Chronic cough overview vector

Chronic Cough: Causes, Symptoms, and Treatment (2024)

by | Updated: Feb 7, 2024

Chronic cough is a prevalent and persistent medical condition that affects millions of individuals worldwide.

Unlike the occasional cough that arises from common colds or respiratory infections, chronic cough lingers for an extended period, often for eight weeks or more.

This article breaks down the causes, symptoms, and potential treatments for chronic cough, providing a comprehensive overview of this unwanted health issue.

What is a Chronic Cough?

A chronic cough is a persistent cough lasting longer than eight weeks in adults or four weeks in children. It can result from various conditions like asthma, acid reflux, smoking, or respiratory infections. Chronic cough can disrupt sleep and daily activities, requiring medical evaluation for proper diagnosis and treatment.

Person with a chronic cough vector

Causes

Chronic cough can be caused by a variety of factors, including:

  • Asthma: Especially cough-variant asthma, which primarily presents with coughing.
  • Postnasal Drip: Mucus from sinus infections or allergies dripping down the throat.
  • Gastroesophageal Reflux Disease (GERD): Acid from the stomach backs up into the esophagus.
  • Chronic Obstructive Pulmonary Disease (COPD): Includes chronic bronchitis and emphysema, often linked to smoking.
  • Infections: Long-term effects from respiratory infections like pneumonia or whooping cough.
  • Blood Pressure Drugs: Particularly ACE inhibitors.
  • Bronchiectasis: Damaged and widened airways causing mucus buildup.
  • Lung Cancer: In rare cases, a chronic cough can be a symptom.
  • Environmental Factors: Exposure to irritants like smoke, dust, or chemical fumes.
  • Other Health Issues: Such as heart failure, tuberculosis, or sarcoidosis.

Note: Identifying the exact cause often requires a medical evaluation, as it can be a symptom of various underlying conditions.

Signs and Symptoms

Alongside the persistent cough, other signs and symptoms that might accompany a chronic cough include:

  • Mucus production
  • Shortness of breath
  • Wheezing
  • Sore throat 
  • Hoarseness
  • Heartburn
  • Stuffy nose
  • Frequent throat clearing
  • Fatigue
  • Chest pain
  • Unintentional weight loss

Note: These symptoms may vary based on the underlying cause of the chronic cough and can impact overall quality of life, necessitating medical attention.

Diagnosis

Diagnosing a chronic cough typically involves a comprehensive evaluation by a healthcare provider. Initially, the process starts with a detailed medical history and physical examination.

The doctor will inquire about the duration and nature of the cough, associated symptoms, environmental exposures, and any past medical conditions.

Often, a chest X-ray is performed to check for lung problems. If asthma or allergies are suspected, pulmonary function tests or allergy testing might be recommended. For symptoms suggesting gastroesophageal reflux disease (GERD), tests like a pH probe or an upper endoscopy can be used.

In cases where more serious conditions like lung cancer or tuberculosis are possible, further imaging tests like a CT scan and sometimes bronchoscopy are utilized. Blood tests may also be conducted to rule out infections or other systemic conditions.

The diagnostic process is tailored to the individual’s symptoms and medical history, aiming to identify and treat the underlying cause of the cough effectively.

Treatment

The treatment for chronic cough focuses on addressing the underlying cause. Common approaches include:

  • Treating Allergies: Antihistamines or nasal steroids for allergies causing postnasal drip.
  • Asthma Management: Inhaled bronchodilators and steroids.
  • Acid Reflux Treatment: Lifestyle changes and medications like proton pump inhibitors or H2 blockers for GERD.
  • Quitting Smoking: Essential for smokers, with assistance through counseling, medications, or nicotine replacement therapy.
  • Antibiotics: For bacterial infections causing cough.
  • Cough Suppressants: Temporary relief for dry cough, though not a long-term solution.
  • Bronchodilators: For COPD, asthma, or bronchiectasis, to open airways.
  • Treating Heart Failure: If the cough is due to heart conditions.
  • Environmental Control: Avoidance of irritants like dust, fumes, or pollutants.
  • Physical Therapy: Breathing exercises and techniques in cases like bronchiectasis.

Note: Consulting with a healthcare provider is crucial for a proper diagnosis and tailored treatment plan, as chronic cough can stem from various health issues.

What is the Cough Reflex?

The cough reflex is a complex physiological mechanism that protects the respiratory system from irritants and clears the airways of mucus and foreign particles.

When irritants such as dust, smoke, or excess mucus stimulate nerve receptors in the airways, a message is sent to the cough center in the brain.

This center, located in the brainstem, processes the signal and triggers a sequence of events: the epiglottis closes, muscles in the chest and abdomen contract forcefully, and then the epiglottis opens suddenly.

