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Chronic Cough

What is chronic cough?

A cough is considered chronic when it lasts for 8 weeks or more. It’s commonly caused by allergies, acid reflux (heartburn), some health conditions, 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 phlegm (thick mucus).
  • Wheezing (making a whistling sound when you breathe in or out).
  • 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 (this is the mucus that drains down the back of your throat from the back of your nose).
  • Certain medicines. Some blood pressure medicines called ACE inhibitors are known to cause a persistent cough.
  • Exposure to air pollution.
  • Asthma (a lung disease).
  • Acid reflux (heartburn). This is when acid from your stomach backs up into your throat. It is more common when you are lying down. Acid reflux flares up when consuming certain foods, such as orange juice, lemonade, and chocolate.
  • Chronic obstructive pulmonary disease (COPD). This is a lung disease that makes it difficult to breathe.
  • This is a respiratory infection that commonly affects children.
  • Upper respiratory infection (such as bronchitis or sinusitis).
  • Lung cancer.

How is chronic cough diagnosed?

Your doctor will examine your health history. He or she will take your temperature, look at the back of your throat and inside your ears, and listen to your breathing with a stethoscope (placing it on your chest and back). He or she will ask you about your symptoms. Your doctor may ask you if you have noticed 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 phlegm sample (taking a sample of mucus you are producing from your cough). Your doctor may order a chest X-ray or a CT (computed tomography) scan to take pictures of your lungs. Later, your doctor may have you do a spirometry test. This test involves breathing into a tube that is connected to a computer. The computer evaluates your breathing. Another breathing test is called the methacholine challenge test. With this test, your doctor will have 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. For example, if your cough is due to allergies, your doctor can prescribe a medicine to treat your allergies. If it is due to smoking, you can 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, he or she 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. It might also help to avoid eating or drinking for a few hours before you lie down. Ask your doctor about over-the-counter or prescription medicines that can help relieve the symptoms of acid reflux by reducing the acid in your stomach.
  • 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 unless your doctor gives you permission.
  • 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 can be uncomfortable. A constant cough can leave you feeling exhausted (from coughing day and night). Also, it causes chest pain, headache, urinary incontinence (when you unexpectedly urinate a little), and even broken ribs. However, it’s possible to live without a cough or reduce it significantly by treating the underlying reason. 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 an annual flu vaccine?


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