The importance of checking a persistent cough

A cough is often viewed as a common, minor symptom associated with colds or respiratory infections. However, when a cough lasts for more than three weeks, it’s considered persistent (or a chronic cough) and warrants medical attention. This is especially crucial if the cough continues for over eight weeks, as it may indicate an underlying health issue that requires further evaluation.

What causes a persistent cough?

A persistent cough can be attributed to various conditions, ranging from mild to serious. The most common causes include:

• Chronic respiratory conditions: Such as asthma or chronic obstructive pulmonary disease (COPD).
• Gastroesophageal reflux disease (GERD): Where stomach acid travels up the oesophagus, irritating the throat.
• Postnasal drip: Caused by sinusitis or allergies leading to mucus accumulation at the back of the throat.
• Infections: Such as bronchitis or, less commonly, tuberculosis.
• Medications: Certain drugs, particularly ACE inhibitors used for high blood pressure, can lead to a chronic cough.
• Lung diseases: Including interstitial lung disease or even early signs of lung cancer.

Why is early evaluation important?

Early diagnosis and treatment of a persistent cough can be key in preventing complications or catching more severe conditions in their initial stages. While many cases are benign and treatable, persistent coughing may be an early indicator of serious conditions such as lung cancer or chronic pulmonary disorders. Prompt investigation by a GP can lead to early intervention, which may improve outcomes and reduce the risk of the condition worsening.

What should you look out for?

Patients should be mindful of other symptoms that accompany a persistent cough, including:

• Unexplained weight loss
• Shortness of breath
• Persistent chest pain
• Coughing up blood (haemoptysis)
• Hoarseness or change in voice
• Recurring fever or night sweats

These signs may point to underlying health issues that require further investigation through imaging, blood tests or referrals to a specialist.

How is a persistent cough evaluated?

To determine the cause of a persistent cough, a GP may carry out a comprehensive assessment. This could involve:

• Medical history review and physical examination
• Chest X-rays or CT scans to look for abnormalities in the lungs
• Spirometry tests to assess lung function
• Allergy tests if postnasal drip or allergic reactions are suspected
• Endoscopy to investigate potential GERD or oesophageal issues

What are the treatment options?

Treatment for persistent cough depends on the underlying cause. Common approaches may include:

• Inhalers or medications for respiratory conditions such as asthma.
• Proton pump inhibitors (PPIs) or lifestyle adjustments for GORD.
• Antihistamines or decongestants for postnasal drip.
• Antibiotics for bacterial infections if needed.
• Referral to a specialist for further management if a serious condition like lung cancer or interstitial lung disease is suspected.

When should you see a doctor?

It’s advisable to consult a doctor if your cough has lasted more than three weeks, is worsening, or is accompanied by worrying symptoms. Prompt action can provide peace of mind and ensure any underlying conditions are managed appropriately.