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Chronic Cough

It is normal to cough occasionally, especially if you have a cold, flu or allergies.

Coughing has a purpose. It is your body’s way of keeping unwanted stuff from getting into your lungs. Coughing helps clear extra mucus from your airways (small tubes in your lungs). This extra mucus could be caused by smoking, a cold, nasal or sinus problems, a lung infection or a lung disease like asthma or COPD.

A cough may be caused by a condition not related to your lungs, such as heartburn, some medications, or throat irritants (for example, dust, pollution, or chemicals in your workplace or home).

Coughing up blood or thick mucus is not normal. If your cough makes you very tired or light-headed, causes chest or stomach pain, or causes you to wet yourself, you should talk to your doctor.

What are the different types of cough?

Doctors divide coughing into three groups, based on how long the cough has lasted: acute (coughing less than three weeks), sub-acute (coughing that lasts from three to eight weeks), or chronic (coughing that lasts longer than eight weeks).

Acute (Up To 3 Weeks)


Just about everybody coughs sometimes. From time to time, you may get a cough that lasts a short while (known as an acute cough), and then goes away. A main cause of acute cough is the common cold. You may catch a cold then have a cough that lasts two or three weeks. If you have an acute cough, follow this treatment advice.
Acute cough warning signs — See a doctor or go to the nearest emergency room, if you are:

  • Extremely short of breath
  • Turning blue in the lips or fingernails
  • Swelling in the lips
  • Coughing up blood

Sub-Acute (3-8 Weeks)

A cough that lasts for 3-8 weeks is often caused by a cold or other lung infection that lasts longer than normal. A cough that lasts 3-8 weeks may go away by itself but it may also need treatment. If you have a three-week cough and you are not sure if you should see your doctor, read the following questions:

  • Are you coughing up blood?
  • Are you short of breath?
  • Has your cough has changed over time?
  • Are you losing weight without trying?
  • Are you coughing up phlegm?
  • Do you have a fever?
  • Do you currently smoke?
  • Did you smoke in the past?
  • Are you living with asthma or COPD or other respiratory conditions?

If you answered yes, to any of these questions, you should talk to your doctor about your cough.

To diagnose your cough your doctor may ask you questions about your family history, things you may have been exposed to at home or work, and if you smoked. Your doctor may want to examine you. Your doctor may also give you a few tests including:

  • A chest X-ray to take a picture of your lungs. This can tell your doctor if you have something like pneumonia or lung cancer.
  • Spirometry – This test measures how much air you can breathe out and in. Your doctor will use spirometry to diagnose conditions such as asthma or COPD.

Chronic

A cough that lasts 8 weeks or longer is known as a chronic cough. A chronic cough is not a disease in itself. It is a sign of something wrong. That’s why it’s important to see your doctor and find out the cause. Some of the most common causes of chronic cough include:

  • Post-nasal drip syndrome, when mucus drips down your throat from the back of your nose
  • Something at home or work that is irritating your nose or airway
  • Allergies
  • Asthma
  • Smoking
  • COPD (new name for emphysema and chronic bronchitis)
  • Acid reflux (sometimes called gastro-esophageal reflux disease or GERD)
  • Some high blood pressure medications
  • Or a combination of these causes

In rare cases, chronic cough can be caused by serious diseases like tuberculosis (TB), lung cancer. Your doctor may want to order a chest x-ray to determine whether you have a serious condition.

Diagnosing a chronic cough

The first step in treating a chronic cough is to find out what’s causing it. Your doctor may do several tests to diagnose the cause.

First your doctor will ask about your medical history. He or she might ask you questions such as whether you have allergies, what medications you are currently taking, whether you smoke or smoked in the past, if you use chemicals at home or work, and if you have been sick lately. Before you go to your doctor, write down everything you want to tell him or her. Your doctor should do a physical exam and may also order a chest X-ray.

Your doctor may also order lung function tests (spirometry).

Your doctor may refer you to a breathing specialist (a respirologist).

Once the doctor knows the cause of your cough, he or she will recommend a treatment.

Most of the time, you can get effective treatment for your cough. If you see your doctor and get help early on, it will be easier to treat your cough.

Chronic

A cough that lasts 8 weeks or longer is known as a chronic cough. A chronic cough is not a disease in itself. It is a sign of something wrong. That’s why it’s important to see your doctor and find out the cause. Some of the most common causes of chronic cough include:

  • Post-nasal drip syndrome, when mucus drips down your throat from the back of your nose
  • Something at home or work that is irritating your nose or airway
  • Allergies
  • Asthma
  • Smoking
  • COPD (new name for emphysema and chronic bronchitis)
  • Acid reflux (sometimes called gastro-esophageal reflux disease or GERD)
  • Some high blood pressure medications
  • Or a combination of these causes

In rare cases, chronic cough can be caused by serious diseases like tuberculosis (TB), lung cancer. Your doctor may want to order a chest x-ray to determine whether you have a serious condition.

Diagnosing a chronic cough

The first step in treating a chronic cough is to find out what’s causing it. Your doctor may do several tests to diagnose the cause.

First your doctor will ask about your medical history. He or she might ask you questions such as whether you have allergies, what medications you are currently taking, whether you smoke or smoked in the past, if you use chemicals at home or work, and if you have been sick lately. Before you go to your doctor, write down everything you want to tell him or her. Your doctor should do a physical exam and may also order a chest X-ray.

Your doctor may also order lung function tests (spirometry).

Your doctor may refer you to a breathing specialist (a respirologist).

Once the doctor knows the cause of your cough, he or she will recommend a treatment.

Most of the time, you can get effective treatment for your cough. If you see your doctor and get help early on, it will be easier to treat your cough.

