Chronic Cough: Why Causes it and How to treat it?

A chronic cough is a cough that doesn’t go away. Common causes for chronic cough include asthma, postnasal drip and acid reflux. Treatment depends on the underlying cause. If you’re an adult with a cough that’s lasted more than two months or if your child’s cough lasts more than four weeks, you should contact a healthcare provider to find out why.

What is chronic cough?

Chronic cough is a cough that lasts more than eight weeks in adults and four weeks in children. It’s one of the most common reasons for doctors’ office visits. Chronic cough isn’t a disease itself. It’s a symptom that results from other health conditions.

How common is chronic cough?

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

What are the symptoms of chronic cough?

Some chronic cough symptoms are more common and less likely to be serious, such as:

A stuffy or runny nose.
Postnasal drip (tickle in the back of your throat).
Heartburn.
Sore throat or frequent throat clearing.
Fever (a temperature higher than 101 degrees Fahrenheit or 38.3 degrees Celsius).

More serious chronic cough symptoms include:

Weight loss without effort.
Coughing up blood or phlegm.
Wheezing or shortness of breath.
Hoarseness that doesn’t go away.
A drenching overnight sweat.

Call a healthcare provider right away if you develop any of the symptoms listed above.

Possible Causes

What does chronic coughing indicate?

Chronic cough can develop alongside a number of other health conditions. People who smoke are at a high risk for developing chronic cough. Other people at risk for developing chronic cough include those with certain conditions, including:

Asthma.
Postnasal drip.
COPD (chronic obstructive pulmonary disease), pulmonary fibrosis or other respiratory conditions.
Bronchiectasis.
Gastroesophageal reflux disease (GERD).
Obesity, particularly in the stomach area.

You can also develop chronic cough from exposure to dust and chemicals or as the result of hypersensitivity in your airway.

What causes chronic cough?

The most common chronic cough causes include asthma, postnasal drip and GERD. These conditions account for up to 90% of all chronic cough cases. Other chronic cough causes include:

Respiratory conditions

Respiratory conditions that can cause chronic cough could include:

Asthma: This is the second most frequent cause of chronic cough. Shortness of breath and wheezing are symptoms of 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 to swelling of your bronchial tubes and an increase in mucus production. There are two types — chronic and acute.
Chronic obstructive pulmonary disease (COPD): COPD refers to a group of respiratory issues that includes chronic bronchitis and emphysema. COPD may develop with or without tobacco use.
Upper respiratory conditions like flu, pneumonia and colds: Viruses generally cause these infections. Coughing is one symptom that tends to last after the others go away.

Sinus conditions

Sinus conditions, such as sinusitis, can produce postnasal drip. This drip sometimes feels like a tickle in the back of your throat, and drainage can lead to chronic cough. This tickle happens when the amount of draining mucus is more than usual.

Allergies

Seasonal allergies such as hay fever can result in a dry chronic cough. You’re more likely to develop chronic cough if you’re allergic to dust, mold, pollen, pet dander or other common allergens.

Infections

Certain infections can cause chronic cough, including:

Whooping cough (pertussis).
Tuberculosis.
Fungal lung infections.
Nontuberculous mycobacteria infections.

ACE inhibitors

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. Providers also use these drugs 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®).
Perindopril (Aceon®).
Ramipril (Altace®).
Tandolapril (Mavik®).

If you have a chronic cough and 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 may recommend a different medication.

Cancer

Many people might worry that chronic coughing means they have cancer. While chronic coughing can sometimes indicate lung or upper airway cancer, it’s not the most likely cause.

Care and Treatment

How is chronic cough diagnosed?

To diagnose chronic cough and determine its cause, a healthcare provider will perform a physical examination and ask about your symptoms. They may also recommend diagnostic tests, which could include:

Lab tests to determine if bacteria are present in your blood or phlegm.
Lung function tests, such as spirometry, that tell your healthcare provider how well your lungs are working.
Imaging tests, such as chest X-rays, CT and MRI scans, ultrasound and nuclear testing.

How do I stop my chronic cough?

Treatment for chronic cough depends on the associated health condition. Your healthcare provider will discuss a tailored treatment plan based on your unique needs.

Possible chronic cough treatments may include:

Decongestants to relieve postnasal drip.
Nasal sprays to alleviate sneezing, runny nose and other allergy symptoms.
Steroids or inhaled bronchodilators to reduce asthma-induced airway inflammation.
Antibiotics for infections like bacterial pneumonia, sinusitis or bronchitis.
Changing certain medications or dosages. (Note: You should never stop taking a medication without discussing it with your healthcare provider.)
Avoiding certain foods to reduce your risk of GERD.

How can I manage my chronic cough symptoms?

To relieve symptoms of chronic cough:

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

What happens if chronic cough 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 can’t sleep (insomnia). Coughing nonstop can also make your muscles hurt and even break your ribs.

You can also develop:

Headache/dizziness.
Urinary incontinence (loss of bladder control).
Subconjunctival hemorrhage (minor bleeding in your eye).
Hernia.
Syncope (fainting or passing out).

How can I reduce my risk for chronic cough?

Because chronic cough is a symptom of so many health conditions, total prevention may not be possible. However, there are certain things you can do to reduce your risk. For example:

Quit smoking, or don’t start smoking, as this is the most common reason for chronic cough.
Avoid contact with anyone you know who may have bronchitis or pneumonia.
Eat fruit and foods that contain fiber. Research suggests that a combination of fiber and flavonoids found in fruit may prevent chronic cough.

When to Call the Doctor

When should I be concerned about a chronic cough?

You should schedule a visit with a healthcare provider if you have a lingering cough that won’t go away. Call your provider right away if you’re:

Coughing up blood or phlegm.
Running a fever (temperature greater than 101 F or 38.33 C).
Losing weight without trying.
Having a drenching sweat overnight.
Experiencing shortness of breath.
Having difficulty swallowing.
Experiencing voice changes.

#Chronic Cough