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Chronic cough – symptoms, causes and other risk factors

When you suffer from chronic cough, then this type of cough lasts longer than normal cough. For children this kind of cough lasts more than 4 weeks and for adults it lasts more than 8 weeks or longer [1]. This is not just annoying type of cough but also it can make problems in your life. You can feel that you are exhausted and also you cannot sleep well. When you have chronic cough then in many cases it can lead to rib fractures, vomiting and lightheadedness. In some cases it is really difficult to find the real cause for this type of cough. But the most common causes for the chronic cough are acid reflux, tobacco use, asthma and postnasal drip. In the most cases when your doctor discovers the real cause for your chronic cause, then it is very easy to be treated.

Symptoms of chronic cough

There are many signs and symptoms of the chronic cough such as

  • Hoarseness
  • A runny or stuffy nose
  • In rare cases the chronic cough can appear with blood
  • Wheezing and shortness of breath [1]
  • A feeling of liquid running down the back of your throat (postnasal drip)
  • Heartburn or a sour taste in your mouth [2]
  • Frequent throat clearing and sore throat

If you have noticed that your cough lasts more weeks and your have blood or sputum, then you should visit your doctor. Also you must visit your doctor if you have noticed that the cough has interrupted your work, school or sleep.

Causes for chronic cough

When we have occasional cough, then this is normal situation for which we should not be worried. This kind of cough can clear the secretions and irritants from our lungs and also it can prevent us from further infections. But if you have noticed that your cough lasts more than one week, then this is serious medical condition. When you have chronic cough, then there are many causes which are involved together in this problem. There are many causes which can lead to chronic cough (in some cases there are in a combination while in other cases there are individual causes for the chronic cough) such as

  • Blood pressure drugs: ACE (Angiotensin – converting enzyme) inhibitors are prescribed for heart failure and high blood pressure. There are many cases in which is proven that these inhibitors lead to chronic cough. [3]
  • Infections: There are some cases when the cough lasts long after the symptoms of cold, flu, pneumonia or other infections that can happen in the upper respiratory tract have gone away. The whooping cough or also known as pertussis is another cause for the chronic cough in adults. [4]

Chronic cough

  • Chronic bronchitis: When you have inflammation of your bronchial tubes that lasts long period, then this can lead to colored sputum. People who suffer from chronic bronchitis are the most common people who smoke at the moment or they have smoked in their past. There is one disease which is known as COPD (chronic obstructive pulmonary disease). This kind of disease is related with the smoking and in most cases leads to chronic bronchitis. [5]
  • Gastroesophageal reflux disease (GERD): When you have this condition, then the stomach acid flows back in your tube which is connection between your esophagus (throat) and stomach. If you have constant irritation in it, then this leads to chronic cough. When you start to cough, then the GERD is worsening. [6]
  • Asthma: When the asthma is a reason for the chronic cough, then this kind of cough can come and go. Also it can become worse if you are exposed to fragrances, chemicals or cold air. In the cough – variant asthma which is a type of the asthma, the cough is the main symptom of the chronic cough. [7]
  • Postnasal drip: When your sinuses or nose produces extra mucus, then it drips down the back of the throat which means that it can trigger your throat and you start to cough. UACS is also the name for this condition which means upper airway cough syndrome. [8]
  • Other less common causes for chronic cough: Also there are other causes which can lead to chronic cough that are not very common such as lung cancer, bronchiolitis, cystic fibrosis, aspiration, sarcoidosis, nonasthmatic eosinophilic bronchitis, bronchiectasis and laryngopharyngeal reflux.

References:

[1] Morice AH, McGarvey L, Pavord I. Recommendations for the management of cough in adults. Thorax. 2006;61(Suppl1):i1–i24. doi:10.1136/thx.2006.065144

[2] Fontana GA, Pistolesi M. Cough. 3: Chronic cough and gastro-oesophageal reflux. Thorax. 2003;58:1092-5.

[3] Ding H, Shi C, Xu X, Yu L. Drug-induced chronic cough and the possible mechanism of action. Annals of Palliative Medicine (APM). 2020;9(5).

[4] Birkebæk NH, Kristiansen M, Seefeldt T, et al. Bordetella pertussis and chronic cough in adults. Clinical Infectious Diseases. 1999;29(5):1239-42.

[5] Kim V, Criner GJ. Chronic bronchitis and chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine. 2013;187(3):228–37. doi:10.1164/rccm.201210-1843CI

[6] Kahrilas PJ, Smith JA, Dicpinigaitis PV. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate. Lung. 2014;192(1):39–46. doi:10.1007/s00408-013-9528-7

[7] Niimi A. Cough and asthma. Current Respiratory Medicine Reviews. 2011;7(1):47–54. doi:10.2174/157339811794109327

[8] Macedo P, Saleh H, Torrego A, et al. Postnasal drip and chronic cough: An open interventional study. Respiratory Medicine. 2009;103(11):1700-5.

Hanan Marshal
Hanan Marshal
Hanan, a medical student (MBBS) having passion for writing and is very much interested in holistic living along with nature. He is very much interested in doing community service and watches anime and play PS4 during his free time. You can reach him through [email protected]

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