Treatment

The treatment for cough depends on what’s causing it. For example, if your cough is caused by asthma, the doctor may give you asthma medicine. If your cough is caused by smoking, your doctor will help you quit.
In general, doctors do not recommend over-the-counter cough medicines for acute or chronic coughs.

For coughs in children under 14 years of age: Children under 14 years should not take over-the-counter cough medicines (cough suppressants or expectorants). Cough is very common in children. Cough and cold medicines (including cough syrups) are not useful in children and can actually be harmful. In most cases, a cough will go away on its own. Sometimes coughs are caused by an underlying problem, like asthma or another lung disease, or by something in the air (pollution, smoke, allergens). Doctors will treat the underlying problem.

For adults: Adults with acute cough or upper airway cough syndrome (also called post-nasal drip syndrome) could take an antihistamine with a decongestant. Adults should not take over-the-counter cough expectorants or cough suppressants, including cough syrups and cough drops. They do not treat the underlying cause of the cough.

FAQs

What causes cough?

Coughing has a purpose. It is your body’s way of keeping unwanted stuff from getting into your lungs. Coughing helps clear extra mucus from your airways (small tubes in your lungs). This extra mucus could be caused by smoking, a cold, a lung infection or a lung disease, like asthma or COPD.
A cough may be cause by a condition not related to your lungs, such as heartburn, some medications, or throat irritants (for example, dust, pollution, chemicals in your workplace or home).

How do I know if my cough is normal?

It is normal to cough occasionally. Coughing with a cold, flu or allergies is normal.
Coughing is not normal if you are coughing up blood or thick mucus.  If your cough makes you very tired, or light-headed, or causing chest or stomach pain, or causing you to “wet” yourself, you should talk to your doctor to find out the cause.

What about smoker’s cough?

Smoking can cause chronic cough, but a nagging smoker’s cough isn’t normal. If you are a smoker, get help to quit smoking. Your local Lung Association can explain different ways to quit, including nicotine replacement therapy, medicines, counseling and support groups.
You may be so used to your “smoker’s cough” that you can’t tell if it has changed.  Are you coughing more than you used to? For longer at a time? Or has your cough changed? Are you coughing up streaks of blood or more phlegm (mucus)? Any of these may be a sign that something is wrong.

A nagging “smoker’s cough” should not be ignored. A chronic cough in a smoker or former smoker may be a sign of COPD (chronic obstructive pulmonary disease, including emphysema and chronic bronchitis). Discuss your cough with your doctor.

I quit smoking but I still have a cough

Smokers and former smokers are at risk of developing COPD. COPD is short for chronic obstructive pulmonary disease – the new name for emphysema and chronic bronchitis. A cough that has lasted a long time is a symptom of COPD. A simple breathing test called spirometry is used to help diagnose COPD. Ask your doctor about spirometry.

Why should I see the doctor now? Can’t it wait?

If you have COPD or another breathing disease, it’s important to catch it early and treat it as soon as possible. If you get early treatment for COPD, you can slow down the damage to your lungs. This means you’ll have fewer symptoms and you’ll be more able to do your regular activities and hobbies. When COPD is diagnosed late, patients have more severe symptoms and the treatments do not work as well.

If you have any questions about COPD, call our free helpline at 1-888-344-5864.

I have asthma but I still cough

If you are coughing a lot, it could be a sign that your asthma is not as well controlled as it could be. See you doctor and ask for help.
Here are some other signs that your asthma might not be under control:

  • You wake up at night because of coughing, wheezing or feeling short of breath more than once a week.
  • Your rescue medicine (blue puffer) doesn’t work quickly or completely to relieve your asthma symptoms.
  • You are using your rescue medicine (blue puffer) more than three times a week.
  • Your asthma symptoms are stopping you from doing regular activities like exercise.

If you have any of these signs, see your doctor. Follow your doctor’s advice.
If you have more questions about your cough and asthma, call us at 1-888-344-5864.

Can I just take cough medicine to make my cough go away?

Unless your doctor recommends it, don’t use over-the-counter cough medicine. They won’t treat your cough; they’ll just hide the symptoms. Once your doctor determines what is causing the cough, he or she can treat the cause.

Can my doctor give me medicine to make my cough go away?

A cough is not a disease itself, rather a cough that lasts three weeks or longer is your body’s way of telling you there is something wrong. The first thing your doctor should do is determine what is causing you to cough. Once your doctor determines what is causing the cough, he or she can treat the cause rather than the cough itself.

How will my doctor know what is causing my cough that lasts 3 weeks or longer?

First your doctor will ask about your medical history. He or she might ask you questions such as whether you have allergies, what  medications you are currently taking, whether you smoke or smoked in the past, if you use chemicals at home or work, and if you have been sick lately. Before you go to your doctor, write down everything you want to tell him or her.
Your doctor should do a physical exam and may also order a chest X-ray.
Your doctor may also order lung function tests (spirometry). Find a lung testing clinic in your area.
Your doctor may refer you to a breathing specialist (a respirologist).
Once the doctor knows the cause of your cough, he or she will recommend a treatment.
Most of the time, you can get effective treatment for your coughs. If you see the doctor and get help early on, it will be easier to treat your cough.

How does acid reflux (GERD) cause cough?

GERD is when stomach juice comes up into your esophagus (tube that carries food from your mouth and throat to your stomach).  If your stomach juices reach your throat, it can cause irritation and cause you to cough. If you have a cough from GERD you may not have heartburn and your only symptom may be cough.

Can you have more than one cause of cough?

Yes, you can have more than one cause of cough. In fact you can have two or three causes at the same time. This is why it is important to work with your doctor to find the causes.