Coughing might sometimes be uncomfortable, but it actually serves a useful purpose. When you cough, you bring up mucus and foreign material from your airways that can irritate your lungs. Coughing can also be in response to inflammation or illness.
Most coughs are short-lived. You may catch a cold or the flu, cough for a few days or weeks, and then you’ll start to feel better.
Less often, a cough lingers for several weeks, months, or even years. When you keep coughing without an obvious cause, you may have something serious.
A cough that lasts eight weeks or more is called a chronic cough. Even chronic coughs often have a treatable cause. They can result from conditions like postnasal drip or allergies. Only rarely are they a symptom of cancer or other potentially life-threatening lung conditions.
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 three 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 disease (GERD)
- chronic bronchitis or other forms of chronic obstructive pulmonary disease (COPD)
- infections, such as pneumonia or acute bronchitis
- ACE inhibitors, which are medications used to treat high blood pressure
Less common causes for a chronic cough include:
- bronchiectasis, which is damage to the airways that causes the bronchial walls in the lungs to become inflamed and thickened
- bronchiolitis, which is an infection and inflammation of the bronchioles, the tiny air passages in the lungs
- cystic fibrosis, an inherited condition that damages the lungs and other organs by causing thick secretions
- interstitial lung disease, a condition that involves scarring of lung tissue
- heart failure
- lung cancer
- pertussis, a bacterial infection which is also known as whooping cough
- sarcoidosis, which consists of clusters of inflamed cells, known as granulomas, 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:
- dizziness or fainting
- chest soreness and discomfort
- 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:
You’re more likely to get a chronic cough if you smoke. Tobacco smoke damages the lungs and can lead to conditions like COPD. People with a weakened immune system are more likely to get infections that can cause a chronic cough.
See your doctor if your cough lasts for more than three weeks. Also, call them if you experience symptoms like unplanned weight loss, fever, coughing up blood, or 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.
- Endoscopy uses a flexible, lighted instrument to look into the esophagus, stomach, and small intestine.
- Sputum cultures check the mucus you cough up for bacteria and other infections.
- Pulmonary function tests see how much air you can breathe out, along with other actions of your lungs. Your doctor uses these tests to diagnose COPD and certain other lung conditions.
- X-rays and CT scans can find signs of 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 upper airways.
Bronchoscopy uses a scope to view the lining of your lower airway and lungs. Your doctor can also use 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:
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. Others will require a prescription from your doctor.
Drugs used to treat asthma can include inhaled steroids and bronchodilators, which require a prescription. These medicines bring down swelling in the airways and widen narrowed air passages to help you breathe more easily. You may need to take them every day, long term, to prevent asthma attacks or as needed to stop attacks when they happen.
Bronchodilators and inhaled steroids are used to treat chronic bronchitis and other forms of COPD.
Antibiotics can help treat pneumonia or other bacterial infections.
Decongestants can dry up secretions. Antihistamines and steroid nasal sprays can block the allergic response that causes mucus production and help bring down swelling in your nasal passages.
Additional ways to manage your symptoms
Research has shown that speech therapy may be effective in lowering the severity of a chronic cough. Your doctor can provide you with a referral to this a speech therapist.
Your doctor might prescribe a medicine such as benzonatate (Tessalon Perles) if over-the-counter medicines don’t help. This numbs the cough reflex. The prescription medication gabapentin (Neurontin), an antiseizure medicine, has been found to be helpful in some individuals with chronic cough.
Other traditional cough medicines often 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 it needs to be treated. Often coughs will go away with the right treatment.
If you’ve been dealing with a cough for more than three 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 can be especially soothing to your throat.
- Suck on a cough lozenge.
- If you have acid reflux, avoid overeating and eating within two to three hours before bed. Losing weight can help as well.
- Turn on a cool mist 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 and help drain 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.