Chronic Cough Overview
What is chronic cough?
Chronic cough is usually defined as a cough that lasts more than eight weeks in adults and four weeks in children. Chronic cough is one of the most frequent reasons for visits to the doctor. Chronic cough is not a disease itself. It is a health problem that results from other health conditions.
What causes coughing?
Your throat is a very sensitive part of the body. The lining of your throat can sense touch, temperature, taste and position. You can sense these things even while you are breathing and eating. Your throat is responsible for getting food and air into the right tubes, making sure you don’t choke. The main job of your throat is keeping your airway safe and clear so you can breathe. A cough can be either voluntary or automatic.
Coughing is one method our bodies use to keep us healthy, but a cough that lasts a long time can affect your life in many ways. Coughing can keep you up at night and make your days miserable from muscle pain and being tired. It’s important to find out why your cough won’t go away.
Who is most likely to experience chronic cough?
People who use tobacco, especially smokers, are at a high risk of developing chronic cough. There is even something called ‘smoker’s cough’ that lasts longer than three weeks. The cough begins when your body tries to clear itself of the irritants that enter when you smoke.
Other people at risk of developing chronic cough include those with certain conditions, including:
- Gastroesophageal reflux disease (GERD).
- Exposure to dust and chemicals, either through an occupation or otherwise.
- Obesity, especially in the stomach area.
What causes chronic cough?
There are several medical conditions that are linked to chronic cough. These include respiratory conditions, such as:
- Asthma: This is the second most frequent cause of chronic cough. Shortness of breath and wheezing happen when you have asthma. These breathing difficulties can result in a chronic cough. There is also a form of asthma (cough-variant asthma) where chronic cough may be the only symptom.
- Bronchiectasis: This condition causes coughing because mucus builds up and lung tissue gets thicker.
- Bronchitis: This condition is a known cause of coughing due the swelling that happens in the bronchial tubes and the increase in mucus production. There are two types —chronic and acute.
- Chronic obstructive pulmonary disease (COPD): COPD is actually a term that refers to a group of respiratory issues that includes chronic bronchitis and emphysema.
- Upper respiratory conditions like flu, pneumonia and colds: These infections are generally caused by viruses. Coughing is one symptom that tends to last after the others are through. The viruses attack the nose, the throat and the sinuses.
Other reasons for chronic cough include sinusitis and allergies. Sinus problems and allergies, along with upper respiratory infections, produce post-nasal drip. This drip is sometimes feels like “a tickle in the back of the throat,” and drainage can lead to chronic cough. This “tickle” happens when the amount of draining mucus is larger than usual.
Many people might worry about cancer if they have a chronic cough. It is possible that coughing that won’t stop is a sign of cancer of the lung or upper airway, but that is not the most likely cause.
Finally, chronic cough is a well-known side effect of angiotensin-converting enzyme (ACE) inhibitors, a specific group of drugs used to treat high blood pressure. These drugs may be used for other things, like preventing kidney damage if you have diabetes. Some common ACE inhibitors are:
- Benazepril (Lotensin®, Lotensin® Hct)
- Captopril (Capoten®).
- Enalapril (Vasotec®).
- Fosinopril (Monopril®).
- Lisinopril (Prinivil®, Zestril®).
- Moexipril (Univasc®)
- Quinapril (Accupril®).
- Peridopril (Aceon®).
- Ramiparil (Altace®).
- Tandolapril (Mavik®).
If you have a chronic cough and you take one of these medications, you shouldn’t just stop taking the medication on your own. Talk with your healthcare provider about what’s going on. They will probably be able to recommend a different medication.
What other symptoms might you have if you have a chronic cough?
Some symptoms can be more common and less likely to be serious, such as:
- A runny or stuffy nose.
- Post-nasal drip (‘tickle' in the back of the throat).
- Wheezing or shortness of breath.
- Sore throat or frequent throat clearing.
- Fever (higher than 101°F).
Other symptoms might be more serious, such as:
- Weight loss without any effort.
- Coughing up phlegm or blood.
- A hoarse voice that does not go away.
- A drenching overnight sweat.
What are the complications of chronic cough that goes untreated?
Chronic coughing can affect your life in negative ways that disrupt your daily routine. The most obvious is that you can become extremely tired because you are unable to sleep (insomnia). Coughing nonstop can also make your muscles hurt and break your ribs.
You might also find that you have:
- Urinary incontinence (loss of bladder control).
- Subconjuctival hemorrhage (minor bleeding in the eye).
- Syncope (fainting or passing out).