Chronic Cough

Treatment of Chronic Cough

A chronic cough is a cough that lasts 8 weeks or longer in adults or 4 weeks in children. A chronic cough can adversely affect a person’s daily life and disrupt their sleep. While it can sometimes be difficult to determine what is causing your chronic cough, it typically resolves once the underlying problem is treated.

Coughing is a vital reflex that helps to clear the airways and throat. It can be triggered by allergies, acid reflux (heartburn), or other medical conditions and typically subsides once the underlying cause, such as germs, mucus, or dust, is eliminated. However, chronic coughing can be prevented by reducing carbonation intake, avoiding irritants like tobacco smoke or dust allergens, and taking appropriate medications or treatment for the underlying condition.

Symptoms of Chronic Cough

In addition to a persistent cough, you may also experience accompanying symptoms such as:

• Congested or runny nose
• Postnasal drip (mucus running down the back of your throat)
• Shortness of breath or chest tightness
• Wheezing
• A hoarse voice, sore throat, and/or frequent throat-clearing
• Heartburn, acid reflux, or in more severe cases, vomiting

A chronic cough can lead to a variety of problems including:

• Sleep disruption
• Headache
• Dizziness
• Vomiting, nausea
• Excessive sweating
• Urinary incontinence (loss of bladder control)
• Fractured ribs
• Syncope (passing out, fainting)

Schedule an appointment with our allergist at Frontier Allergy Asthma and Immunology if your cough lingers for more than 2-3 weeks, especially if you are coughing up phlegm or blood, if your cough disrupts your sleep, or if your cough negatively impacts your performance at school or work.

Causes of Chronic Cough

Although an occasional cough here and there is completely normal, a cough that continues daily for weeks can be a sign you are suffering from an underlying medical problem. In many cases, there may be one or more causes involved. Common causes, either alone or in combination, that may be responsible for your chronic cough include:

• Postnasal drip (upper airway cough syndrome). When your nose or sinuses produce excessive mucus, it can drip down the back of your throat, causing you to cough.
• Asthma. An asthma-related cough may come and go depending on the time of year as certain allergens increase or decrease. It may also appear after an upper respiratory tract infection or after exposure to cold air or certain chemicals or fragrances. Cough-variant asthma is a type of asthma where coughing is the main symptom.
• Chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory lung disease that restricts airflow from the lungs. Chronic bronchitis and emphysema are most readily seen in patients with COPD, both of which can contribute to a chronic, productive cough.
• Infections. A cough can linger long after the other symptoms of your infection resolve. This is seen primarily in patients with pneumonia, the flu, a cold, or other upper respiratory tract infections. Chronic cough can also be attributed to whooping cough (pertussis), tuberculosis (TB), or lung infection with fungus or nontuberculous organisms.
• Gastroesophageal reflux disease (GERD). This is a common condition that is often seen in addition to postnasal drip. In GERD, stomach acid can escape the stomach and travel up your esophagus. This irritation leads to chronic coughing, which can, in turn, worsen your GERD.
• Blood pressure drugs. ACE inhibitors (angiotensin-converting enzyme) can also be culprits of chronic cough in some people.

Less often, chronic cough can be caused by:

• Aspiration (food or foreign bodies going into the trachea)
• Bronchiectasis (damaged, dilated airways)
• Bronchiolitis (inflammation of the small airways of the lung)
• Cystic fibrosis (a genetic disease that affects the cells that produce mucus, sweat, and digestive juices)
• Laryngopharyngeal reflux (somewhat like GERD, but stomach acid flows up into the throat)
• Lung cancer
• Non-asthmatic eosinophilic bronchitis
• Sarcoidosis (collections of inflammatory cells that may accumulate in the lungs)
• Idiopathic pulmonary fibrosis (chronic scarring of the lungs due to an unknown cause)

You are more at risk to develop chronic cough if you are a current smoker, a former smoker, or are frequently exposed to large amounts of second-hand smoke.

Diagnosis and Treatment of Chronic Cough

Treating chronic coughing depends on its cause. Doctors may suggest different medication to control coughing and treat the root cause of the coughing. If smoking is the cause, quitting is recommended. Finding out what's causing the cough is critical to finding the best treatment plan for long-term relief. If more than one issue is causing the cough, it's important to identify and treat each one. A chronic cough can be the result of a wide variety of underlying causes or conditions. Your doctor will ask about your medical history and symptoms and perform a physical exam. Your doctor may also order tests to determine the cause of your chronic cough. If your doctor suspects one or more underlying causes for your chronic cough, they may forgo expensive tests and start you on a personalized plan of care and observe your symptoms over a short period of time.

Next steps

If you are interested in further discussion about your specific needs, Dr. Reshamwala is happy to see you and answer any questions you may have. Please call 512-382-1933 or email clinic@frontierallergist.com to schedule an appointment today! Book an appointment