Chronic Cough: Symptoms, Causes & Treatment

Chronic cough is a life threatening cough that lasts more than eight weeks in adults and four weeks in children. A chronic cough can interrupt your sleep and leave you feeling exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness and even rib fractures. The treatment depends on the underlying causes.

It affects about 10% to 20% of the U.S. population. It’s one of the most common reasons why people visit their doctors every year.

Symptoms of chronic cough

Together with the cough, you may also have other symptoms, depending on the cause. The following are the common symptoms that often go along with a chronic cough:

• wheezing
• postnasal drip, or a feeling of liquid dripping down the back of your throat
• heartburn
• hoarse voice
• runny nose
• sore throat
• stuffed nose
• shortness of breath

When to seek a medical attention or emergency:

• have night sweats
• become dizzy or faint
• cough up blood
• are running a high fever
• have trouble breathing or getting enough air
• have persistent chest pain
• lose weight without trying

Causes of chronic cough

A cough that persists for weeks or months is usually regard to as a medical problem. In many cases, more than one cause is involved.

The following causes alone or in combination, are responsible for the majority of chronic cough cases:

• Asthma. An asthma-related cough may come and go with the seasons, appear after an upper respiratory tract infection, or become worse when you’re exposed to cold air or certain chemicals or fragrances. In one type of asthma (cough-variant asthma), a cough is the main symptom.
• Postnasal drip. When your nose or sinuses produce extra mucus, it can drip down the back of your throat and trigger your cough reflex. This condition is also called upper airway cough syndrome (UACS).
• Gastroesophageal reflux disease (GERD).In this common condition, stomach acid flows back into the tube that connects your stomach and throat (esophagus). The constant irritation can lead to chronic coughing. The coughing, in turn, worsens GERD, a vicious cycle.
• Infections. A cough can linger long after other symptoms of pneumonia, flu, a cold or other infection of the upper respiratory tract have gone away. A common but under-recognized cause of a chronic cough in adults is pertussis, also known as whooping cough. Chronic cough can also occur with fungal infections of the lung, tuberculosis (TB) infection or lung infection with nontuberculous mycobacterial organisms.
• Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.
• Chronic obstructive pulmonary disease (COPD). A chronic inflammatory lung disease that causes obstructed airflow from the lungs, includes chronic bronchitis and emphysema. Chronic bronchitis can cause a cough that brings up colored sputum. Emphysema causes shortness of breath and damages the air sacs in the lungs (alveoli). Most people with COPD are current or former smokers.

Other causes may include:

• Bronchiectasis (damaged, dilated airways)
• Aspiration (food in adults; foreign bodies in children)
• Bronchiolitis (inflammation of the very small airways of the lung)
• Cystic fibrosis
• Laryngopharyngeal reflux (stomach acid flows up into the throat)
• Lung cancer
• Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
• Idiopathic pulmonary fibrosis (chronic scarring of the lungs due to an unknown cause)
• Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)

You can also read about symptoms and causes of pneumonia

Risk factors of chronic cough

While chronic coughing has many several underlying causes, there are many risk factors and problems that increase the likeliness of developing it. Some of this risk factors include:

• weakened immune system
• smoking or vaping
• asthma
• GERD (Gastroesophageal reflux disease)
• sinus inflammation

Complications of chronic cough

Chronic cough affects your life in negative ways that disrupt your daily routine and activities. The very obvious is that you can become extremely tired because you can’t sleep (insomnia). Chronic coughing nonstop can also make your muscles hurt and even break some of your ribs. Other common complications include:

• Headache/Unconsciousness
• Urinary incontinence (loss of bladder control).
• Hernia.
• Subconjunctival hemorrhage (minor bleeding in your eye).
• Syncope (fainting).

You can also read about risk factors and complications of asthma

Prevention of chronic cough

The following are the tips to prevent or relieve a chronic coughing:

• Avoid inhaling dust, smoke or other pollutants as much as possible.
• Drink plenty of water (at least eight 8-ounce glasses a day).
• Gargle with warm saltwater to help remove any mucus.
• Use extra pillows at night to prop up your head and upper body.
• Try over-the-counter cough medicines that contain guaifenesin and/or dextromethorphan.
• Try cough lozenges.

Diagnosis of chronic cough

Your healthcare provider will ask about your medical history and also perform physical examinations. With the type of symptoms you are having and your medical history, your doctor will perform other tests to rule out what’s causing your chronic cough. These tests include:

• Blood tests. This can look for signs of infection or other conditions.
• Acid reflux tests. This measures the amount of acid in the fluid inside your esophagus.
• Imaging tests, This include X-rays and CT scans, which will help a doctor see your chest and airways.
• Spirometry. This is a lung function test that measures airflow in and out of your lungs.
• Endoscopy. This uses a flexible, lighted instrument to look into the esophagus, stomach, and small intestine.
• Sputum cultures. This check the mucus you cough up for bacteria and other infections.
• Pulmonary function tests. This measure how well your lungs are working.
• Allergy tests. This can help diagnose environmental allergies that could be causing a reaction.

You can also read about Prevention and diagnosis of lung cancer

Treatment of chronic cough

The management of chronic cough will depends on the underlying health conditions. Your doctor will discuss with you which treatment plan is best for you. In many cases of chronic cough, more than one problem (underlying condition) is associated with it.

If you are a smoker, your healthcare provider will discuss with you, the readiness to quit and also provide assistance to achieve that goal for you.

If you’re the type that is on medication like ACE inhibitor drugs, your doctor may recommend another medicine that doesn’t have cough as a side effect.

Drugs used in the treatment of chronic cough include:

• Inhaled asthma drugs. The most effective treatments for asthma-related cough are corticosteroids and bronchodilators, which reduce inflammation and open up your airways.
• Antihistamines, corticosteroids and decongestants. These drugs are standard treatment for allergies and postnasal drip.
• Antibiotics. If a bacterial, fungal or mycobacterial infection is causing your chronic cough, your doctor may prescribe medications to address the infection.
• Acid blockers. When lifestyle changes don’t take care of acid reflux, you may be treated with medications that block acid production. Some people need surgery to resolve the problem.

Other treatment options and home remedies include:

• Cough suppressants. This can help speed up the symptoms relief.
• Saline nose spray or a nasal irrigation device. Such as a neti pot. The salt water will loosen up and help drain the mucus that’s making you cough.
• Drink lots of water. The extra fluid will loosen and thin mucus. Warm liquids like tea and broth can be especially soothing to your throat.

Using Over-the-counter cough and cold medicines. This are intended to treat the symptoms of coughs and colds, not the underlying conditions.

Note: Don’t use over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children younger than 6 years old. Also, consider avoiding use of these medicines for children younger than 12 years old. Before taking any drugs or over-the-counter Medicines, make sure to seek the advice of your doctor first.

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