What is chronic cough?
Most coughs cause discomfort, but they are usually helpful because when we cough, we expel germs, mucus and foreign material from our lungs. Most of the time coughs last only a short time. However, sometimes they linger for weeks or even months. Chronic cough is defined as a cough that lasts eight weeks or longer in adults or more than four weeks in children.
Potentially, they can be very disruptive to the patient’s life, disrupt sleep and cause fatigue, and in severe cases, can cause vomiting, dizziness and even rib fractures.
Prognosis of chronic cough
Chronic cough usually goes away once the cause is diagnosed and treated.
Symptoms of chronic cough
The cough itself is a symptom of an underlying condition, but it may be accompanied by other symptoms, some of which may be the result of the cough.
- Nasal congestion.
- Runny nose.
- Postnasal drip.
- sore throat
- hoarseness
- wheezing / shortness of breath
- heartburn
- sour taste in the mouth
- coughing up blood (rare)
Medical tests for chronic cough
The physician will initially perform a review of the patient’s medical history, as well as a physical examination. A complete medical history and physical examination can provide important clues to the causes of a chronic cough.
Diagnostic tests include:
- Imaging tests: x-ray, can be used to detect lung cancer, pneumonia and other lung diseases. A sinus x-ray may reveal evidence of a sinus infection; or a computed tomography (CT) scan, which checks the lungs for conditions that can cause chronic coughing or the sinus cavities for pockets of infection.
- Liver function tests are simple, noninvasive tests, like spirometry, used to diagnose asthma and chronic obstructive pulmonary disease. They measure how much air your lungs can hold and how fast you can exhale.
- Laboratory tests: If the mucus you breathe out is colored, your doctor may test a sample of it for bacteria.
- Endoscopic studies: special tests used to find the explanation for the cough. Some of them are bronchoscopy or rhinoscopy.
In the case of children, a chest X-ray and spirometry, at a minimum, will be performed, as they are often helpful in finding the cause of chronic cough in children.
What are the causes of chronic cough?
There are several things that can cause chronic cough:
- Asthma.
- Chronic bronchitis.
- Infections (e.g., pneumonia caused by smoking).
- Postnasal drip.
- Gastroesophageal reflux disease (GERD).
- Certain medications (e.g., ACE inhibitors for high blood pressure).
In rarer cases, the following may also be responsible:
- Bronchiectasis (damaged airways).
- Cystic fibrosis.
- Lung cancer.
- Aspiration pneumonia.
- Sarcoidosis.
- Bronchiolitis.
- Whooping cough.
Can it be prevented?
Being a smoker or ex-smoker is one of the main risk factors for chronic cough, so one of the best preventions is not smoking.
In addition, frequent exposure to secondhand smoke can also cause coughing and lung damage.
Treatments for chronic cough
Treatment for chronic cough depends largely on the cause, as treatment tends to focus on the underlying disease rather than the symptom.
For example, antibiotics may be prescribed to treat a bacterial infection, while asthma may be treated with steroids and/or bronchodilators. If you have a chronic cough, consult a physician and follow his or her advice.
What type of specialist treats chronic cough?
When a cough lasts eight weeks or more in adults or more than four weeks in children you should see a Pulmonary and Respiratory Medicine specialist or an Otolaryngologist.
If you cough up blood or experience weight loss, fever or trouble sleeping, you should see your primary care physician.