Chronic Cough: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Chronic cough is a cough that lasts for more than eight weeks in adults or four weeks in children. It can be a bothersome symptom that affects your quality of life and may be indicative of an underlying health issue.
Causes of Chronic Cough
There are many possible causes of chronic cough, but some of the most common ones are:
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A chronic lung disease characterized by inflammation and narrowing of the airways, causing wheezing, shortness of breath, and coughing. Asthma can be triggered by allergens, irritants, infections, exercise, or psychological stress.
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It is caused by stomach acid flowing back into the esophagus, causing heartburn, regurgitation, and coughing. Eating spicy or fatty foods, lying down after eating, and being overweight can worsen GERD.
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An allergic reaction, cold, flu, sinus infection, or environmental factors can cause postnasal drip, which causes excess mucus to drip down the back of the throat, irritating the cough reflex.
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Inflammatory lungs and lung diseases caused by obstructions in the airways, such as chronic bronchitis and emphysema. COPD is mainly caused by smoking, but can also be caused by air pollution, dust, or chemicals.
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Various infections, such as tuberculosis, pertussis, or fungal infections, can cause persistent coughs that last for weeks or months. These infections require specific tests and treatments to diagnose and treat.
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A dry cough may be caused by certain medications, such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, or aspirin. If you suspect your medication is the cause, you should talk to your doctor about changing or stopping it.
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These conditions may also have other symptoms besides coughing, and further investigation may be needed to determine the cause. Other less common causes of chronic cough include lung cancer, pulmonary fibrosis, sarcoidosis, cystic fibrosis, and heart failure.
Symptoms of Chronic Cough
A chronic cough can have different characteristics depending on the cause, such as:
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When a cough is dry, there is no mucus produced, whereas a productive cough produces phlegm or sputum. The color and consistency of the mucus can indicate the type of infection or inflammation.
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A cough that occurs mostly at night may indicate asthma, GERD, or postnasal drip, whereas a cough that occurs mostly during the day may indicate COPD, infections, or medications.
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These symptoms can help narrow down the possible causes and guide the diagnosis of chronic cough, such as fever, chest pain, weight loss, blood in the sputum, wheezing, shortness of breath, or hoarseness.
Diagnosis of Chronic Cough
You will be asked about your medical history, your symptoms, your medications, and whether you have been exposed to smoke or other irritants to diagnose a chronic cough. In addition to examining your chest, throat, nose, and ears, your doctor will listen to your lungs with a stethoscope.
Your doctor may order some tests to confirm the diagnosis, such as:
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Chest X-ray: A simple imaging test that can show signs of lung diseases, such as pneumonia, bronchitis, emphysema, or cancer.
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Spirometry: A breathing test that measures how much and how fast you can exhale air from your lungs. It can help diagnose asthma, COPD, or other lung disorders that affect your airflow.
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Sputum culture: A laboratory test that analyzes the mucus you cough up to identify the bacteria, viruses, or fungi that may be causing your infection.
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Allergy tests: Skin or blood tests that can detect your sensitivity to specific allergens, such as pollen, dust mites, or animal dander. They can help diagnose allergic asthma or postnasal drip.
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Esophageal pH test: A test that measures the acidity of your esophagus to detect GERD. It involves inserting a thin tube through your nose into your esophagus and attaching it to a recorder that you wear for 24 hours.
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Other tests: Depending on your symptoms and suspected cause, your doctor may order other tests, such as bronchoscopy, CT scan, MRI, echocardiogram, or biopsy, to rule out or confirm more serious conditions.
Treatment of Chronic Cough
The treatment of a chronic cough depends on the underlying cause and may include:
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It is possible that your doctor will prescribe medications based on the cause of your cough, such as antibiotics for bacterial infections, antihistamines or corticosteroids for allergies, bronchodilators for asthma, proton pump inhibitors and antacids for GERD, or mucolytics or expectorants for mucus production.
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Changing your lifestyle may also help prevent or reduce your cough, including quitting smoking, avoiding exposure to irritants, drinking plenty of fluids, using a humidifier or saline nasal spray, elevating your head while sleeping, or avoiding foods that cause reflux.
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Honey, lemon, ginger, turmeric, and peppermint tea are some home remedies that may relieve your cough and soothe your throat. It is important to use these remedies with caution, especially in children or people with allergies, as they are not a substitute for medical treatment.
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Surgery: In rare cases, surgery may be required to treat the cause of your cough, such as removing a tumor, repairing a hiatal hernia, or correcting a deviated septum.
Prevention of Chronic Cough
Some tips to prevent or reduce the risk of developing a chronic cough are:
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It is important to avoid tobacco use and secondhand smoke: Smoking can cause chronic coughs and lung diseases, and secondhand smoke can worsen other conditions that make people cough. Quitting smoking or avoiding secondhand smoke can improve your lung health and reduce your cough.
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Make sure you are up to date with your vaccinations and consult your doctor about the best schedule for you. Some vaccines protect you from infections that cause chronic cough, such as pertussis, influenza, or pneumococcal pneumonia.
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The best way to manage your allergies and asthma is to follow your doctor's advice on controlling your symptoms and avoiding triggers. Taking medications regularly or using an inhaler on a regular basis may be necessary. To reduce your sensitivity to allergens, allergy shots or immunotherapy may be beneficial.
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If you suffer from GERD, you should follow your doctor's advice on how to manage it and prevent complications. You may need medications to reduce stomach acid or prevent reflux. In addition to avoiding foods that worsen your symptoms, you may also need to lose weight, eat smaller meals, and avoid lying down after eating if you have GERD.
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Don't ignore or self-treat your cough, as it may indicate a serious condition that requires medical attention if it lasts more than eight weeks.
