Chronic Cough

What is chronic cough?

Chronic cough is a cough that lasts longer than eight weeks in adults and four weeks in children. It’s one of the most common reasons people visit their healthcare providers.

Coughing is usually a good thing. It helps you get rid of substances that can irritate your airway. Everyone coughs sometimes. But chronic cough is often a symptom of a health condition. Depending on what’s causing it, you may also have symptoms like:

• Fever
• Heartburn
• Chest Pain
• Hoarseness
• Shortness of breath
• Runny or stuffy nose
• Sore throat or frequent throat clearing
• Tickle in the back of your throat

No matter the cause, frequent coughing can leave you exhausted and self-conscious about when the next coughing fit will happen. This is why it’s important to see a healthcare provider to find ways to manage it.

What causes chronic cough?

The most common chronic cough causes include:

• Asthma. Asthma is the most common cause of chronic cough. Coughing may worsen in certain seasons or in response to dry or cold air. It may get worse when you’re around mold, pollen or smoke.
• Postnasal drip. Another name for this condition is upper airway cough syndrome (UACS). Allergies and nasal disease can cause your nose to make too much mucus. It can drip down your throat and irritate your windpipe and lungs, making you cough.
• GERD (gastroesophageal reflux disease). With GERD, stomach acid backflows into your food pipe (esophagus). It can irritate the tissue lining and make you cough.
• Other lung disease. Bronchitis, COPD, pleural effusions, pneumonia, pulmonary fibrosis and lung masses can also cause chronic cough.

Other reasons for chronic cough include:

• ACE inhibitors (a drug class of blood pressure medicine)
• Allergies
• Heart failure
• Smoking
• Upper respiratory infections (like whooping cough)

When providers can’t find the cause, chronic cough becomes a condition instead of a symptom. In this case, they call it “chronic refractory cough.” In children, providers sometimes call this condition “habitual cough.”

How is chronic cough treated?

Treatment depends on the condition causing your cough. Usually, it involves a mix of medications and lifestyle changes to either cure or manage the condition causing issues. Your healthcare provider will recommend a customized treatment plan based on your needs.

Medicines

Lots of medications treat chronic cough. Your healthcare provider may prescribe or suggest:

• Antacids, H2 blockers or PPIs to manage GERD symptoms
• Antibiotics for bacterial infections
• Antihistamines and nasal sprays to relieve allergy symptoms
• Decongestants to relieve postnasal drip
• Expectorants that thin mucus so it’s easier to cough out (well-known ones include Mucinex^® and Robitussin^®)
• Mucolytics to break up mucus
• Steroids or inhaled bronchodilators to reduce swelling or inflammation in your airway from asthma or other lung conditions

Sometimes, the remedy is to stop taking medicines, like ACE inhibitors. But only do this if your healthcare provider says so. And never give over-the-counter medicines to children under 6 years old unless their pediatrician tells you it’s safe.

Lifestyle changes

To relieve symptoms of chronic cough, try soothing home remedies. Get enough sleep, eat balanced meals and make sure you’re drinking enough water. If you think reflux is part of your cough, you can raise the head of your bed. Work with your provider to identify food or substances that can trigger the cough. Then, make a plan to avoid them.

This advice may sound obvious. But it’s easy to let these kinds of things slide when you’re distracted by something annoying like a persistent cough. Tending to the basics can make a big difference when it comes to feeling better.

What happens if chronic cough goes untreated?

Chronic coughing can keep you up at night and rob you of precious sleep (insomnia). The effects can snowball into fatigue and stress that impact every part of your life. The frequent coughing can make you self-conscious — so much so that you avoid being around others.

In severe cases of chronic cough, you may have related medical issues like:

• Bleeding in your eye
• Broken ribs
• Dizziness
• Headaches
• Hernia
• Loss of bladder control
• Muscle pain in your coughing muscles

Can chronic cough be prevented?

You can’t always prevent chronic cough. But you can do things to reduce your risk. You can:

• Quit smoking. If you don’t smoke, don’t start.
• Protect yourself from germs that can make you sick. This may mean staying up-to-date on flu shots, masking or washing your hands often. There are lots of ways to protect yourself.
• See your primary care provider and discuss the issue with them. They’ll help you decide if you need testing or treatment based on your symptoms.

When should chronic cough be treated by a doctor or healthcare provider?

If your cough lasts 10 days or more, and you don’t know why, it’s time to see your provider. If you have more serious symptoms, let your provider know right away or seek urgent medical care. Reasons to seek urgent medical care include:

• Coughing up blood
• Drenching night sweats
• Hoarseness that doesn’t go away
• Shortness of breath
• Trouble swallowing
• Unexplained weight loss
• Wheezing