The doctor will find some inflammatory changes in the nose and throat. Post nasal drip may or may not be of allergic nature. A therapeutic trial of antidecongestants and nasal steroids may be of great help. The diagnosis can be made by a good rhinolaryngoscopic examination, radiological exam of the sinuses. A limited CT may be all that is needed.
Treatment consists of antibiotics for good lengths of time, decongestants, nasal steroids.
Ocassionally a ENT consultation is required, as these patients may require surgery to control the chronic sinusitis. These above 3 condirtions account for 90 per cent of the causes of chronic cough. The abnormal presence of gastric acid in the esophagus triggers a reflex cough. We need to suspect GE reflux when the patient also suffers from heartburn, when the cough is predominantly at night, and when we have not been able to explain the cough by other, more common conditions. Again, we may offer the patient a therapeutic trial of antireflux medicines and recommendations.