or a pulmonologist (lung specialist) for deeper investigation.
Common Causes of Chronic Cough
- Postnasal drip (upper airway cough syndrome)
- Asthma or cough-variant asthma
- GERD (acid reflux)
- Chronic bronchitis or COPD
- Allergies or sinus issues
- Smoking-related lung disease
- Medication side effects (e.g., ACE inhibitors)
When to See an ENT Specialist
An ENT doctor focuses on conditions affecting the nose, sinuses, throat, and upper airways.
Signs You May Need an ENT:
- Persistent cough linked to sinus infections or postnasal drip.
- Chronic sore throat, hoarseness, or voice changes.
- Cough triggered by allergies or environmental irritants.
- Suspected tonsil or throat problems.
- GERD-related throat irritation (sometimes co-managed with GI specialists).
ENT Evaluation May Include:
- Nasal endoscopy (to view nasal passages/sinuses).
- Allergy testing.
- Throat and voice box examination.
When to See a Pulmonologist
A pulmonologist specializes in lung and respiratory diseases.
Signs You May Need a Pulmonologist:
- Cough with wheezing, shortness of breath, or chest tightness.
- History of asthma, COPD, or chronic bronchitis.
- Recurrent lung infections or pneumonia.
- Chronic cough in a smoker or former smoker.
- Concern for interstitial lung disease or pulmonary fibrosis.
- Cough that persists despite ENT or general treatments.
Pulmonologist Evaluation May Include:
- Chest X-ray or CT scan.
- Spirometry (lung function tests).
- Bronchoscopy (looking into the lungs with a camera).
- Blood oxygen level and allergy/asthma assessments.
Red Flag Symptoms Requiring Urgent Medical Attention
Regardless of the specialist, see a doctor immediately if your chronic cough is accompanied by:
- Coughing up blood.
- Unexplained weight loss.
- Night sweats and persistent fever.
- Severe shortness of breath or chest pain.
- History of tuberculosis, lung cancer, or heart failure.
Conclusion
A chronic cough is more than an inconvenience—it can reveal problems in the upper airway (ENT-related) or the lungs (pulmonologist-related). If your cough lasts longer than 8 weeks, or is associated with red flag symptoms, it’s time to seek specialist care. Early evaluation helps not only in finding relief but also in catching potentially serious conditions early.
FAQs
1. How long should I wait before seeing a specialist for a chronic cough?
If your cough lasts longer than 8 weeks, ask your primary doctor for a referral.
2. Can postnasal drip really cause a long-term cough?
Yes. It’s one of the most common causes of chronic cough and often managed by ENT specialists.
3. Do pulmonologists treat asthma-related cough?
Yes. Pulmonologists manage asthma, COPD, and other lung diseases linked to persistent cough.
4. Is a chronic cough always a sign of something serious?
Not always. Many cases are due to treatable conditions like reflux or allergies, but evaluation is important to rule out serious causes.
5. Can medications cause a chronic cough?
Yes. ACE inhibitors (for high blood pressure) are a well-known cause and may require switching to another drug.
