It’s normal to cough when something tickles your throat or a piece of food “goes down the wrong pipe.” After all, coughing is your body’s way of clearing your throat and airways of mucus, fluids, irritants, or microbes. A dry cough, a cough that doesn’t help to expel any of these, is less common.
A dry, hacking cough can be irritating. But it could also be a sign of something more serious, such as chronic lung disease. If you’ve got a persistent dry cough, here are a few reasons why you should get it checked out by a doctor.
It’s more than a chronic cough
A cough can signal a number of things happening in your body, especially if it doesn’t go away. In fact, a cough is the most common reason people visit their primary care physicians, according to Cleveland Clinic. Chronic cough, a cough that lasts more than eight weeks, may seem worrisome. But it can actually be quite common and may be caused by:
- gastroesophageal reflux disease (GERD)
- postnasal drip
- therapy with angiotensin-converting-enzyme inhibitors
In nonsmokers, these are the causes for chronic coughs in nine out of 10 patients, according to Harvard Health. But paired with other symptoms, chronic dry cough can be the result of a larger, more serious problem including:
- lung infection
- lung cancer
- acute sinusitis
- chronic sinusitis
- cystic fibrosis
- pertussis (whooping cough)
- heart failure
- idiopathic pulmonary fibrosis (IPF)
If you currently smoke cigarettes or used to smoke, you have an increased risk of developing a chronic dry cough, according to the American Lung Association. Given the long list of reasons that can cause a dry cough, it’s safe to say that it alone isn’t enough to diagnose a larger problem. Your doctor will most likely need to do further evaluation and testing to understand the root cause before recommending treatment options.
When to see a doctor
A persistent dry cough can be a sign of something more serious when you start experiencing other symptoms. Chronic lung diseases like IPF, lung cancer, and heart failure can worsen quickly if left untreated. You should see a doctor right away if your dry cough is accompanied by the following symptoms:
- shortness of breath
- high or prolonged fever
- coughing up blood or bloody phlegm
- weakness, fatigue
- appetite loss
- chest pain when you’re not coughing
- night sweats
- worsening leg swelling
Often, it’s the combination of one or more of these symptoms along with dry cough that can be alarming, say experts, but it’s important not to jump to conclusions until a full workup has been done.
“A persistent dry cough is one common symptom of IPF. There are usually other symptoms of IPF as well, such as shortness of breath and a Velcro-like crackle in the lungs a doctor can hear through a stethoscope,” says Dr. Steven Nathan, medical director of the Advanced Lung Disease and Transplant Program at Inova Fairfax Hospital.
“However, physicians generally try to rule out more common conditions causing a cough, such as postnasal drip, GERD, or a hyperactive airway. Once a physician determines a more common condition isn’t the issue and patients aren’t responding to therapies, then a physician focuses on more uncommon diagnoses, such as IPF.”
Testing and evaluation
Depending on what other symptoms you have, your doctor may order a number of tests to help diagnose the cause of your dry cough. After conducting a physical exam, your doctor will ask you some questions about your dry cough like when it started, if you notice any triggers, or if you have any medical illnesses. Some tests your doctor may order include:
- chest X-ray
- blood sample
- CT scan of your chest
- throat swab
- phlegm sample
- methacholine challenge test
Some of these will help your doctor get a closer look inside your chest as well and test your bodily fluids to check for infections or other health issues. Others will test for how well you can breathe. If these still aren’t enough to pinpoint an issue, you may be referred to a pulmonologist, a doctor who specializes in lung and respiratory diseases, who may order more tests.
A number of over-the-counter medications and natural remedies are available for you to try to find temporary relief from dry cough. But because cough is almost always a symptom of a larger problem, it’s important to remember that these solutions aren’t likely to make the cough go away. Based on any diagnosis your doctor makes after your visit, they will recommend treatment options accordingly.
In the meantime, you can try the following, recommended by the American Lung Association, to help ease your chronic cough:
- cough drops or hard candy
- steamy shower
Long-term risks of dry cough
A chronic dry cough can pose a threat to your overall health if it’s not treated. It can make any current conditions like IPF worse by scarring your lung tissue even more. It can also make your daily life more difficult and cause discomfort and potentially damage.
“No current evidence exists to suggest a dry cough is damaging. However, some physicians think it could be damaging due to the tremendous force and pressure to the airway that a cough generates,” says Dr. Nathan.
The American Lung Association outlines some risks you may face with a chronic dry cough:
- exhaustion and decreased energy
- headaches, nausea, vomiting
- chest and muscle aches
- sore throat and hoarseness
- broken ribs
If the problem is severe, you may even find yourself avoiding social situations, which can lead to anxiety, frustration, and even depression. Persistent dry cough may not always be a sign of something life-threatening, but it can be harmful. As such, it’s important to address it quickly.