This rapid sequence creates a high-speed expulsion of air from the lungs, effectively dislodging and expelling the irritant. The cough reflex is an essential part of the body’s defense mechanism, helping to keep the airways clear and prevent infection.

Home Remedies for Chronic Cough

Home remedies can be useful for managing symptoms of a chronic cough, though they should complement, not replace, medical treatment.

Some effective home remedies include:

  • Honey: Its soothing properties can reduce throat irritation. Mix with warm tea or lemon water.
  • Hydration: Drinking plenty of fluids helps thin mucus, making it easier to cough up.
  • Humidifier: Adds moisture to the air, easing cough and loosening mucus.
  • Steam Inhalation: Breathing in steam from a hot shower or a bowl of hot water can provide relief.
  • Saltwater Gargle: Helps with a sore throat and mucus in the throat.
  • Avoid Irritants: Stay away from smoke, dust, and chemical fumes.
  • Elevate the Head While Sleeping: Reduces postnasal drip and acid reflux symptoms at night.
  • Ginger Tea: Known for its anti-inflammatory properties, it can soothe the throat.
  • Peppermint: Its menthol content can soothe the throat and act as a decongestant.
  • Turmeric: Has anti-inflammatory properties; can be used in teas or warm milk.

Remember: These remedies may alleviate symptoms but won’t cure the underlying cause of a chronic cough. It’s important to consult a healthcare professional for a proper diagnosis and treatment plan.

FAQs About a Chronic Cough

What is the Most Common Cause of a Chronic Cough?

Postnasal drip, asthma, and gastroesophageal reflux disease (GERD) are the most common causes of a chronic cough.

Each of these conditions may contribute to the persistent nature of the cough, and their prevalence varies among different populations.

What Does Chronic Coughing Indicate?

Chronic coughing often indicates an underlying medical condition.

While it can be associated with common issues like asthma, GERD, and upper respiratory infections, it can also be a symptom of more serious conditions such as chronic obstructive pulmonary disease (COPD), lung cancer, or heart failure.

The nature of the cough and associated symptoms can help in pinpointing the underlying cause.

How Common is a Chronic Cough?

Chronic cough is a prevalent condition, affecting approximately 10% of the population.

It is more common in certain groups, such as smokers, older adults, and individuals with underlying health conditions like asthma or GERD.

What is a Nagging Cough?

A nagging cough, often used interchangeably with chronic cough, refers to a cough that persists over a long period, typically more than eight weeks in adults and four weeks in children.

It is characterized by its persistent and bothersome nature, frequently disrupting daily activities and sleep.

What is Upper Airway Cough Syndrome?

Upper airway cough syndrome (UACS), formerly known as postnasal drip syndrome, is a condition in which nasal or sinus secretions drip down the back of the throat, leading to coughing.

This syndrome is often caused by allergies, sinus infections, or irritants, and is a common cause of chronic cough.

How Do I Stop My Chronic Cough?

Stopping a chronic cough involves treating the underlying cause. This could mean using antihistamines and decongestants for allergies, inhalers for asthma, or acid reducers for GERD.

Lifestyle changes like quitting smoking and avoiding irritants are also crucial. It’s essential to consult with a healthcare provider for a precise diagnosis and tailored treatment plan.

What Happens if a Chronic Cough Goes Untreated?

If a chronic cough goes untreated, it can lead to complications such as physical exhaustion, sleep disruption, hoarseness, and even rib fractures from severe coughing.

Additionally, the underlying cause of the cough, if left untreated, may worsen, leading to more serious health problems.

When to See a Doctor for a Chronic Cough?

You should see a doctor for a chronic cough if it lasts longer than eight weeks for adults or four weeks for children, is severe or gets progressively worse, is accompanied by symptoms like shortness of breath, chest pain, or blood, or if it disrupts sleep and daily activities.

Note: Early medical intervention is key in identifying the underlying cause and starting appropriate treatment.

Final Thoughts

Chronic cough is a persistent condition that warrants attention due to its potential underlying causes and impact on an individual’s quality of life.

By addressing its root sources through thorough diagnosis and management, healthcare professionals and patients can work towards relieving this chronic and sometimes debilitating symptom.

A no-nonsense approach to understanding and addressing chronic cough is crucial for those seeking relief from its enduring and often frustrating presence.

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Alhajjaj MS, Bajaj P. Chronic Cough. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
  • ite this Page
    Sharma S, Hashmi MF, Alhajjaj MS. Cough. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
  • Bali, Vishal, et al. “Understanding the Economic Burden of Chronic Cough: A Systematic Literature Review.” BMC Pulmonary Medicine, vol. 23, no. 1, Oct. 2023

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