Chronic cough

Overview

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.

Symptoms

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
• Hoarseness
• 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.

Causes

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. Chronic cough can also occur with fungal infections of the lung, tuberculosis (TB) infection or lung infection with nontuberculous mycobacterial organisms.
• Chronic obstructive pulmonary disease (COPD). COPD, a chronic inflammatory lung disease that causes obstructed airflow from the lungs, includes chronic bronchitis and emphysema. Chronic bronchitis can cause a cough that brings up colored sputum. Emphysema causes shortness of breath and damages the air sacs in the lungs (alveoli). Most people with COPD are current or former smokers.
• 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.

Less commonly, chronic cough may be caused by:

• Aspiration (food in adults; foreign bodies in children)
• Bronchiectasis (damaged, dilated airways)
• Bronchiolitis (inflammation of the very small airways of the lung)
• Cystic fibrosis
• Laryngopharyngeal reflux (stomach acid flows up into the throat)
• Lung cancer
• Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
• Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)
• Idiopathic pulmonary fibrosis (chronic scarring of the lungs due to an unknown cause)

Risk factors

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.

Complications

Having a persistent cough can be exhausting. Coughing can cause a variety of problems, including:

• Sleep disruption
• Headache
• Dizziness
• Vomiting
• Excessive sweating
• Loss of bladder control (urinary incontinence)
• Fractured ribs
• Passing out (syncope)