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Definition

What is chronic cough?

A chronic cough is a cough that lasts eight weeks or longer in adults or four weeks in children. A chronic cough is more than just an annoyance. A chronic cough can interrupt your sleep and make you feel exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness, and even rib fractures.

Fortunately, chronic cough typically disappears once the underlying problem is treated.

How common is chronic cough?

Chronic cough is reported by 10-20% of adults. Cough may be work-related and a thorough occupation history is very important in assessment.

However, it can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of chronic cough?

A chronic cough can occur with many other signs and symptoms including:

  • A running nose
  • A feeling of liquid running down the back of your throat (postnasal drip)
  • Frequent throat clearing and sore throat
  • Hoarseness
  • Wheezing and shortness of breath
  • Heartburn or a sour taste in your mouth
  • In rare cases, coughing up blood

When should I see my doctor?

You must seek immediately medical attention if you experience these symptoms.

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently.

Causes

What causes chronic cough?

You should notice that an occasional cough is normal — it helps clear irritants and secretions from your lungs and prevents infection as well. However, a cough that persists for weeks is usually the result of a medical problem. In many cases, more than one cause is involved.

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

  • 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).

  • 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.

  • 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.

  • 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 bronchitis

This long-standing inflammation of your major airways (bronchial tubes) can cause a cough that brings up colored sputum. Most people with chronic bronchitis are current or former smokers. Chronic bronchitis is usually part of the spectrum of smoking-related lung disease called chronic obstructive pulmonary disease (COPD). Emphysema is also incorporated under this term, and chronic bronchitis and emphysema often coexist in current or former smokers with COPD.

Less commonly, chronic cough may be caused by:

  • Aspiration (food in adults; foreign bodies in children)
  • Bronchiectasis (damaged airways)
  • Bronchiolitis
  • Cystic fibrosis
  • Laryngopharyngeal reflux (stomach acid flows up into the throat)
  • Lung cancer
  • Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
  • Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)

Risk factors

What increases my risk for chronic cough?

Risk factors for developing a chronic cough are:

  • Smoking: Current or former smoking is a major risk factor for chronic cough. This is caused by direct inhalation of cigarette toxins or secondhand smoking (breathing cigarette toxins in the air).
  • Allergies: People with allergies have an increased risk of developing cough when exposed to a specific allergy trigger.
  • Environmental: Some workplaces may have irritants in the air that one can breathe in and cause cough. High pollution areas or using coal for cooking or heating can also increase your risk of cough.
  • Chronic lung diseases: People with asthma, bronchiectasis (enlarged airways), COPD, and previous lung infections with scars are at increased risk of developing cough.
  • Female gender: Women have a more sensitive cough reflex, increasing their risk of developing chronic cough.

Diagnosis &treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is chronic cough diagnosed?

Physical Exam

At the doctor’s office, they will take your vital signs including your temperature. They may check your oxygen levels by attaching a small painless clip to your finger. Your doctor will look at the back of your throat and ears when necessary. They will listen to your lungs and heart with a stethoscope and may also look at your legs and skin.

Tests

Your doctor may decide to order additional tests, which could include:

  • Chest X-ray: quick and easy chest picture.
  • Blood sample: to see if your body is fighting an infection.
  • CT scan of the chest: a better quality picture of the chest.
  • Throat swab: usually done with a long cotton swab.
  • Phlegm sample: collected after a deep cough
  • Spirometry: you will be asked to breathe out hard and fast into a small plastic device to measure how well you breathe out air.
  • Methacholine challenge test: a standard asthma breathing test often used to assess for cough variant asthma.

How is chronic cough treated?

If you are taking an ACE inhibitor medication, your doctor may switch you to another medicine that doesn’t have a cough as a side effect.

Medications used to treat chronic cough may include:

  • Antihistamines, glucocorticoids and decongestants. These drugs are standard treatment for allergies and postnasal drip.
  • Inhaled asthma drugs. The most effective treatments for asthma-related cough are glucocorticoids and bronchodilators, which reduce inflammation and open up your airways.
  • Antibiotics. If a bacterial infection is causing your chronic cough, your doctor may prescribe antibiotics.
  • 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.
  • Cough suppressants. If the reason for your cough can’t be determined and it’s causing serious problems for you, such as keeping you from sleeping, your doctor may prescribe a cough suppressant. However, there’s no evidence that over-the-counter cough medicines are effective.

Lifestyle changes &home remedies

Maintaining a healthy lifestyle, especially if you are at high risk, is important. This includes things like:

  • Quit smoking

After you stop smoking, you will be much less likely to catch colds or suffer from a chronic cough.

  • Dietary changes

If you need help to adjust your diet, your doctor may be able to advise you or refer you to a dietitian.

  • Medical conditions

It’s advisable to stay away from anyone suffering from contagious illnesses, such as bronchitis, to avoid coming into contact with germs. You should wash your hands frequently, and not share cutlery, towels, or pillows.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 4, 2017 | Last Modified: January 4, 2017

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