Coughing is a normal body function, but when it lasts for a protracted time, it can affect daily activities. A chronic cough can be wet and produce phlegm or dry and tickle the throat.
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A chronic cough is a cough that lasts longer than 8 weeks in adults or 4 weeks in children. Common causes include allergies, asthma, bronchitis, or gastroesophageal reflux disease (GERD). Less commonly, it can be a sign of a more severe condition, such as a heart cough or lung disease.
What causes a chronic cough?
A range of factors can cause a chronic cough. Sometimes, more than one factor may be responsible.
Some of the more common causes of chronic cough include:
- Bronchitis. Chronic bronchitis causes long-term inflammation of the airways that can result to a severe cough. This can be a part of an airway disease called chronic obstructive pulmonary disease (COPD) that is caused by excessive smoking.
- Asthma. This occurs when the upper airways are sensitive to cold air, irritants in the air, or exercise. One type of asthma, known as cough-variant asthma, specifically causes a cough.
- Gastroesophageal reflux disease (GERD). GERD occurs when acid comes back up from a person’s stomach and into their throat. The result can be chronic irritation in the throat that leads to a cough.
- Lingering after-effects of infection. A chronic cough can linger if a person has had a severe infection, such as pneumonia or flu. Even when most of their symptoms have gone away, the airways may still remain inflamed for some time.
- Postnasal drip. A postnasal drip is the result of mucus dripping down the back of the throat. This irritates the throat and triggers a cough reflex.
- Blood pressure-lowering medications. Medications to lower blood pressure such as angiotensin-converting enzyme (ACE) inhibitors can cause a chronic cough in some people.
Some less common causes of a chronic cough include:
- Cystic fibrosis. Cystic fibrosis causes excess mucus in the lungs and airways, which can lead to a chronic cough.
- Aspiration. Aspiration occurs when food or saliva goes down the airway instead of the food pipe. The excess fluid can collect bacteria or viruses and may cause inflammation of the airway. Aspiration can cause pneumonia in some cases.
- Bronchiectasis. Excess production of mucus can make the airways to become larger than normal.
- Lung cancer. Persistent coughing can be a sign of lung cancer. A person with this disease may also experience chest pain and blood in their sputum.
- Bronchiolitis. This is a common condition that affects children. It is caused by a virus that causes inflammation of the bronchioles, which are small airways in the lungs.
- Heart disease. Coughing and shortness of breath can be symptoms of heart failure or heart disease. This is called a heart cough. A person with this condition may notice their cough aggravates when they are lying completely flat.
- Sarcoidosis. This causes small growths to develop in the lungs, lymph nodes, eyes, and skin
A cough is typically the result of something that is irritating the airways causing the muscles in the chest and stomach to contract. The irritation also causes the glottis that covers the airways to open quickly, causing air to rush out. The result is a cough.
A cough can be ‘dry’ or ‘wet’. A dry cough is a cough that does not produce mucus. People who smoke cigarettes and those who take ACE inhibitors tend to have a dry cough. A wet cough is one that produces mucus or sputum. This is the case when, for example, a person has postnasal drip or cystic fibrosis.
When to see a doctor
If a person experiences the following symptoms along with a chronic cough they should seek emergency treatment:
If a chronic cough interferes with a person’s everyday activities, it often warrants further examination by a doctor. Other symptoms that may mean a person needs to see their doctor include:
- appetite loss
- coughing up a lot of mucus
- night sweats
- unexplained weight loss
A doctor will begin by asking the person when their symptom first appeared, what makes the symptoms better, and what aggravates them. They will ask about the person’s medical history and lifestyle habits, such as whether they smoke. A doctor will likely also listen to the person’s lungs using a stethoscope.
Sometimes a doctor will require further testing to help with diagnosis. Tests may include:
- taking a sputum sample and examining it for the presence of blood or cancerous cells
- imaging scans, such as X-rays or computed tomography scans to determine if there are signs of lung disease or inflammation
- a bronchoscopy, where a doctor views the lungs for signs of irritation or disease
Each of these tests, as well as a variety of other tests, can help a doctor identify the underlying causes of a chronic cough.
Treatments for a chronic cough depend upon the underlying cause. If a doctor cannot determine the exact cause straight away, they might decide to treat the most common contributing factors for a chronic cough.
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Postnasal drip is a common cause, so a doctor may recommend the person takes decongestants or antihistamines to dry up secretions and reduce inflammation that can lead to postnasal drip. Decongestant or nasal steroid sprays may also help.
Other treatments may be more specific to a particular underlying medical condition. For example, a person may be able to control their GERD through making lifestyle changes and taking medications that reduce the effects of acid on the stomach. Examples of these changes can include:
- eating several small meals a day
- avoiding foods known to trigger GERD, such as caffeine, citrus fruits, tomato-based foods, high-fat foods, chocolate, or peppermint
- refraining from lying down until two hours after eating
- sleeping with the head of the bed raised or using extra pillows to elevate the head
- taking medications, such as ranitidine (Zantac), cimetidine (Tagamet), or famotidine (Pepcid)
Those who have a cough related to ACE inhibitors may wish to talk to their doctor. There are some medications that may be able to reduce high blood pressure without causing a cough.
Smoking cigarettes and exposure to second-hand smoke can also increase a person’s risk. The smoke can irritate the airways and cause a chronic cough as well as lung damage. Exposure to chemicals in the air, such as from working in a factory or laboratory, can also lead to long-term coughing.
Coughing can be problematic if it interferes with a person’s daily life. A chronic cough can have the following additional effects:
- insomnia if coughing occurs at night
- daytime fatigue
- difficulty concentrating at work and school
Although rare, very severe coughing can cause the following complications:
- broken ribs
- urinary incontinence
Disclaimer: The content provided on healthdiary365.com is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.