When should you see a pulmonologist for a cough?

When does your cough require specialist attention?
When does your cough require specialist attention?

Pulmonologists diagnose and treat different conditions of the respiratory system. This may include a troublesome cough, whether it’s acute (lasting less than three weeks) or chronic (longer than three weeks).

While coughing is a vital function of the body, expelling dust or dirt particles from the airways, it can, however, really compromise your quality of life, especially if it occurs at night and you struggle to sleep. This kind of chronic cough may need to be addressed by a pulmonologist.

Coughing can indicate a number of health problems; it is therefore important that the type of cough be established and its cause be determined before any treatment is undertaken.

While your general practitioner (GP) can diagnose underlying causes such as asthma, allergies, chronic obstructive pulmonary disease (COPD) or allergies, there are situations where you might need the help of a pulmonologist.

In the following cases, a pulmonologist will examine your lungs and respiratory system to determine the exact cause of your cough:

1. When your chronic cough doesn’t respond to treatment by your GP

If your cough has been going on for longer than three weeks, it’s classified as chronic. Even if your doctor has already diagnosed you with an underlying condition such as asthma or COPD, it might be a good idea to consult a pulmonologist if your first line of treatment is not working.

It is especially important to determine the cause of the cough if the cough persists after you've had a respiratory infection such as bronchitis. A pulmonologist can rule out any serious respiratory conditions such as lung cancer or can provide you with a different treatment or combination of treatments if your current treatment is not working.

2. When you experience unintentional weight loss and fever

Weight loss and fever together with a chronic cough can be a cause for concern, especially if the fever lasts longer than a week. These symptoms could be a sign of tuberculosis or lung cancer. It could also signify a bacterial infection or even HIV.

3. When you cough up blood

When your chronic cough is suddenly accompanied by blood (haemoptysis), it could be a serious underlying medical condition that needs urgent attention. Coughing up blood can be a symptom of bronchitis, tuberculosis, pulmonary embolism, or even physical trauma to the lung. The blood could potentially come from outside the airway and originate in the stomach or the nose, but whatever the cause, it is reason for concern. A pulmonologist will be able to establish the exact cause of the bleeding.

woman examining lung xray

4. When you have difficulty breathing

Any respiratory distress or a wheezing sound when coughing is cause for concern as this could be a sign of COPD, involving obstruction of the airways. You should also have your cough examined by a specialist if you have a tight chest.

If you already suffer from COPD or asthma and experience a flare-up of breathing difficulties, a pulmonologist will test your lung function and take a chest X-ray to determine why you are not responding to treatment.

5. When you are at risk of lung disease such as tuberculosis or COPD

If you have any reason to be concerned about lung disease, you might want to have a chronic cough examined by a specialist. If you have been recently exposed to someone with tuberculosis, you might have been infected. If you have been a smoker for many years, you could also be at risk for lung diseases such as COPD (especially emphysema, which is linked to tobacco smoke).

Some occupations such as in the mining and construction industries also pose a high risk for the contraction of COPD, as the dust and exposure to gases can lead to this condition. If you suffer from chronic coughing and work in one of these industries, a further examination to rule out COPD is vital. 

When will my GP refer me to a pulmonologist?

If your doctor has cause for concern and wants more sophisticated testing of your lungs and respiratory system, they may refer you to a pulmonologist. Actually, if you feel the need for a second opinion, you might not have to wait for your general practitioner to refer you to a pulmonologist, depending on the specifications of your medical aid.

Image credits: iStock

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