Sometimes a cough is the first sign of the flu or a cold. Other times, you might have a cough for weeks without developing an illness. Explore the potential causes of a chronic cough so you can take steps to relieve your symptoms and seek medical attention when necessary.
What Is a Nagging Cough?
Doctors define chronic cough as a dry, ongoing cough that lasts for longer than four weeks in children and eight weeks in adults. Along with the cough, you might experience heartburn, shortness of breath, wheezing, hoarse voice, sore throat, frequent need to clear the throat, postnasal drip or nasal congestion.
Common Causes of a Persistent Cough
According to the Mayo Clinic, these are the common underlying causes of chronic cough:
- Blood pressure medications called ACE inhibitors, which may cause nagging cough as a side effect
- Chronic obstructive pulmonary disease, including emphysema, chronic bronchitis and related lung disorders caused by smoking
- Lingering effects of cold, flu, pneumonia, an acute or chronic sinus infection, or another previous respiratory infection
- Gastroesophageal reflux disease, a condition that causes the backflow of stomach acid into the throat
- Asthma, especially after a recent exacerbation or respiratory infection
- Whooping cough, or pertussis, which has resurged in some areas as vaccination rates have declined
Many people who have chronic cough also have a history of smoking or exposure to secondhand smoke. Less common causes of persistent coughing include heart disease, exposure to environmental pollutants, pulmonary fibrosis, lung cancer, cystic fibrosis, and aspiration of foreign bodies or food into the lungs.
When To See a Doctor
Any chronic cough should be checked out by your doctor, especially when your usual remedies don't control your symptoms. Medical care is especially important when a persistent cough makes it difficult to sleep, work or go to school. This symptom can also cause dizziness, headache, sweating and nausea when untreated. Go to the doctor right away if you cough up blood, lose bladder control, vomit, fracture your ribs or lose consciousness while coughing. You also need medical help for coughs that cause chest pain, night sweats, wheezing, loss of appetite, fatigue, leg swelling (edema), difficulty breathing or high fever.
Your doctor will ask you about your symptoms and take a thorough medical history. Prepare to provide information about any history of smoking, other symptoms that occur with your cough, when the cough occurs, whether the cough produces blood or mucus, and how long you have experienced an uncontrolled cough.
The doctor will also do a physical exam and may recommend medications or treatments to resolve cough caused by infection or allergy. In some cases, your doctor may recommend imaging tests or lab exams to diagnose other health problems that might be causing your cough. He or she may also refer you to a lung specialist, especially if you have a serious condition such as COPD.
Treatment for Chronic Cough
When possible, resolving the underlying cause often improves ongoing cough symptoms. For example, if you have postnasal drip, decongestants and cough medication combined with moist steam and nasal irrigation may provide relief. People who have asthma can benefit from bronchodilator spray and corticosteroids, while those who have COPD may be prescribed corticosteroids or antibiotics to assist with chronic cough. If your doctor diagnoses GERD, he or she will likely recommend diet modifications and antacids. For high blood pressure, changing to a different ACE inhibitor can sometimes resolve a nagging cough.
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