One of the most common reasons seen in the office for chronic cough is chronic sinus and nose inflammation. This condition has a long and complicated name, chronic rhinosinusitis, but let’s just call it CRS. CRS is much more complicated than most people think and explaining it may be just as tough, but here goes.
CRS may occur with or without polyp formation (tiny, benign growths in the nose and sinuses), and some patients, especially those with polyps, may worsen their condition when they take aspirin. What is interesting in CRS is that the inflammation in the nose and sinuses seems to occur because of a chronic inflammation that once started is difficult, if not impossible, to stop. This is no small problem in the US where approximately 31 million patients are affected at a cost of 5.8 billion dollars a year.
CRS is often associated with lung disease, such as asthma. This is why I often have patients get a CT scan of their sinuses as part of their asthma workup to see if CRS is a complicating factor in their cough symptoms. As I mentioned, some patients with CRS and polyps should not take aspirin or drugs like aspirin. The mechanism is not clear but these patients will have a significant increase in inflammation in the nose and sinuses and may have serious problems with their asthma when they use aspirin.
Treatments can help CRS but, like many chronic diseases, there is no current cure. However, research continues into this important health problem.