Three big causes of lasting cough

DEAR DR. DONOHUE: Three months ago, I had a cold and cough. The cold has gone, but the cough hasn't. I have used every commercial cough medicine, to no avail. The cough drives me and my wife crazy. It keeps her awake at night. I don't feel all that bad, but I can't stop coughing. What can I do? -- R.S.

ANSWER: A cough lasting more than eight weeks qualifies as a chronic cough. Its three big causes are asthma, postnasal drip and gastroesophageal reflux (the upward spurting of stomach acid into the esophagus and sometimes the throat).

Asthma is detected through lung function tests. It's a sudden narrowing of airways along with airway irritation, which fills the airways with thick mucus. Cough can be the only sign of asthma. If your cough is asthma-induced, asthma medicines should rid you of it.

Postnasal drip is the aggravating trickling of mucus from the nose and sinuses into the throat, where it triggers a cough reflex. Atrovent nasal spray and an antihistamine taken before bedtime often can stop the irritating drip.

Gastroesophageal reflux is heartburn. It can occur without heartburn pain. Stomach acid in the throat and airways sparks a bout of coughing that can almost always be controlled by medicines that turn down acid production. Prilosec is one example.

A cough that stays and stays after a respiratory infection like a cold can be handled in the same way as postnasal drip.

A long list of other cough causes exists, and you won't be able to track the right one down without the help of your family doctor. Medicines like ACE inhibitors for blood pressure control make some people cough. Whooping cough is another cause of a chronic cough, and it's often forgotten because people consider it a childhood illness. The cause that poses the greatest threat is lung cancer, and that's something that needs to be addressed quickly.

DEAR DR. DONOHUE: For all my life, my nipples have hardly been visible. I am told this is called inverted nipples. Is this a sign of anything bad? I am only 23. Can they be fixed? -- S.M.

ANSWER: Most inverted nipples only appear to be inverted. They have sunk somewhat into a depression in the breasts' soft tissues. Squeezing them at their sides temporarily brings them out of the depression.

Nipples that can't be everted by applying pressure to their sides are truly inverted nipples. Fibrous tissue arising from breast tissue has lassoed them and drawn them inward and into the breast.

In either case, surgery can correct the situation if a person desires it. Neither is a sign of a health problem.

Nipples that had been in the correct position and become inverted can be a sign of cancer and demand an investigation.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved