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What Causes a Chronic Cough? 8 Reasons--and Their Treatment

by James Hubbard, M.D., M.P.H.

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That nagging cough just won't go away. You've had it so long you don't even notice it at times, but it drives your co-workers, friends and spouse crazy.  Is it just an annoying habit, or a symptom of a more serious problem?

A medical definition of a chronic cough is one that persists for eight weeks or more. It that occurs, see your doctor for a workup.

There are many causes, but here are eight of the more common. (Eight weeks, eight causes. Get it?)

 

1. ALLERGIC RHINITIS

Nasal allergies can result in a runny or stuffy nose, but it's that drip down the back of your throat that triggers the cough.

Treatment: Find what you're allergic to and stay away from it. OK, that's not so simple sometimes, so an over-the-counter antihistamine might help. You can use the non-drowsy form; however, the Benadryl type might work even better, depending on your tolerance to the drowsy side effect. For allergy assessment and alternative treatment options, see your doctor.

More information: "Allergy Treatment: What Medicines to Take for Allergies—and How to Take Them"


2. ASTHMA

Not everyone with asthma knows they have it. Sometimes, the only symptom is a cough.

Evaluation and treatment: A doctor will listen to your lungs and may order an in-office pulmonary function test. (You just blow really hard into a tube connected to a machine). A trial of an inhaler might be justified just to see if it relieves your cough. Exercise, allergies, smoke, barometric pressure changes or infections may trigger the asthma and hence the cough.

More information: "Asthma Guide: Causes, Symptoms, Treatment, What It Is"


3. GASTROESOPHAGEAL ACID REFLUX (GERD, HEARTBURN)

The acidic contents of your stomach can come up, or reflux, into the back to your throat, irritating it. This may occur only when you are lying down asleep, so you never know it's happening. However, as a result of the chronic irritation, you may develop the cough.

Evaluation and treatment: Sometimes, a doctor can see this irritation in the throat but, often, the diagnosis is just made by strong suspicion. People who are overweight or smoke are prone to GERD. Antacids can help, along with avoiding heavy meals and alcohol in the evening. You can try propping up the head of your bed on a book or two. Your doctor may prescribe a medication to stop stomach acid production altogether. Rarely, people require surgery to fix a dysfunctional stomach valve.

Related information: "The Most Common Type of Heartburn: Non-Erosive Esophageal Reflux Disease"


woman-ash-tray4. SMOKING

Is there anyone who does not know smoking damages your lungs and throat? That includes tobacco cigarettes, cigars, hookah (just another way to smoke tobacco), marijuana, or anything else you decide to suck down your windpipe.

Treatment: Quit, completely, now.

More information: American Lung Association: "How to Quit Smoking"


5. MEDICATIONS

Never stop a prescription medication without talking it over with your prescribing doctor, but know that some can have the side effect of a chronic cough. One well-known culprit group is ACE-inhibitors, used for heart or blood pressure problems and in diabetics.  Examples are lisinopril (Prinivil) and enalapril (Vasotec), to name two of many. They're fantastic and effective medications, but your doctor should be able to find a good substitute if the ACE is causing you to cough.


6. INFECTIONS

Any respiratory infection can cause a cough. Some bacterial and fungal infections, even tuberculosis, can cause a chronic cough. You'll at least need a chest X-ray for diagnosis.


7. LUNG CANCER

Rarer than most of the others but the one we all fear. Putting off the diagnosis will only decrease your potential benefit in treatment.


newsletter-graphic8. SLEEP APNEA

This is usually not in the list of causes for a chronic cough, but it is in mine since it was my reason for a cough that persisted over three years without a diagnosis. I slept with my mouth open. The diagnosis was made after a sleep lab study, and the treatment is a CPAP machine. You can read about my ordeal in my blog.

More information:


Eight weeks is not a magic number. Don't wait that long if you are having other problems, such as fever, weight loss, fatigue, coughing up blood or shortness of breath, or if you're just worried.


JAMES HUBBARD, M.D., M.P.H.,
is the publisher of MyFamilyDoctorMag.com, the Web site written by health-care providers for you.  He's been a family doctor for over 25 years.

Last updated and/or approved: April 2010.

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written by Bobsey George , December 12, 2015

Hi my cough has been with me for the past 10 years off and on , I'm on omeprazole for the acid reflux and cetirizine for seasonal allergy, but nothing is helping , and I test for every thing that you talk about ,what else can I do.

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nagging cough - dehydration?
written by A L , May 02, 2015

Since the 80s I was taking ranitidine for my acid reflux coughing and it was working fine. But in August 2014, the med. stopped working and my cough was back with a vengeance! Well, my doctor increased my med. and even added omeprazole to my ranitidine. Cough subsided a little, but after a while, kicked up again really bad. Another doctor suggested 2 tablespoons of Gaviscon nightly, but I wouldn't touch that awful stuff. A friend asked me if I was taking a diuretic along with my blood pressure meds, and I said Yes, HCTZ. She asked if I was drinking enough water with it, and I said I didn't like water, but I like to drink apple juice sometimes. She said the diuretic is dehydrating me and I should be drinking lots of water. Well, anything to get rid of this cough, so I started drinking 6 to 8 glasses of water per day for about 2 weeks. Guess what? My cough is all but GONE!! Not completely, but I seldom cough anymore. I can sleep at night without getting up to cough and suck on a piece of candy or get a sip of water. My stomach muscles aren't sore anymore and my throat feels much better. I still take my acid reflux meds, but I'm going to ask my doctor about cutting back on them to see if I still need the full dosages.
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Coincidence? I think not.
written by Kurt Bockoven , June 24, 2011

I wrote a blog post about 7 reasons why people cough today too. Slightly different from yours. I hadn't considered sleep apnea nor lung cancer. Thank you for enlightening me. Check my article out at medicinesimplyput.com
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Good article
written by Danh H. Nguyen, MD , May 24, 2011

The postnasal drip cough was the culprit for my chronic cough for nearly 2 months. I couldn't figure it out until my pulmonologist told me to take an anti-histamine. Once I did, the cough was gone in 2 days!
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