Chronic Cough

What is chronic cough?

Coughing is necessary to clear your throat and airways. A chronic cough lasts for 8 weeks or more. It’s commonly caused by allergies, acid reflux (heartburn), some health conditions, infections, or medicine. It usually goes away after the underlying condition is treated.

Symptoms of chronic cough

Coughing is a symptom of an underlying health condition. An occasional cough is common. However, see your doctor if your cough won’t go away and includes any of the following:

• Coughing up thick mucus
• Wheezing (making a whistling sound while breathing)
• A temperature (fever) higher than 101°F
• Losing weight without trying
• Night sweats (significant sweating while you sleep)
• Coughing up blood
• Swollen face and hives (an allergic skin reaction)
• Difficulty breathing
• Chest pain

What causes chronic cough?

Several lifestyle and health conditions can cause chronic cough, including:

• Smoking
• Common allergies (hay fever, mold, pets)
• Postnasal drip (the mucus that drains down the back of your throat from the back of your nose)
• Certain medicines (blood pressure medicines called ACE inhibitors can cause a persistent cough.)
• Air pollution
• Asthma (a lung disease)
• GERD/acid reflux /heartburn (when acid from your stomach backs up into your throat)
• Chronic obstructive pulmonary disease (COPD is a lung disease that makes it difficult to breathe)
• An upper respiratory infection such as bronchitis or sinusitis (some respiratory infections commonly affect children)
• Viral and post-viral infections (the cough can last for weeks after the infection has cleared)
• Lung cancer

Sometimes, a chronic cough occurs because of aspiration (inhaling food or drink).

How is chronic cough diagnosed?

Your doctor will examine you. This includes taking your temperature, looking at the back of your throat, and inside your ears. They will place a stethoscope on your back and chest. This is to listen to you breathe. They will ask you about your symptoms and health history. Your doctor may ask you if you know what triggers your cough. Your doctor also may check your oxygen level by placing a small clip on your index finger. This device measures how much oxygen you are getting. A reading of 100 is ideal. A reading of less than 90 is a concern. You may be given oxygen by placing a mask over your nose. The mask is connected to the oxygen canister with a tube.

Additional tests may include lab tests, such as a blood sample (to check for infection), throat swab, and mucus sample. Your doctor may order a chest X-ray or a CT (computed tomography) scan to look at your lungs. They may have you do a spirometry test. This involves breathing into a tube that is connected to a computer. The computer evaluates your breathing. Another breathing test is the methacholine challenge test if your doctor believes you may have asthma. For this test, you breathe in a mist of a substance called methacholine. Methacholine causes your lungs to open and close. After breathing in the methacholine, you will do a spirometry test.

Can chronic cough be prevented or avoided?

You can prevent or avoid a chronic cough if the underlying cause of your cough is treatable. If your cough is due to allergies, your doctor can treat your allergies with medicine. If it is caused by smoking, you should quit smoking. If your cough is triggered by food, avoid those foods. If your doctor believes your chronic cough is due to other health conditions or medicines you take, they can evaluate alternative options.

Chronic cough treatment

Treatment depends on the cause of your chronic cough.

• Smoking: Stop smoking. See your doctor for suggestions if you have difficulty stopping.
• Allergies: If you have postnasal drip from allergies, avoid the things that bother your nose and throat. That might be dust, smoke, the outdoors, pets, cleaning products and deodorizers, and chemical fumes. Some over-the-counter medicines can help your allergy symptoms. If that doesn’t help, ask your doctor for prescription medicine.
• Acid reflux (heartburn): If you have acid reflux, try raising the head of your bed about 4 inches. Avoid overeating and consuming things that trigger your cough. Don’t eat or drink for a few hours before you lie down. Ask your doctor about over-the-counter or prescription medicines that can help relieve the acid in your stomach. This reduces acid reflux.
• Medicine: If you are taking a medicine that causes you to cough, your doctor might be able to prescribe another medicine for you. Don’t stop taking the medicine without consulting your doctor.
• Asthma: If you have asthma, your doctor will help you decide on the right treatment for your symptoms.

Living with chronic cough

Living with a chronic cough is uncomfortable. It leaves you feeling exhausted (from coughing day and night). It causes chest pain, headache, urinary incontinence (when you unexpectedly urinate a little), and even broken ribs. It’s possible to live without a cough or reduce it by treating the underlying cause. See your doctor instead of suffering unnecessarily.

Questions to ask your doctor

• Do cough drops, hot drinks, or water help ease a chronic cough?
• What serious illness could cause chronic cough?
• Does excessive coughing affect your heart health?
• Does removing your tonsils and adenoids help with chronic cough?
• Should I get vaccinated for common respiratory infections, such as flu, RSV, and COVID-19?

Resources

American Lung Association: Chronic Cough
National Heart, Lung, and Blood Institute: Bronchitis
National Institutes of Health, MedlinePlus: Cough