The Cough That Won't Go Away


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The Cough That Won't Go Away

October 15, 2014



When does a cough require medical attention?

The ability to cough is an important part of normal lung function. However, sometimes a cough can become a chronic condition that requires a medical evaluation. Chronic cough is usually defined as a cough that lasts for three weeks or longer.


What are the causes of chronic cough?

The most common causes of chronic cough are postnasal drip, asthma, and gastroesophageal reflux disease (GERD).


Postnasal drip is the most common cause of chronic cough. This may be caused by sinusitis or allergies. People with postnasal drip may complain of stuffy or runny nose, sensation of liquid in the back of the throat, or frequent throat clearing. However, some people with post nasal drip are unaware of any secretions.


Asthma is generally reported to be the second most frequent cause of chronic cough in adults, and is the leading cause in children. Though cough due to asthma is often accompanied by wheezing and shortness of breath, some people have a condition, known as cough variant asthma, in which cough is the only symptom of asthma.  A diagnosis of asthma as the cause of the cough is also suspected when the patient has a history of multiple allergies, or has a family history of asthma. Asthma-related cough may be seasonal, may follow an upper respiratory infection, or may get worse on exposure to cold, dry air, or certain fumes or fragrances.


Gastroesophageal reflux disease, or GERD, is a disease in which acid from the stomach flows back (refluxes) into the tube connecting the stomach and the throat (the esophagus). Many patients with cough due to GERD complain of symptoms including heartburn or a sour taste in the mouth. However, these symptoms are absent in more than 40 percent of patients with cough due to reflux.

Less common causes:

Respiratory tract infection

Use of ACE inhibitors

Chronic bronchitis


Lung cancer

Eosinophilic bronchitis


How will I find out the cause of my cough?

Many times, the history and physical exam alone can make the diagnosis.  Of course, some times tests are necessary.  Which tests are performed will be guided by which diagnosis is most likely.


What about treatment?

Of course, treatment will depend on what the underlying cause of the cough is.  Though cough suppressants may be helpful in short term cough, they should not be used for chronic cough without a careful evaluation for treatable cause.


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