A Cough That Will Not Go Away: Causes and When to Be Seen

What it involves

MedlinePlus calls coughing a reflex that keeps your throat and airways clear, and says it helps your body heal or protect itself. Its encyclopedia sorts coughs by length: acute coughs usually go away after about three weeks, subacute coughs last three to eight weeks, and chronic coughs last longer than eight weeks. A dry cough brings nothing up, while a productive cough brings up mucus.

Who this is for

• Adults whose cough has lasted more than a week or two after a cold or flu
• Patients who cough at night, when lying down, or after meals
• Patients with asthma, allergies, reflux, or a smoking history whose cough has changed
• Patients who started a new medicine and then developed a cough

What to expect

• Questions about when the cough began, what it sounds like, any pattern, and what makes it better or worse
• A physical exam
• A review of your medicines, smoking history, allergies, and symptoms such as heartburn or a runny nose
• A plan that treats the likely cause, with tests or a follow-up visit if the cough does not clear

Common causes of a cough

MedlinePlus lists these common causes of coughing:

• Allergies that involve the nose or sinuses
• Asthma and COPD, including chronic bronchitis
• The common cold, flu, and other viral infections
• Lung infections such as pneumonia or acute bronchitis
• Sinusitis with postnasal drip
• Gastroesophageal reflux disease (GERD)

Medicines and smoke

MedlinePlus says ACE inhibitors, and less often ARB medicines, used to treat high blood pressure, heart failure, or kidney disease can cause a cough. Cigarette smoking and secondhand smoke are also on its list. Never stop a blood pressure medicine on your own; ask your provider whether it could be the cause. MedlinePlus adds that sometimes no specific cause is found. The hypertension visit page covers medicine review.

Reflux, allergies, and postnasal drip

Several common causes of a lingering cough start outside the lungs. NIDDK says GERD can cause chronic cough or hoarseness, and the heartburn and acid reflux guide covers it. For allergies, MedlinePlus suggests staying indoors when airborne allergens are high, keeping windows closed and using air conditioning, and showering and changing clothes after being outside. Pollen allergies are a common source of postnasal drip, and the seasonal allergies guide lists the nose, eye, and throat symptoms that go with them and how a provider confirms them. Wheezing or chest tightness along with a cough can point to asthma instead, and the asthma symptoms evaluation explains the pattern, the triggers, and the tests a provider may use.

Cough from a cold or the flu

A cough that follows a cold often fades with the cold. The cold vs. flu guide explains how the two usually differ, and the sore throat page covers throat symptoms that come with them. MedlinePlus says that for a cough from a cold or the flu, antihistamines may work better than non-prescription cough medicines. A cough that is worse at night after a cold can also go along with sinusitis, which the sinus infection or cold evaluation explains, including when the pattern points past a simple cold. A cough that follows a cold and brings up mucus may be acute bronchitis, which the acute bronchitis guide explains, including why antibiotics are often not needed.

What may ease a cough at home

MedlinePlus says water can help ease a cough, whether you drink it or add it to the air with a steamy shower or vaporizer. Cough drops or hard candy can soothe a dry, tickling cough in adults, and guaifenesin helps break up mucus. It advises checking with your provider before using decongestants if you have high blood pressure. Do not smoke, and stay away from secondhand smoke.

Cough symptoms that need prompt attention

MedlinePlus says to call 911 for shortness of breath or difficulty breathing, or for hives or a swollen face or throat with difficulty swallowing. It says to contact your provider right away for a cough that lasts longer than 10 to 14 days, brings up blood, or comes with fever, unintentional weight loss, or night sweats. A cough that gets worse when you lie down, or comes with leg swelling, may be a sign of heart failure; see the leg swelling guide.

Sources

• MedlinePlus — Cough
• MedlinePlus — Cough (Medical Encyclopedia)
• NIDDK — Symptoms & Causes of GER & GERD