A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children.
A chronic cough is more than just an annoyance. A chronic cough can interrupt your sleep and leave you feeling exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness and even rib fractures.
While it can sometimes be difficult to pinpoint the problem that’s triggering a chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux. Fortunately, chronic cough typically disappears once the underlying problem is treated.
A chronic cough can occur with other signs and symptoms, which may include:
A runny or stuffy nose
A feeling of liquid running down the back of your throat (postnasal drip)
Frequent throat clearing and sore throat
Wheezing and shortness of breath
Heartburn or a sour taste in your mouth
In rare cases, coughing up blood
When to see a doctor
See your doctor if you have a cough that lingers for weeks, especially one that brings up sputum or blood, disturbs your sleep, or affects school or work.
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An occasional cough is normal — it helps clear irritants and secretions from your lungs and prevents infection.
However, a cough that persists for weeks is usually the result of a medical problem. In many cases, more than one cause is involved.
The following causes, alone or in combination, are responsible for the majority of cases of chronic cough:
Postnasal drip. When your nose or sinuses produce extra mucus, it can drip down the back of your throat and trigger your cough reflex. This condition is also called upper airway cough syndrome (UACS).
Asthma. An asthma-related cough may come and go with the seasons, appear after an upper respiratory tract infection, or become worse when you’re exposed to cold air or certain chemicals or fragrances. In one type of asthma (cough-variant asthma), a cough is the main symptom.
Gastroesophageal reflux disease (GERD). In this common condition, stomach acid flows back into the tube that connects your stomach and throat (esophagus). The constant irritation can lead to chronic coughing. The coughing, in turn, worsens GERD — a vicious cycle.
Infections. A cough can linger long after other symptoms of pneumonia, flu, a cold or other infection of the upper respiratory tract have gone away. A common but under-recognized cause of a chronic cough in adults is pertussis, also known as whooping cough.
Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.
Chronic bronchitis. This long-standing inflammation of your major airways (bronchial tubes) can cause a cough that brings up colored sputum. Most people with chronic bronchitis are current or former smokers. Chronic bronchitis is usually part of the spectrum of smoking-related lung disease called chronic obstructive pulmonary disease (COPD). Emphysema is also incorporated under this term, and chronic bronchitis and emphysema often coexist in current or former smokers with COPD.
Less commonly, chronic cough may be caused by:
Aspiration (food in adults; foreign bodies in children)
Bronchiectasis (damaged airways)
Laryngopharyngeal reflux (stomach acid flows up into the throat)
Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)
Being a current or former smoker is one of the leading risk factors for chronic cough. Frequent exposure to secondhand smoke also can lead to coughing and lung damage.
Women tend to have more-sensitive cough reflexes, so they’re more likely to develop a chronic cough than are men.
Having a persistent cough can be exhausting. Coughing can disrupt your sleep and cause a variety of other problems, including:
Loss of bladder control (urinary incontinence)
Passing out (syncope)
See your doctor if your cough lasts for more than a few weeks. Also, call if you experience symptoms like unplanned weight loss, are coughing up blood, or are having trouble sleeping.
During your doctor’s appointment, your doctor will ask about your cough and other symptoms. You may need to have one of these tests to find the cause of your cough:
Acid reflux tests measure the amount of acid in the fluid inside your esophagus.
Lab tests check your mucus for bacteria.
Lung function tests see how much air you can breathe out. Your doctor uses these tests to diagnose COPD.
X-rays can find cancer or infections like pneumonia. You might also need an X-ray of your sinuses to look for signs of infection.
If these tests don’t help your doctor identify the cause of your cough, they might insert a thin tube into your throat or nasal passage to see the insides of your airways.
Bronchoscopy uses a scope to view the lining of your airway. Your doctor can also use a bronchoscopy to remove a piece of tissue to test. This is called a biopsy.
Rhinoscopy uses a scope to view the inside of your nasal passages.
– Chronic cough is defined as a cough that persists for >8 weeks in adults.
– In children, chronic cough is often defined as a cough of >4 weeks in duration.
– Subacute cough describes a cough lasting 3–8 weeks.
– Patients present because of fear of the causative illness (e.g., cancer), as well as annoyance, self-consciousness, and hoarseness.
– At the primary care level, chronic obstructive pulmonary disease
– (COPD) and smoking-related cough are common causes of chronic cough.
– System(s) affected: Gastrointestinal; Pulmonary