Many people have written in to ask about coughing, so once again, I will answer them all together. Here is a correspondence I wrote that may be helpful to you. It is well known that almost all people have a cough since birth. Coughing is a normal human reflex that helps to clear foreign bodies from the respiratory tract. For example, if a meal is accidentally dropped into the trachea while eating, the meal can be coughing out with the help of coughing so as not to cause pneumonia. Moreover, coughing is a signal that something is wrong with the body if there is no reason for it to keep coughing, so you should seek medical attention. Cough medications, mainly anesthetic and neuroleptic drugs, suppress the cough reflex and relieve the patient’s symptoms rather than treat the disease itself. The most common causes of cough include: inflammation of the respiratory tract caused by bacteria, viruses and other organisms; tumors of the trachea, bronchi, lungs, pleura and pericardium; autoimmune abnormalities (rheumatoid, lupus erythematosus, interstitial pneumonia), etc. Some diseases are not serious in themselves, but the symptoms of coughing are intense and affect the life of the patient. These are called chronic coughs, such as postnasal drip syndrome, gastroesophageal reflux, variant asthma, and even psychiatric factors can cause a cough. Many people may not believe that the cough originates from the nose, but it is actually caused by postnasal drip syndrome. A patient, Ms. Wang, has a cough in the spring and wakes up with a cough in the middle of the night, day or night. She tried all kinds of cough drops, but in her words, “she drank them as tea”, but they were still not good. After listening to her story, we performed a fiberoptic bronchoscopy and found that Ms. Wang had a lot of phlegm in her throat and mild inflammation in her trachea. After asking her medical history, it turned out that Ms. Wang had a history of chronic sinusitis, which came on in spring. According to Ms. Wang’s condition, she was prescribed some medication for rhinitis, and after 1 week of use, Ms. Wang’s rhinitis was controlled and her cough was cured. Postnasal drip syndrome accounts for about 41% of chronic coughs. The causes of postnasal drip syndrome include acute and chronic rhinitis, sinusitis, nasal polyps, etc. When inflammatory diseases occur in the nasal cavity and sinuses, postnasal and sinus secretions drip into the throat or respiratory tract, stimulating the cough receptors here and producing a cough. Therefore, when chronic cough patients have symptoms of nasal diseases such as runny nose, nasal congestion and headache, they should undergo nasal and sinus examinations to clarify the diagnosis and provide symptomatic treatment. A Mr. Wang had a recurrent cough for more than 2 months, especially at night when he slept. He had seen many doctors and had been treated with antibiotics but did not improve, so he went to our cough center. Cough caused by GERD is often overlooked. Gastric contents can move in the reverse direction into the lower esophagus, which is often physiological reflux. Severe reflux of gastric contents leads to gastroesophageal reflux disease. In addition to typical symptoms such as heartburn, acid reflux, retrosternal pain, and dysphagia, chronic cough can develop, mainly due to coughing from respiratory spasm caused by gastric contents irritating the nerves or accidentally inhaling into the respiratory tract. Treatment for these patients usually includes a high-protein, low-fat diet with an abstinence from acidic foods, coffee, alcohol, and chocolate. Reduce beverages 2 hours before going to bed and between meals, and raise the head of the bed. Gastric power medication such as gastrofacial, and acid control medication such as ranitidine are administered. The treatment course should be long, usually 3 months after the cough has disappeared. Another young female patient had a cough for several months, most severe at night and in the early morning, and worse after exercise and inhalation of cold air. The patient was later diagnosed with cough variant asthma, also known as cough asthma, and the cough symptoms were significantly relieved by anti-asthmatic treatment. Approximately 5-6% of patients with bronchial asthma present with only a persistent cough for several years prior to the onset of typical asthma symptoms and are therefore often misdiagnosed as pharyngitis or bronchitis. The typical clinical manifestations are: first, a prolonged and persistent cough lasting longer than two weeks, often triggered by respiratory irritants such as smoke, cold air and laughter; second, a family or personal history of allergies; third, seasonality, more often in spring and autumn; fourth, ineffectiveness of general cough suppressants and antibiotic therapy; especially in children, cough may be the only clinical manifestation of asthma and, in the absence of early and appropriate treatment, about half of the patients will develop typical asthma. There is another group of coughs with a more specific etiology, a psychogenic cough, mostly seen in children and adolescents, which we call psychogenic cough. The diagnosis of this disorder begins with the exclusion of other causes of cough, including the ones mentioned above. Our cough center once met a high school student who had to cough incessantly every time before an exam, and no medicine worked, and when the exam was over and also strange, the cough naturally got better. When we meet such patients, if the symptoms persist and affect work and study, it is necessary to go through psychotherapy. There are often many big problems hidden behind a small cough, especially a chronic cough of more than 8 weeks, do not just drink cough drops and get rid of it. You should not ignore it, but go to the hospital and “find out the truth” with the help of your doctor. The first step is to go back in your medical history with your doctor. For example, any history of heart disease, tumors, rhinitis, stomach problems, exposure to pollen, seeds, pets or old dust, high blood pressure medication, etc. Based on your medical history and symptoms such as dry cough or sputum, blood in the sputum, etc., the doctor will combine various tests and examinations to find out the cause of your illness as soon as possible. As the saying goes, you need to find the culprit to cure your cough.