Chronic Cough
Our ability to cough is important; coughing clears particles from our lungs and it helps us to prevent infection. But if a cough lasts for eight weeks or more in an adult, and four weeks or more in a child, it is considered to be a chronic cough and requires medical evaluation and treatment.
Symptoms
A chronic cough is a symptom of an underlying condition. It may be accompanied by a number of other symptoms, including postnasal drip (that sense that liquid is pouring down the back of your throat), hoarseness, a runny nose, wheezing, heartburn, frequent throat clearing, and a sore throat.
Causes
There are a number of reasons why an occasional cough might develop into a chronic cough. Among them are:
- Postnasal drip, which can trigger the reflex that makes us cough
- Asthma, which can be seasonal or can become worse with exposure to specific chemicals or fragrances
- Gastroesophageal reflux disease (GERD), in which acid from the stomach flows back toward the throat
- Chronic sinusitis, in which the sinus spaces are inflamed for 12 weeks or more
- Laryngeal dysfunction, laryngeal hypersensitivity, vocal cord dysfunction, and cough hypersensitivity syndrome
- Weather issues, like cold air or high humidity
- Respiratory tract infections, like the flu, a cold, pneumonia, or whooping cough
- Chronic obstructive pulmonary disease (COPD), or chronic bronchitis, in which the airflow is obstructed
- Bronchiectasis, a damaged airway or airways
- Lung cancer or some other type of cancer
- Interstitial lung diseases such as pulmonary fibrosis, which is a scarring of the lungs and can cause a dry cough
- Blood pressure drugs. The ACE inhibitors often prescribed for heart issues and for high blood pressure can cause a chronic cough.
- Smoking, which sits at the root of many lung issues.
Risk Factors
The biggest risk factor in developing a chronic cough is being a smoker—current or former. Secondhand smoke is also a danger.
Complications
Chronic coughing can be disruptive and annoying. But it can also lead to other complications, among them dizziness, headache, shortness of breath, disrupted sleep patterns, vomiting, urinary incontinence, fractured ribs, and passing out.
When to See a Doctor
If you have had a cough for weeks, see a doctor, especially if you are experiencing any of these problems:
- Coughing up blood or sputum
- Can’t sleep because of coughing
- Fever
- Loss of weight
- Shortness of breath
- Trouble swallowing
- Change in your voice
Diagnosis
To diagnose a chronic cough, your medical provider will consider your history and do a physical exam, which may include testing. Possible tests include:
- Spirometry, which measures how much air you are able to breathe in and out of your lungs, as well as how quickly you can exhale.
- Lab tests, in which your provider may inspect samples of your blood and sputum to look for possible infections.
- X-rays, which won’t diagnose the most likely reasons for a chronic cough (acid reflux, asthma, or postnasal drip), but might reveal pneumonia, lung cancer, and other lung diseases.
- A CT (computerized tomography) scan to give a picture of your lungs and sinuses.
- Bronchoscopy, in which a thin tube with a camera is passed into your air passages to allow examination.
- Endoscopic Rhinolaryngoscopy, in which a thin tube with a camera is used to look at your sinuses and upper airways.
Treatment
The treatment for a chronic cough will depend on the underlying cause. Patients can take steps themselves, in consultation with their doctors, to gain some relief. The first step, for smokers, is to quit. Similarly, patients will be encouraged to avoid secondhand smoke as well as pollutants and other irritants. It’s often recommended that patients stay hydrated and drink about eight 8-ounce glasses of water a day, or half a gallon. Gargling with salt water can also help.
Your healthcare professional may recommend one or more of the following (depending on suspected underlying cause):
- Antihistamines (especially nasal antihistamines), corticosteroids (especially nasal corticosteroids) , and decongestants, which help with allergies and postnasal drip.
- Inhaled asthma medications
- Cough suppressants, which may help with the symptoms but won’t treat the underlying cause.
- If you take an ACE inhibitor, your doctor might have you try a different medication that doesn’t have coughing as a side effect.
- Antibiotics, if it’s determined that a bacterial infection is causing the cough.
- Inhaled asthma drugs, like bronchodilators and corticosteroids, which should open up your airways and make breathing easier.
- Acid blockers, if stomach acid is a contributing factor to your cough.
- Speech therapy
- Smoking cessation
- Consultation with another medical provider about possible causes
End a Chronic Cough
If you are plagued by a chronic cough, look to the health professionals at Florida Medical Clinic’s Department of Allergy, Asthma & Immunology for diagnosis and treatment.
Make an appointment today by clicking here.
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