Cough, Chronic Cough, Rhinitis and Sinusitis - a Primer for Patients, Physician Assistants, Nurse Clinicians & Physicians

Lawrence Martin, M.D., FACP, FCCP


By far the most common cause of chronic cough (defined as >3 weeks duration) in adults is post nasal drip (PND). PND comes from inflammation in the nasal passages (rhinitis) and/or sinuses (sinusitis). Other well-known causes of chronic cough (asthma, chronic bronchitis, gastric reflux, drug reaction) occur much less commonly than PND. PND causes chronic cough by mucus dripping down onto areas of the respiratory system which contain sensitive nerves (throat, voice box, windpipe and lungs). Because chronic cough is often thought of as a 'lung condition' by health care providers, PND as a cause is often overlooked (even though the medical literature documents it as the number one cause).

There are several causes of rhinitis/sinusitis, most commonly allergy and infection. Many medications are available to treat these conditions, by both prescription and over the counter. Sometimes patients with chronic sinusitis don't improve with medication, and sinus surgery may be needed.

Web Links & References / Table of Drugs used to treat rhinitis & sinusitis / 10 Common Myths, Misconceptions, Errors and Mistakes about Chronic Cough / Chronic throat clearing