Chronic Cough – Symptoms and Causes
What Is a Chronic Cough?
A chronic cough persists for eight weeks or longer in adults, or four weeks in children. This isn’t just a minor nuisance—it can seriously disrupt sleep patterns and cause extreme fatigue. In severe cases, people might experience:
- Vomiting
- Dizziness
- Rib fractures from forceful coughing
The main causes of chronic cough include:
- Tobacco Use
- Asthma
- Postnasal Drip (fluid flowing from the nose down the throat)
- Acid Reflux (stomach acid moving up into the esophagus)
The good news is that treating the underlying problem typically resolves the chronic cough. For example, quitting smoking, using asthma medication, or taking steps to reduce acid reflux can help the cough disappear.
Signs You May Notice
A chronic cough often comes with other problems. You might have a runny or stuffy nose. Some people feel liquid going down the back of their throat, which doctors call postnasal drip.
You may clear your throat often or have a sore throat. Other signs include a hoarse voice, wheezing, and trouble breathing. Some people feel heartburn or a sour taste in their mouth. In rare cases, you might cough up blood.
When You Should Visit a Doctor
You should make an appointment with your healthcare provider if your cough lasts for several weeks.
Seek medical help if you cough up mucus or blood, if the cough disturbs your sleep, or if it affects your ability to work or study normally. Getting proper medical care can help identify the cause and provide relief.
Causes
A persistent cough that continues for several weeks typically signals an underlying health issue. Most chronic coughs stem from one or more common causes rather than being random occurrences.
The most frequent causes of chronic cough include:
Postnasal Drip
When excess mucus forms in your nose or sinuses, it can flow down your throat, triggering coughing. Doctors sometimes refer to this condition as upper airway cough syndrome.
Asthma
Asthma-related coughs often follow seasonal patterns or appear after respiratory infections. Exposure to cold air, chemicals, or certain fragrances may worsen symptoms. Some people experience cough-variant asthma, where coughing is the primary symptom rather than wheezing.
Gastroesophageal Reflux Disease (GERD)
This common condition occurs when stomach acid flows back into the esophagus—the tube connecting your stomach and throat. The ongoing irritation often leads to chronic coughing, which can then worsen the reflux, creating a difficult cycle.
Respiratory Infections
Coughs can persist long after other symptoms of pneumonia, flu, or colds have disappeared. Whooping cough (pertussis) frequently causes chronic cough in adults but often goes unrecognized.
Fungal lung infections, tuberculosis (TB), and nontuberculous mycobacterial (NTM) infections found in soil, water, and dust can also cause long-lasting coughs.
Chronic Obstructive Pulmonary Disease (COPD)
This lifelong inflammatory lung condition restricts airflow and includes:
- Chronic bronchitis, which may cause coughing with colored mucus
- Emphysema, which damages air sacs in the lungs and causes breathing difficulty
Most COPD patients are current or former smokers.
Blood Pressure Medications
ACE inhibitors (angiotensin-converting enzyme inhibitors), commonly prescribed for high blood pressure and heart failure, can trigger chronic coughing in some people.
Less Common Causes
Several less frequent conditions can also lead to chronic cough:
| Condition | Description |
|---|---|
| Aspiration | Food or other substances accidentally entering the lungs |
| Bronchiectasis | Widened airways that struggle to clear mucus |
| Bronchiolitis | Inflammation and mucus buildup in small lung airways |
| Cystic Fibrosis | Genetic disorder affecting lungs and other organs |
| Idiopathic Pulmonary Fibrosis | Unexplained scarring of lung tissue |
| Lung Cancer | Cancerous growths starting in the lungs |
| Nonasthmatic Eosinophilic Bronchitis | Airway inflammation not caused by asthma |
| Sarcoidosis | Inflammatory cell clusters forming in various body parts, especially lungs |
For proper diagnosis, doctors must consider that multiple factors often work together to cause chronic coughing. What seems like a simple cough might actually result from two or more conditions happening simultaneously, making treatment more complex.
Risk Factors
Smoking is a major risk factor for chronic cough. People who currently smoke or have smoked in the past often develop this problem.
Being around others who smoke can also cause coughing and harm your lungs, even if you don’t smoke yourself.
Complications
A persistent cough can lead to several uncomfortable and potentially serious complications. When coughing continues for extended periods, it can significantly impact your quality of life and physical well-being.
Sleep problems are common with ongoing coughs. The constant need to cough can wake you up multiple times during the night, leading to poor sleep quality and daytime fatigue.
Physical discomfort often accompanies persistent coughing. This may include:
- Headaches
- Feelings of dizziness
- Excessive sweating
- Vomiting or nausea
Some complications can be more embarrassing or painful. Many people experience urinary incontinence (unexpected bladder leakage) during strong coughing fits. This happens because coughing creates pressure on the bladder.
In severe cases, the force of repeated coughing can lead to more serious issues:
- Rib Fractures: The physical strain from constant, forceful coughing can actually break ribs, especially in older adults or people with bone-weakening conditions.
- Fainting (Syncope): In some cases, intense coughing spells can cause a person to lose consciousness temporarily. This happens because coughing can affect blood flow and pressure.
The impact of these complications can vary based on:
- The intensity of the cough
- How long the cough has lasted
- Your overall health
- Age and physical condition
For children and older adults, these complications may be more concerning and require closer medical attention. Children might struggle to express their discomfort, while older adults may face increased risks from complications like rib fractures.
If you experience severe complications from coughing, it’s important to seek medical care. These symptoms might indicate that your cough is a sign of a more serious underlying condition that needs treatment.
