Coughing might sometimes be uncomfortable, but it actually serves a useful purpose. When you cough, you bring up mucus, germs, and dust from your lungs that might make you sick.
Most coughs are short-lived. You may catch a cold or the flu, cough for a few days, and then you’ll start to feel better.
Less often, a cough lingers for weeks, months, or even years. When you keep coughing without an obvious cause, you have something more serious.
A cough that lasts eight weeks or more is called a chronic cough. Even chronic coughs usually aren’t serious. They often are caused by conditions like postnasal drip or allergies. Only rarely are they a symptom of a life-threatening disease like cancer.
A chronic cough can have a big impact on your life, though. It can keep you awake at night and distract you from work and your social life. That’s why you should have your doctor check out any cough that lasts for more than a few weeks.
The most common causes of a chronic cough are:
- postnasal drip
- asthma, especially cough-variant asthma, which causes a cough as the main symptom
- acid reflux or gastroesophageal reflux (GERD)
- chronic bronchitis
- infections, such as pneumonia or acute bronchitis
- ACE inhibitors, which are medications used to treat high blood pressure
There are also less common causes for a chronic cough, which include:
- bronchiectasis, which is damage to the airways that causes the bronchi walls in the lungs to thicken
- bronchiolitis, which is an infection of the bronchioles, the tiny air passages in the lungs
- cystic fibrosis, an inherited condition that damages the lungs and other organs
- heart failure
- lung cancer
- pertussis, which is also known as whooping cough
- sarcoidosis, which is clusters of inflamed cells that form in the lungs and other parts of the body
Along with the cough, you might have other symptoms, depending on the cause. Common symptoms that often go along with a chronic cough include:
- a feeling of liquid dripping down the back of your throat
- hoarse voice
- runny nose
- sore throat
- stuffed nose
- shortness of breath
A chronic cough can also cause these issues:
- broken ribs if you cough very hard
- dizziness or fainting
- frustration and anxiety, especially if you don’t know the cause
- sleep loss
- urine leakage
More serious symptoms are rare, but call a doctor if you:
- cough up blood
- have night sweats
- are running a high fever
- are short of breath
- lose weight without trying
- have chest pain
You’re more likely to get a chronic cough if you smoke. Tobacco smoke damages the lungs and can lead to conditions like chronic obstructive pulmonary disease (COPD). People with a weakened immune system are more likely to get infections that can cause a chronic cough.
When to see a doctor
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.
Treatment will depend on the cause of your cough. Possible treatments include:
You’ll take medicine to neutralize, reduce, or block acid production. Reflux medicines include:
- H2 receptor blockers
- proton pump inhibitors
You can get some of these drugs over-the-counter and others with a prescription from your doctor.
Drugs used to treat asthma include inhaled steroids and bronchodilators. These medicines bring down swelling in the lungs and widen narrowed air passages to help you breathe more easily. You can take them long-term to prevent asthma attacks or to stop attacks when they happen.
Bronchodilators and inhaled steroids are used to treat chronic bronchitis.
Antibiotics can help treat pneumonia or another bacterial infection.
Decongestants, antihistamines, and steroid nasal sprays can thin and remove extra mucus and bring down swelling in your nasal passages.
Additional ways to manage your symptoms
To control your cough, you could try a cough suppressant. Over-the-counter cough medicines that contain dextromethorphan (Mucinex, Robitussin) relax the cough reflex.
Your doctor might prescribe a stronger medicine such as benzonatate (Tessalon Perles, Zonatuss) if over-the-counter medicines don’t help. Some cough medicines contain the narcotic codeine or hydrocodone. Though these medicines can help calm your cough, they also cause drowsiness and may become habit forming.
Your outlook will depend on what caused your chronic cough, and how you treat it. Often coughs will go away with the right treatment.
If you’ve been dealing with a cough for more than a few weeks, see your doctor. Once you know what’s causing the cough, you can take steps to treat it.
Until the cough goes away, try these tips to manage it:
- Drink lots of water or juice. The extra fluid will loosen and thin mucus. Warm liquids like tea and broth are especially soothing to your throat.
- Suck on a cough lozenge.
- If you have acid reflux, avoid foods that trigger it, like spicy foods, citrus fruits, peppermint, chocolate, and caffeine.
- Turn on a humidifier to add moisture to the air, or take a hot shower and breathe in the steam.
- Use a saline nose spray or nasal irrigation (neti pot). The salt water will loosen up the mucus that’s making you cough.
- If you smoke, ask your doctor for advice on how to quit. And stay away from anyone else who smokes.