Solving Your Chronic Cough: Symptoms, Diagnosis & Treatments
An occasional cough—a normal reaction to a tickling sensation in your throat—helps clear irritants and secretions from your lungs and prevents infection. But if you develop a chronic bothersome cough, you should get evaluated. In adults, a cough lasting longer than eight weeks is considered a chronic cough. While it can sometimes be difficult to pinpoint the problem triggering a chronic cough, the most common causes include:
- Chronic bronchitis
- Asthma and allergies
- Respiratory infections
- Tobacco use
- Chronic obstructive pulmonary disease
- Interstitial lung disease
- Postnasal drip
- Allergies
- Acid reflux
- Some medicines, including ACE inhibitors prescribed to treat hypertension and cardiac conditions
- Upper airway hypersensitivity
In severe cases, chronic coughing can also be accompanied by vomiting, lightheadedness, headaches, loss of bladder control, or fractured ribs.
Chronic cough diagnosis
A chronic cough is usually diagnosed by method of exclusion. Health care professionals may use multiple methods to determine the cause of a persistent, disabling cough. These can include:
- Brief trials of medications
- Pulmonary function testing
- Chest x-ray
Sometimes a small scope is inserted into the upper airway to look for abnormalities that could cause a cough. Evaluation by a specialist may be needed to assess for pulmonary, ear, nose, and throat (ENT), laryngeal, or sleep problems that might cause your cough.
A common cause of persistent cough is a condition called cough hypersensitivity syndrome. When your cough reflex gets more sensitive, it can cause you to cough when you're exposed to even small stimuli like talking, smelling perfumes, and drinking cold liquids. Cough hypersensitivity syndrome often gets better after behavioral speech therapy techniques.
However, a cough can persist in a substantial number of patients despite an extensive investigation into possible clinical causes. Many of these patients’ chronic coughs can’t be attributed to a common cause.
Treatments for Underlying Conditions
If an underlying condition is determined to be causing your chronic cough, a health care professional may combine pulmonary, ENT, and behavioral speech therapies, as well as standard treatments when other remedies haven't worked.
- H20: You can ease your cough with water, whether you drink it or add it to the air with a steamy shower or vaporizer. Your provider may recommend a non-medical-grade or medical-grade nebulizer with saline solution to help directly hydrate your throat and vocal folds (vocal cords) to avoid drying irritation that may worsen a cough.
- Antihistamines or cough medicine: If you have a cold or flu, you may find antihistamines work better than non-prescription . Some people find that cough drops containing menthol products worsen their cough and should be avoided.
- Quit tobacco use: If your chronic cough is caused by tobacco use, your best bet is to quit. Be patient as you may cough even more after quitting because cough receptors start to grow back as the lining of air tubes heals. When that occurs, you may think quitting is making your coughing worse. By four weeks, your cough should subside, and you'll be on your way to a tobacco- and cough-free existence.
- Diagnostic testing: For other causes of persistent coughs, treatments usually follow the standard therapy for the underlying causes discovered during diagnostic testing. For example, for acid reflux cough, a patient may be put on an eight-week trial of powerful antacids. For postnasal drip—the most common cause of chronic cough—the patient may be prescribed a nasal saltwater rinse, antihistamines, decongestants, or nasal steroids.
If you have concerns about your cough, contact your primary care doctor. They can refer you to a specialist or a chronic cough clinic to help improve your cough.
