Living with chronic cough: causes, challenges, and breakthrough treatments

Chronic coughing is defined as a persistent cough that lasts for at least eight weeks in adults and four weeks in children. They can disrupt sleep, breathing, and the general comfort of a patient, leading to fatigue and rawness of the throat. In extreme cases, they can even cause vomiting, dizziness, and rib fractures from the force of coughing. In this article, a leading pulmonologist goes over possible causes of chronic coughing, and the methods of treating it.

Coughing is an instinctive impulse from the body to try and purge contaminants and blockages from the lungs and airways. Coughing itself is symptomatic of other pathologies, and may be accompanied by other symptoms like:

• Stuffed or runny nose
• Mucus build-up
• Sore throat
• Wheeziness or shortness of breath
• Heartburn
• Blood in spit

Patients with chronic cough will likely find that their lives have been disrupted by it. They may struggle in social and professional environments as they are unable to maintain conversations due to interruptions from the coughing and may miss out on opportunities because of it. They could be tired in their days due to interrupted sleep from coughing, and unable to focus on tasks or projects, again due to being sidetracked by coughing.

What causes chronic cough?

Chronic coughing can be caused by ailments such as asthma, postnasal drip, pneumonia, chronic obstructive pulmonary disease (COPD), and bronchitis. In rarer cases, it can also be caused by cystic fibrosis, lung cancer, and whooping cough. Being a frequent smoker can also be a reason. That being said, any long-term illness affecting the lungs can be the cause of coughing, so a diagnosis by a doctor can help initiate treatment and the elimination of triggers.

The cause of chronic cough can be determined through examinations and tests. Doctors will typically ask about a patient’s medical history and conduct a physical exam, before progressing to more thorough tests like an X-ray or a CT scan to check the physical condition of the lungs and sinuses and see if there are any abnormalities or infections.

Non-invasive tests for lung function can be used in the diagnosis of asthma or COPD. These include spirometry, which is a simple test that measures how much air can be exhaled in one go, or a cardiopulmonary exercises test to assess how the lungs (in conjunction with the heart and muscles) react under strain.

Other tests include bronchoscopy, in which a camera and light are fed through the airways to examine the inside of the lungs, or a rhinoscopy, which is similar but is used more for the nasal passages, sinus, and upper airways.

How is chronic cough treated?

There are lifestyle adaptations that can be made to address chronic coughing. Keeping hydrated by drinking fluids, as well as trying to stay in humid or moist environments (with the assistance of a steamy shower or an air humidifier) can help to soothe and lubricate the throat. Smokers are always encouraged to cease as the smoke irritates the lungs and strains blood vessels in the body.

As chronic cough tends to be a symptom, the best way to treat it is to address the condition causing it. However, many medications are available to treat coughing, such as:

• Antihistamines, corticosteroids and decongestants. These medicines are standard treatment for allergies and postnasal drip.
• Inhaled asthma medicines. The most effective treatments for asthma-related cough are corticosteroids and bronchodilators. They reduce inflammation and open up the airways.
• Antibiotics. If a bacterial, fungal or mycobacterial infection is causing your chronic cough, doctors may prescribe antibiotic medicines for the infection.
• Lozenges and cough medicines. These can ease a dry cough and help with irritation in the throat, but will not address the root condition.

There is a breakthrough in the form of a new, orally-taken drug called Gefapixant which has been trialling in the UK. The studies have shown that the use of the drug has resulted in a reduction of coughing for up to six months. It works by blocking receptors in the sensory nerves that signal to cough, and reducing their sensitivity. In these trials that were conducted for a year, nearly 70% of the patients exhibited positive results. Gefapixant is now being evaluated by the drug regulator of the UK, the MHRA, and if approved, it can soon go to market and be available to patients all over the country.

If you are struggling with chronic cough and would like to explore treatment options, you can consult with a specialist today via Top Doctors.