Chronic Cough
A chronic cough is a cough that persists for eight weeks or longer in adults or four weeks or longer in children. Although coughing is a common symptom of many illnesses that affect the lungs and airways, a chronic cough cannot always be linked to a specific disease and often does not respond to initial treatments.
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Find a DoctorCauses of Chronic Cough
The most common chronic cough causes are:
- Upper airway cough syndrome (UACS)
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UACS, formerly known as postnasal drip syndrome, is irritation of the upper airways and nasal passages typically caused by exposure to irritants such as dust, allergens and chemicals. When you have UACS, your sinuses produce extra mucus that can drip down the back of your throat and settle in the glottis (the area above the windpipe), where it can trigger the cough reflex. UACS is the most common cause of chronic cough in adults.
- Asthma
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Asthma is a chronic disease of the lungs and airways. In response to a sensitivity to allergens or other irritants, the airways in a person with asthma become inflamed, swollen and narrow while often producing extra mucus, making breathing difficult. Cough-variant asthma, in particular, is a type of asthma in which the defining symptom is a chronic, dry, non-productive cough.
- Acid reflux disease
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Acid reflux is when stomach acid repeatedly flows back into the esophagus (the tube connecting your mouth and stomach), irritating its lining. When acid repeatedly flows from the stomach into the esophagus alone, the condition is called gastroesophageal reflux disease (GERD). If stomach acid travels up into the esophagus and flows into the throat or voice box (pharynx/larynx), the condition is known as laryngopharyngeal reflux (LPR).
- Infections
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A cough can linger long after other symptoms of flu, pneumonia, cold, pertussis (whooping cough) and other upper respiratory tract infections have resolved. Fungal infections of the lung, tuberculosis (TB) and lung infection with nontuberculous mycobacterial organisms can also lead to a chronic cough.
- Chronic obstructive pulmonary disease (COPD)
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COPD, a chronic inflammatory lung disease that causes obstructed airflow, includes such conditions as chronic bronchitis and emphysema. Chronic bronchitis can cause a chronic cough that brings up colored sputum (mucus that is coughed up from the lower airways). Emphysema is a condition characterized by damaged air sacs (alveoli) in the lungs typically accompanied by shortness of breath, chronic coughing and other related symptoms. Most people with COPD are current or former smokers.
- Blood pressure drugs
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Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed to treat for high blood pressure and heart failure, are known to cause chronic cough in some individuals.
Other less common causes of chronic cough include:
- Bronchiectasis
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Bronchiectasis is a condition in which the bronchial tubes (the two large tubes that branch off the bottom of the windpipe to carry air to and from the lungs) become damaged, making clearing mucus difficult.
- Bronchiolitis
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Inflammation of the bronchial tubes that occurs in young children and infants.
- Aspiration
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When food, liquid or some other material accidentally enters your airway and moves into the lungs.
- Cystic fibrosis
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A progressive, genetic disease that affects the lungs, pancreas and other organs.
- Lung cancer
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- Nonasthmatic eosinophilic bronchitis
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Bronchitis is an inflammation of the lining of the bronchial tubes. People with nonasthmatic eosinophilic bronchitis have an abnormally high amount of eosinophils, a type of white blood cell, in their mucus.
- Idiopathic pulmonary fibrosis
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Chronic scarring of the lungs due to an unknown cause.
- Sarcoidosis
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A rare condition that causes small patches of swollen tissue, called granulomas, to develop in the lungs, lymph nodes and other organs.
Chronic Cough Symptoms
Ways to Manage a Chronic Cough Throat Clearing and All That Mucous
If you are plagued with nasal allergies, voice changes, a nagging cough or sticky mucus, you won’t want to miss this health talk.
Listen NowIn addition to persistent coughing, other symptoms that may accompany a chronic cough include:
- Stuffy or runny nose
- Feeling of mucus gathering and dripping down the back of the throat (postnasal drip)
- Frequent throat clearing and sore throat
- Shortness of breath
- Wheezing
- Hoarseness
- Heartburn and sour taste in mouth
- Rarely, coughing up blood
Complications of Chronic Cough
A long-lasting cough can cause a number of health problems, including:
- Sleep disruption and associated exhaustion
- Dizziness
- Vomiting
- Headache
- Excessive sweating
- Urinary incontinence
- Changes in voice
- Fractured ribs
- Fainting
When to Call the Doctor
A cough caused by an infection or exposure to allergens or common irritants will usually clear up within a few weeks. Make an appointment with a healthcare provider if your cough lasts longer than three weeks or is accompanied by any of the following symptoms:
- Fever
- Shortness of breath
- Thick mucus that is green or yellow in color
- Night sweats
- Unexplained weight loss
If you experience a cough that lasts six weeks or longer, we suggest you follow up with a primary care doctor even if you previously visited a doctor as a result of getting sick. A primary care doctor may then refer you to an ear, nose and throat (ENT) specialist.
Seek emergency care if you develop a cough that is accompanied by any of the following symptoms:
- Coughing up blood
- Difficulty breathing
- High fever
- Skin turning pale or blue
- Chest pain
- Fainting
- Confusion
How Is Chronic Cough Diagnosed?
To diagnose a chronic cough and determine its cause, your healthcare provider will conduct a physical examination and ask you about your symptoms. They may also order diagnostic tests, which could include:
- Imaging tests such as chest X-rays, MRI and CT scans, ultrasound and nuclear testing.
- Lab tests, including a throat swab or blood sample to see if bacteria are present in your phlegm or blood, respectively.
- Spirometry or other lung function tests, which measure how well your lung work. Spirometry measures the amount and/or speed of air you can inhale and exhale.
How to Stop Coughing?
Treatment for chronic cough depends on the cause. Your doctor will recommend a treatment plan tailored to your unique needs. Depending on the cause of your cough, your treatment may include one or more of the following:
- Nasal sprays to alleviate runny nose, sneezing and other allergy symptoms.
- Decongestants, antihistamines or corticosteroids for the relief of postnasal drip.
- Steroids or inhaled bronchodilators to reduce airway inflammation caused by asthma.
- Antibiotics for pneumonia, sinusitis, bronchitis and other bacterial, fungal and mycobacterial infections.
- Avoiding certain foods to reduce the occurrence of GERD.
- Acid blockers to block acid production in people with GERD.
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