Chronic Cough

What is chronic cough?

Chronic cough is a cough that lasts more than eight weeks in adults and four weeks in children. It’s one of the most common reasons for healthcare visits. Chronic cough is usually a symptom of another health condition. But sometimes, it’s a disease without an underlying cause.

More commonly, chronic cough doesn’t cause serious illness. You might notice:

• A stuffy or runny nose.
• Postnasal drip (tickle in the back of your throat).
• Heartburn.
• Sore throat or frequent throat clearing.
• Fever (a temperature higher than 101 degrees Fahrenheit or 38.3 degrees Celsius).

Less commonly, you might notice more serious signs of chronic cough. Contact your healthcare provider if you notice:

• Weight loss without effort.
• Coughing up blood or phlegm.
• Wheezing or shortness of breath.
• Hoarseness that doesn’t go away.
• A drenching overnight sweat.

How common is chronic cough?

Chronic cough affects 10% to 20% of the U.S. population. It’s one of the most common reasons why people visit their healthcare providers every year.

What causes chronic cough?

The most common chronic cough causes include asthma, postnasal drip and GERD (gastroesophageal reflux disease). These conditions account for up to 90% of all chronic cough cases. Not all causes of chronic cough are respiratory. Sometimes, chronic cough can indicate that something is going on. Causes of chronic cough include:

• Allergies.
• Asthma.
• Bronchiectasis.
• Bronchitis.
• Cancer.
• Chronic obstructive pulmonary disease (COPD).
• Fungal infections in your lungs.
• Gastroesophageal reflux disease (GERD).
• Nontuberculous mycobacteria infection.
• Obesity, particularly in the stomach area.
• Taking angiotensin-converting enzyme (ACE) inhibitors, a prescription medication.
• Tuberculosis.
• Whooping cough (pertussis).
• Sinus conditions like sinusitis.
• Upper respiratory conditions like flu, pneumonia and colds.

How is chronic cough diagnosed?

To diagnose chronic cough and determine its cause, a healthcare provider will perform a physical examination and ask about your symptoms. They may also recommend diagnostic tests, which could include:

• Lab tests to see if there’s bacteria in your blood or phlegm, or to check for markers of inflammation.
• Lung function tests, like spirometry, that tell your healthcare provider how well your lungs are working.
• Imaging tests — like chest X-rays, CT (computed tomography) and MRI scans (magnetic resonance imaging), ultrasound and nuclear testing — to get a closer, more detailed look inside your body.

How is chronic cough treated?

Treatment for chronic cough depends on the associated health condition. Your healthcare provider will discuss a tailored treatment plan based on your unique needs.

Possible chronic cough treatments may include:

• Decongestants to relieve postnasal drip.
• Nasal sprays to alleviate sneezing, runny nose and other allergy symptoms.
• Steroids or inhaled bronchodilators to reduce asthma-induced airway inflammation.
• Antibiotics for infections like bacterial pneumonia, sinusitis or bronchitis.
• Changing certain medications or dosages. (Note: You should never stop taking a medication without discussing it with your healthcare provider.)
• Avoiding certain foods to reduce your risk of GERD.

How can I manage my chronic cough symptoms?

To relieve symptoms of chronic cough:

• Drink plenty of water (at least eight 8-ounce glasses a day).
• Gargle with warm salt water to help remove any mucus.
• Avoid inhaling dust, smoke or other pollutants as much as possible.
• Use extra pillows at night to prop up your head and upper body.
• Try cough lozenges.
• Try over-the-counter (OTC) cough medicines that contain guaifenesin and/or dextromethorphan.

What happens if chronic cough goes untreated?

Chronic coughing can affect your life in negative ways that disrupt your daily routine. The most obvious is that you can become extremely tired because you can’t sleep (insomnia). Coughing nonstop can also make your muscles hurt and even break your ribs.

You can also develop:

• Headache/dizziness.
• Urinary incontinence (loss of bladder control).
• Subconjunctival hemorrhage (minor bleeding in your eye).
• Hernia.
• Syncope (fainting or passing out).

How can I reduce my risk for chronic cough?

Because chronic cough is a symptom of so many health conditions, total prevention may not be possible. However, there are certain things you can do to reduce your risk. For example:

• Quit smoking, or don’t start smoking, as this is the most common reason for chronic cough.
• Avoid contact with anyone you know who may have bronchitis or pneumonia.
• Eat fruit and foods that contain fiber. Research suggests that a combination of fiber and flavonoids found in fruit may prevent chronic cough.

When should I be concerned about a chronic cough?

You should schedule a visit with a healthcare provider if you have a lingering cough that won’t go away. Call your provider right away if you’re:

• Coughing up blood or phlegm.
• Running a fever (temperature greater than 101 degrees F or 38.33 degrees C).
• Losing weight without trying.
• Having a drenching sweat overnight.
• Experiencing shortness of breath.
• Having difficulty swallowing.
• Experiencing voice changes.