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Chronic Cough

PULMONOLOGY

Chronic cough is defined as a cough that persists for more than 8 weeks, In the absence of an underlying medical condition that explains the cough, it is called refractory chronic cough. It is a common symptom that can be caused by a variety of factors, including respiratory and non-respiratory conditions.

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What is Chronic Cough?

A chronic cough is defined as a cough that persists for more than 8 weeks, in the absence of an underlying medical condition that explains the cough. It is a common symptom that can be caused by a variety of factors, including respiratory and non-respiratory conditions.

Respiratory Causes of Chronic Cough

  • Asthma: This is a chronic condition that causes inflammation and narrowing of the airways, leading to coughing, wheezing and shortness of breath.

  • Chronic obstructive pulmonary disease (COPD): This is a group of lung diseases that includes chronic bronchitis and emphysema. It can cause coughing, shortness of breath, and wheezing.

  • Gastroesophageal reflux disease (GERD): This is a condition where stomach acid flows back into the esophagus, causing irritation and inflammation that can trigger coughing.

  • Postnasal drip: This is when mucus from the nose and sinuses drips down the back of the throat, causing irritation and coughing.

Non-Respiratory Causes of Chronic Cough

  • Medications: Certain medications, such as ACE inhibitors used to treat high blood pressure, can cause chronic cough as a side effect.

  • Allergies: Allergies to pollen, dust, and other allergens can cause a chronic cough.

  • Chronic sinusitis: This is an inflammation of the sinuses that can cause postnasal drip and chronic cough.

  • Smoking: Smoking can cause chronic bronchitis and chronic cough.

Chronic cough can be a bothersome and disruptive symptom, and it is important to identify and treat the underlying cause to help alleviate the cough. A healthcare provider can perform a thorough evaluation and determine the most appropriate treatment plan.

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Symptoms of Chronic Cough

Chronic cough is a persistent cough that lasts for more than 8 weeks, and it can be associated with various symptoms. Some common symptoms of chronic cough include:

  • Persistent cough: A cough that lasts for more than 8 weeks is the main symptom of chronic cough.

  • Shortness of breath: Chronic cough can cause shortness of breath, especially during physical activity.

  • Chest discomfort: Some people with chronic cough may experience chest discomfort or tightness.

  • Wheezing: Wheezing is a high-pitched whistling sound that occurs when breathing, and it may be present in people with chronic cough.

  • Sputum production: Sputum is mucus that is coughed up from the lungs. People with chronic cough may produce sputum, which can be clear, white, yellow, or green.

  • Fatigue: Chronic cough can be exhausting and lead to fatigue.

  • Sleep disturbance: Chronic cough can disrupt sleep, making it difficult to fall asleep or stay asleep.

  • Gastrointestinal symptoms: In some cases, chronic cough may be associated with gastroesophageal reflux disease (GERD), which can cause heartburn, regurgitation, and other gastrointestinal symptoms.

Treatments for Chronic Cough

The treatment of chronic cough depends on the underlying cause. If an underlying condition is identified, treatment will focus on managing or treating that condition. In cases where no underlying cause is found, treatment may focus on managing the cough itself. Some common treatments for chronic cough include:

  • Medications: Depending on the underlying cause of chronic cough, medications may be prescribed to manage symptoms. For example, in cases of asthma or COPD, bronchodilators and inhaled corticosteroids may be used to reduce inflammation and open the airways. In cases of GERD, proton pump inhibitors or H2 blockers may be used to reduce stomach acid and alleviate symptoms.

  • Cough suppressants: In some cases, cough suppressants such as dextromethorphan may be used to reduce coughing and improve sleep.

  • Airway clearance techniques: In cases of chronic bronchitis or other conditions that cause excess mucus production, airway clearance techniques such as chest physiotherapy or postural drainage may be used to help clear the lungs and reduce coughing.

  • Lifestyle modifications: Making lifestyle changes such as quitting smoking, avoiding irritants such as air pollution, and staying hydrated can help reduce chronic cough symptoms.

  • Speech therapy: In rare cases where the chronic cough is due to habitual cough or tic cough, speech therapy may be recommended to retrain the cough reflex.

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It’s important to work closely with a healthcare provider to determine the most appropriate treatment plan for chronic cough. Some underlying conditions that cause chronic cough can be serious, so it’s important to seek medical evaluation if you have a persistent cough that lasts for more than 8 weeks.

Medications

The treatment of chronic cough depends on the underlying cause. If an underlying condition is identified, medications may be prescribed to manage or treat that condition. Some common medications that may be used to treat chronic cough include:

  • Bronchodilators: These are medications that relax the muscles in the airways and help open the airways. They are often used to treat asthma or COPD, which can cause a chronic cough. Examples of bronchodilators include albuterol and salmeterol.

  • Inhaled corticosteroids: These are medications that reduce inflammation in the airways, which can help reduce coughing. They are often used to treat asthma or COPD. Examples of inhaled corticosteroids include fluticasone and budesonide.

  • Antihistamines: These are medications that can help reduce coughing by blocking the effects of histamine, which can cause coughing. They are often used to treat allergies, which can cause a chronic cough. Examples of antihistamines include loratadine and cetirizine.

  • Proton pump inhibitors (PPIs): These are medications that reduce the amount of acid produced by the stomach. They are often used to treat GERD, which can cause a chronic cough. Examples of PPIs include omeprazole and esomeprazole.

  • Cough suppressants: These are medications that can help reduce coughing by blocking the cough reflex. They are often used to treat dry, unproductive coughs. Examples of cough suppressants include dextromethorphan and codeine.

It’s important to work closely with a healthcare provider to determine the most appropriate treatment plan for chronic cough. Some underlying conditions that cause chronic cough can be serious, so it’s important to seek medical evaluation if you have a persistent cough that lasts for more than 8 weeks.

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(443) 499-4005

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