How Do Allergists Diagnose a Chronic Cough?
Key Takeaways
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A lingering cough can be more than frustrating. It can disrupt your sleep, interfere with daily activities and just generally bring you down. While many people chalk it up to a cold, flu or allergies, a chronic cough may indicate something more complex. That’s where your local board-certified allergist comes in.
What Is a Chronic Cough?
A chronic cough is any cough that lasts for a prolonged period of time — eight weeks or longer for adults or four weeks for children. This type of cough can be dry or produce mucus. It often worsens at night, after physical activity or when you’re exposed to certain triggers like smoke, pets or pollen.
Because chronic coughs can have multiple causes, allergists use a detailed process to diagnose the root of the issue through targeted testing and personalized care.
You can learn more about how to identify chronic symptoms in our blog, “Are Allergies or Asthma Causing Your Cough?”
Step 1: A Full Medical History
Some allergy and asthma conditions tend to run in families, which is why your allergist will begin by reviewing your personal and family health history. As part of your chronic cough evaluation, they’ll ask questions such as:
- Symptom patterns: When does the cough occur? Is it worse indoors or outdoors?
- Environmental exposures: Have you been around pets, dust, mold or smoke?
- Family history: Does anyone in your family have asthma, allergies or eczema?
- Previous treatments: What medications or therapies have (or haven’t) worked for you?
- Other symptoms: Do you experience wheezing, shortness of breath, nasal congestion or postnasal drip?
This conversation helps your allergist narrow down the most likely causes of your chronic cough and determine which tests to perform next.
Step 2: Allergy Testing
If allergies are suspected, your allergist may recommend one or both of the following allergy testing methods: allergy skin testing or an allergy blood test.
- Skin Prick Testing: Tiny amounts of allergens are gently pricked into the surface of the skin, usually on the forearm or back. If you’re allergic, you’ll develop a small bump, similar to a mosquito bite, within 15–20 minutes.
- Blood Testing (IgE): If you’re unable to stop certain medications or have a skin condition that prevents skin testing, a blood test can measure your body’s allergic response to specific allergens.
These tests can help identify whether your cough is being triggered by substances such as dust mites, pollen, mold or pet dander.
Step 3: Asthma Testing & Lung Function Evaluation
Sometimes, a chronic cough isn’t just about allergies. It could also be a sign of asthma. This is especially true if you experience wheezing, chest tightness, shortness of breath or coughing during exercise or at night.
To assess for asthma, your allergist may perform the following assessments.
- Spirometry: A simple breathing test that measures how much air you can inhale and exhale, and how quickly you can exhale.
- FeNO Testing: This test measures the level of nitric oxide in your breath, which can indicate airway inflammation associated with asthma.
- Methacholine Challenge: If your initial breathing tests are inconclusive, your allergist might perform this test to assess airway sensitivity more deeply.
Treating a chronic cough without understanding the cause often leads to frustration and recurring symptoms. With the right diagnosis, your allergist can build a targeted treatment plan.
For the full breakdown on asthma testing at Allergy & Asthma Specialists, read: “Asthma Testing 101: What to Expect During Your Visit”
Step 4: Ruling Out Other Causes
In addition to allergies and asthma, other potential causes of chronic cough may include:
- Postnasal drip
- Acid reflux (GERD)
- Respiratory infections
- Medication side effects (especially ACE inhibitors)
- Smoking or environmental irritants
Your allergist may refer you for additional evaluations or collaborate with other specialists if these conditions are suspected.
Breathe Easier With Expert Care
If you’ve been battling a chronic cough and are ready for answers, our board-certified allergists are here to help. At Allergy & Asthma Specialists, local allergy and asthma specialists offer comprehensive testing and personalized treatment plans to help you breathe easier, whether your symptoms are allergy-related, asthma-related or both. Schedule your allergist appointment with Allergy & Asthma Specialists today.
About Family Allergy & Asthma
Founded in 1979, Family Allergy & Asthma’s practice network of allergy and asthma specialists provides high-quality, reliable and lasting allergy relief throughout Arkansas, Florida, Illinois, Indiana, Kentucky, Missouri, Ohio, Pennsylvania and Tennessee, and includes affiliates Allergy & Asthma Specialists (AAS), Asthma and Allergy Associates of Florida (AAAF) and Arkansas Allergy and Asthma Clinic (AAAC). For more information, visit .familyallergy.com, and follow Family Allergy & Asthma on Facebook, Instagram and X.
FAQs
1. When is a cough considered chronic?
A cough is considered chronic when it lasts eight weeks or longer in adults or four weeks or longer in children. A persistent cough may be related to allergies, asthma or other conditions and may warrant further evaluation.
2. Can allergies cause a chronic cough?
Yes. Allergens such as pollen, mold, dust mites and pet dander can contribute to a lingering cough. Allergies may also cause nasal congestion and postnasal drip, which can irritate the throat and trigger coughing. Allergy testing can help identify potential triggers.
3. How do allergists test for a chronic cough?
An allergist typically starts by reviewing your medical history, symptoms, family history and possible environmental triggers. Depending on what they find, they may recommend allergy skin testing or blood testing, lung function tests such as spirometry, or other assessments to evaluate for asthma.
4. How can you tell the difference between an allergy-related cough and an asthma cough?
An allergy-related cough may occur alongside sneezing, nasal congestion, a runny nose or itchy, watery eyes. An asthma-related cough may be accompanied by wheezing, chest tightness or shortness of breath and may worsen at night or during exercise. Because symptoms can overlap, an allergist can help determine the cause through an evaluation and appropriate testing.
5. What happens if allergies and asthma aren’t causing my chronic cough?
Your allergist may consider other potential causes, including postnasal drip, acid reflux, respiratory infections, medication side effects or exposure to smoke and other irritants. If needed, they may recommend additional evaluation or coordinate care with another specialist.
