Persistent Cough: The Houseguest That Overstays Its Welcome

If you’ve ever been that person with the constant cough in a quiet room, you know the feeling. Of course you try to suppress it, and it gets worse.  A few stares and a sip of water later you’re wondering why you still have this cough when you don’t even feel sick!

Just like memories of your last relationship, lingering coughs can be hard to get rid of.  In many cases, you may not even know what’s causing it. Hopefully you’ll be able to put away your SARS mask and learn about a few common reasons you might be coughing.

Generally, people cough in order to protect their airways and lower lungs from irritants and damage. However, several other illnesses can also cause prolonged cough. As it turns out, not all coughs are created equal. If your symptoms last for less than three weeks, this is considered an acute cough. Coughs lasting three to eight weeks are classified as sub-acute coughs, and finally those lasting longer than eight weeks are considered chronic.

Four common causes include GERD (acid reflux), postnasal drip, asthma, and respiratory infections.  Each of these is detailed below:

GERD: Coughing can occur in up to forty percent of patients with GERD. Although you already know plenty about GERD, you may not know that in many patients with acid reflux, their only symptom is a cough.  When stomach acid hits the lower esophagus, a cough reflex is generated and can linger despite not having any other symptoms of GERD. In many cases, this can be resolved by a trial of an acid-reducing medication and a few lifestyle changes.

Postnasal drip: Secretions and mucous often collect in the back of the throat. Typically these are very thin and can drain from the nasal passage without you even noticing. In some cases, however, the mucous accumulates in the back of your throat and irritates your upper airway. This is called postnasal drip (PND).  One of the most common causes of PND is an allergy (this may be seasonal or triggered by a specific irritant). In both cases, the body reacts to these irritants by increased mucous production. As the drainage gets backed up in your throat, you often begin to cough. Inflammation of the sinuses can also contribute to PND and present as an acute or sub-acute cough. You may want to try an allergy medication if you suspect that PND is causing your cough.

Asthma: Although commonly mentioned, asthma often goes undiagnosed. Asthma is a condition that causes swelling and constriction of the lowest parts of the respiratory tract. This can cause significant coughing, wheezing, and difficulty breathing. Recent studies suggest that asthma is the second-leading cause of chronic cough in adults. Irritants, allergies, and even exercise can provoke lower airway swelling and cough. Certain individuals with diseases like eczema may also be more prone to developing asthma.

You may have outgrown your high school jeans, but beware of having a childhood asthma diagnosis and thinking you’ve outgrown it. Certain studies suggest childhood asthma may be outgrown later in life; however, some adults may still present with milder symptoms of coughing and wheezing when specific triggers are present. Your personal physician can help diagnose you with asthma and provide guidance for a treatment plan to help you breathe better and improve or eliminate your cough.

Respiratory Infections: In the days of Facebook, Twitter, BBM, and texting, URI may have lots of meanings. For most physicians, however, upper respiratory infections (URI) are often synonymous with cough. Many of these URI are caused by viruses and may take up to three weeks to resolve. Other respiratory infections caused by bacteria (and treated with antibiotics) may also cause persistent cough long after other symptoms have completely subsided. These are termed post-viral or post-infectious coughs. Some studies suggest that these coughs can last an average of eight weeks after the illness has resolved. The inflammation following a URI is thought to make the upper airways more sensitive and lead to chronic coughs. This symptom is easily treatable once it is identified. Your physician may need to give you an inhaled medication to calm the inflammation.They may also suggest other treatments depending on the severity of your cough.

One last cause of cough worth mentioning is Pertussis.This is a bacterial infection that has returned to the scene with a vengeance! It has been responsible for numerous deaths of both adults and children. Pertussis can cause a significant cough that often has a deep sound (hence the name: “whooping” cough). Many people also develop such a severe cough that they may vomit. You can prevent Pertussis by getting vaccinated. Speak to your physician about your most recent immunizations and Pertussis booster (it’s one shot combined with tetanus). This is one pain in the butt (or arm) that’s definitely worth getting.

Hopefully you learned a little more about what could be causing your persistent cough. As always, speak with your personal physician about your symptoms. These are just a few of the most common causes of cough. Your doctor can provide a detailed treatment plan specifically for you.

Comments are closed.