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What to Do About a Nagging Cough

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The Symptoms, Causes and Treatment of Chronic Cough

Posted by Sean P. Duffy, MD

That annoying cough. It takes hold when you catch a nasty cold, the flu or an upper respiratory infection. For some, it strikes during allergy season. It can happen if you swallow food “down the wrong pipe,” encounter strong fumes, a lot of dust, or smell smoke. During these times, coughing is your body’s automatic response to clear away mucus and other irritants out of the throat and lungs.

But what does it mean when you have a lingering cough that worsens or just won’t go away?

A persistent cough is the most common presenting symptom I see patients for at the Chronic Cough Program at the Temple Lung Center. It's also one of the most common presenting symptoms seen by pulmonologists nationwide.

When Does a Cough Become Chronic?

A cough is considered chronic if it lasts longer than 8 weeks.

A short-term, or acute cough, lasts less than 3 weeks. It's most commonly caused by viral respiratory infections, asthma and seasonal allergies, as well as chronic obstructive pulmonary disease (COPD) or bronchitis flare-ups.

A subacute, or medium length cough, typically lasts 3 to 8 weeks. It most commonly presents as a cough that lingers long after other symptoms from a cold, the flu or other respiratory infection have passed. Pertussis (Whooping cough) also causes subacute cough.

The length of time that passes when a cough becomes chronic.

What Are the Most Common Causes of Chronic Cough?

Ninety percent of all chronic cough conditions are caused by:

Less common conditions that can also cause chronic cough include ACE inhibitors (medications to treat high blood pressure), COPD, chronic bronchitis, pneumonia and lung cancer.

How Do Doctors Treat Chronic Cough?

To treat chronic cough, physicians must first focus on finding the underlying cause. This process begins with an oral history and physical exam. You’ll be asked questions such as:

  • When did the cough start?
  • Do you cough more in the morning or night?
  • Is it a dry cough or mucus producing?
  • Have you ever coughed up blood?
  • Have you ever coughed so hard that you passed out or vomited?
  • Is your cough accompanied by heartburn, postnasal drip, vomiting, hoarseness or difficulty swallowing?
  • Are you currently a smoker or have you ever smoked and if so, for how long?
  • What medications are you currently taking?

Because most cases of chronic cough are caused by asthma, GERD or upper airway cough syndrome, pulmonary specialists focus on these conditions first. If one of these conditions is suspected, your doctor will treat it accordingly.

However, if these interventions don’t help, your physician will re-review your medications. Further tests may be needed to see if there is a more serious underlying condition. These tests include chest X-ray or CT scan, lung function tests for asthma or COPD, and sputum culture. In some cases, more invasive testing such as fiberoptic bronchoscopy may be necessary.

When Should You See a Doctor?

As you can see, cough is a symptom of many conditions and illnesses. While most go away on their own, if you develop a persistent cough for more than a few weeks, you should see a doctor.

Additionally, you should see a doctor if you have short-term cough accompanied by concerning symptoms like coughing up blood or vomiting. Experienced pulmonary specialists, such as those in the Chronic Cough Program at the Temple Lung Center, will work with you to discover the underlying cause and prescribe prompt, proper treatment.

Consider scheduling an appointment with a pulmonologist to find relief from a nagging cough. Request an appointment online or call 800-TEMPLE-MED (800-836-7536).

Sean P. Duffy, MD

Dr. Duffy is a pulmonology and critical care specialist at the Temple Lung Center, with expertise in chronic obstructive pulmonary disease (COPD), sarcoidosis, interstitial lung disease and cough. An Associate Professor of Clinical Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University, Dr. Duffy is also a member of the American Thoracic Society.

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