Chronic Cough: Symptoms, Causes and Treatments

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A chronic cough can be defined as a cough that is long-term, persistent and does not seem to go away in spite of treatment. It is a defense mechanism developed by the body in an attempt to keep the airways free of mucus or other debris.

A chronic cough is one of the most common reasons prompting a visit to the doctor's office. It can be debilitating, as it interferes with sleep, causes chest pain and leaves you feeling angry and frustrated.

There are many possible causes for a chronic cough. It can be caused by an infection in the lungs or from outside irritants such as cigarette smoke or air pollution.

A chronic cough may, or may not, be a symptom of a serious, underlying lung condition like chronic obstructive pulmonary disease or lung cancer. That's a major reason why it warrants further investigation from your healthcare provider.

What Exactly Is a 'Chronic Cough'?

Most doctors consider a cough "chronic" if it's been going on for eight weeks or more. It's far from unusual — in fact, it may occur in up to 40% of people.

Although you can cough at will, most coughs are involuntary. Involuntary coughing occurs when something irritates or stimulates your airways, which triggers a reflexive action in your lungs and throat to breathe in deeply and then suddenly expel air from your lungs.

Chronic coughs can be productive, or "wet" — in other words, they produce mucus for you to expel by mouth — or your coughs can be non-productive, or "dry." Different conditions will produce different types of coughs.

For example, when you have chronic obstructive pulmonary disease, you're more likely to have a productive cough, since your body needs to rid itself of the mucus that's clogging your lungs. But when you're exposed to dust, fumes or chemicals at work, that's more likely to lead to a non-productive cough.

Possible Causes of Chronic Cough

The three top causes of chronic cough include:

  • Post-nasal drip syndrome. In this condition, too much mucus from your nose continually drips down the back of your throat, irritating the tissues there and leading to a chronic cough. There's a wide range of conditions that can lead to post-nasal drip syndrome, including allergies, structural abnormalities in the nose itself, pregnancy, and certain medications.
  • Asthma. Although many people think wheezing and difficulty breathing are the primary signs of asthma, sometimes the only asthma symptom you have, at least initially, is a chronic cough. It's important to get this type of asthma, known as cough variant asthma, properly diagnosed and treated, because if you don't there's a good chance it will progress into "classic" asthma symptoms.
  • Gastroesophageal reflux disease (GERD). Yes, GERD usually involves digestive symptoms like heartburn and reflux. But in many cases, GERD also causes chronic cough. In fact, some 25% of chronic cough cases may be due to GERD. Some people with chronic cough due to GERD also have the "classic" reflux symptoms, while others do not.

    Other possible (but less likely) causes of chronic cough include:

    Many people have more than one cause for their chronic cough.

    Since there are so many possible causes of chronic cough — some of which are unlikely but quite serious — it's critical for you to visit your physician and get a proper diagnosis and treatment for your chronic cough.

    Sources:

    American Academy of Otolaryngology-Head and Neck Surgery. Post-Nasal Drip fact sheet. Accessed Feb. 9, 2016.

    Benich JJ et al. Evaluation of the Patient with Chronic Cough. American Family Physician. 2011 Oct 15;84(8):887-892.

    D'Urzo A et al. Chronic cough. Three most common causes. Canadian Family Physician. 2002 Aug; 48: 1311–1316.

    Madanick RD. Management of GERD-Related Chronic Cough. Gastroenterology & Hepatology. 2013 May; 9(5): 311–313.

    Niimi A. Cough and Asthma. Current Respiratory Medicine Reviews. 2011 Feb; 7(1): 47–54.

    Pratter MR. Overview of common causes of chronic cough: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):59S-62S.

    Sundar KM et al. Chronic Cough and OSA: A New Association? Journal of Clinical Sleep Medicine. 2011 Dec 15; 7(6): 669–677.

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