Symptoms, Causes, and Treatment of Chronic Cough

03 January, 2021
Chronic coughs are usually due to perfectly manageable causes. In fact, those cases associated with serious illnesses are a minority. In any case, it's always best to consult a health care professional if a cough persists for more than six weeks.

A chronic cough is much more than just a health concern. This is because it often disrupts sleep and can strike at the most inopportune times, such as when speaking in public. Also, it can be exhausting in the most severe cases. In fact, it can lead to vomiting and even fractures.

This is a frequent symptom in clinical practice and due to various causes – smoking is one of the most common. Estimates indicate that smokers are three times more likely to develop a chronic cough at some point in their lives than ex-smokers or those who don’t smoke.

Other causes are environmental pollution, asthma, gastric reflux, and posterior nasal drip. The good news is, the chronic cough usually disappears as soon as you figure out and treat the cause.

What’s a chronic cough?

A woman coughing.

A chronic cough is one that lasts more than three weeks. If it lasts longer than eight weeks, a medical consultation is unappealable. Estimates indicate that up to 23% of healthy, non-smoking people go through stages of chronic cough for various reasons.

Coughing is a reflex or voluntary act to expel secretions or foreign elements. These elements may lodge in the larynx or respiratory tract. As you can see, coughing is a defense mechanism of the body to clean certain areas when there is a need for it.

Everyone coughs and it doesn’t mean there’s an underlying health problem. However, a persistent cough that lasts for several weeks could definitely be a symptom of serious health problems.

Symptoms

The main symptom is obviously a persistent cough with phlegm that lingers for a long time. Consult a physician if the cough doesn’t go away and you also have the following symptoms:

  • Wheezing when breathing
  • Thick or bloody mucus
  • Fever
  • Swelling in the face or hives
  • Difficulty breathing
  • Chest pain
  • Night sweats
  • Weight loss for no apparent reason

Often, the physician will conduct a physical examination while taking into account your medical history. Then, they may recommend treatment for a chronic cough without doing diagnostic tests. However, they may follow up with an X-ray, a computerized tomography (CT scan), spirometer, laboratory analysis, and stress test in those patients who don’t respond to treatment.

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Causes of chronic cough

A woman sneezing.

Smoking is the leading cause of chronic cough. In fact, 90% of non-smokers have this problem for three basic reasons: asthma, reflux, and retro-nasal drip. The causes vary in the additional 10%. These range from the action of certain medications to serious lung diseases.

Estimates indicate that 75 % of those afflicted by neutrophilic asthma also have a chronic cough. Likewise, persistent bacterial bronchitis also leads to it. In these cases, we’re referring to chronic cough with a lower airway (lung) condition.

Furthermore, it’s also associated with upper airway conditions such as chronic rhinosinusitis, allergic rhinitis, obstructive sleep apnea, vocal cord dysfunction, and laryngopharyngeal or gastroesophageal reflux. Actually, chronic cough appears after 50% of the reflux episodes.

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Treatment

The most appropriate treatment will depend on the cause of chronic cough. Physicians usually recommend a conservative treatment at the beginning. It includes home care and administration of antihistamines, glucocorticoids, and decongestants. This is because these are the treatments of choice for allergies and postnasal drip.

However, physicians may prescribe glucocorticoids and bronchodilators, absorbed by inhalation, if the cough is due to asthma. These decrease inflammation and open the airways. They may also prescribe antibiotics if there’s a bacterial infection. Similarly, they’ll most likely suggest an acid blocker if the cough is due to reflux.

Home care measures are effective in many cases: drinking plenty of fluids, humidifying the air, bypassing tobacco smoke, and cough drops. We also advise using a saline solution to clear your nose and drink mucilaginous herbal infusions.

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