Understanding chronic cough: Causes, symptoms, and treatment

In his latest medical article, distinguished consultant respiratory physician, Professor James Hull, provides us with an all-you-need-to-know guide in relation to chronic cough. 

What is a chronic cough?

A chronic cough is a persistent cough that lasts for eight weeks or longer in adults or four weeks in children. While a cough is a natural reflex to clear the airways, a chronic cough can be a symptom of an underlying condition and can significantly impact a person’s quality of life. Understanding the causes, symptoms, and treatment options is crucial for managing this condition effectively.

What are the main causes?

Several factors can contribute to a chronic cough. One common cause is postnasal drip, also known as upper airway cough syndrome, which occurs when mucus from the nasal passages drips down the back of the throat, triggering a cough reflex. Asthma is another frequent cause, where the cough might be the primary or only symptom, often accompanied by wheezing and shortness of breath.

Gastroesophageal reflux disease (GERD) is also a major contributor, occurring when stomach acid backs up into the oesophagus, causing irritation and a chronic cough. Respiratory infections like chronic bronchitis or lingering effects from previous infections can lead to a prolonged cough.

Certain medications, particularly ACE inhibitors used for high blood pressure, can cause a chronic cough in some individuals. Additionally, chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, often presents with a persistent cough and phlegm production.

What are the symptoms that typically accompany a chronic cough?

A chronic cough can be dry or productive (producing mucus) and might be accompanied by other symptoms, such as a sore throat, hoarseness, shortness of breath, wheezing, frequent throat clearing, and a sensation of a lump in the throat. Diagnosing the cause of a chronic cough involves a thorough medical history, physical examination, and potentially a series of tests, including chest X-rays, CT scans, spirometry, and endoscopy.

How is a chronic cough treated?

Treatment focuses on addressing the underlying cause of the cough. For postnasal drip, antihistamines, decongestants, or nasal steroids might be prescribed. Asthma-related coughs are treated with inhalers, bronchodilators, and corticosteroids. GERD-related coughs can be managed with lifestyle changes, antacids, or proton pump inhibitors. Infections might require antibiotics or antivirals if a bacterial or viral infection is present. If medications like ACE inhibitors are causing the cough, switching medications might be necessary.

In addition to medical treatments, certain lifestyle modifications can help manage symptoms. Staying hydrated, using a humidifier, avoiding irritants like smoke, and elevating the head during sleep can provide relief. Consulting with a healthcare professional is essential for developing an effective treatment plan tailored to the individual’s needs.