Chronic cough is defined as a persistent cough that lasts for more than eight weeks in adults or more than four weeks in children. It’s a common symptom that can be caused by a wide range of underlying conditions. Here’s a comprehensive overview:
Causes of Chronic Cough
- Postnasal Drip: Excess mucus from conditions like allergies, sinusitis or rhinitis can irritate the throat and lead to coughing.
- Gastroesophageal Reflux Disease (GERD) or Laryngopharyngeal Reflux (LPR): Acid reflux can irritate the throat and trigger coughing, particularly when lying down or after eating.
- Asthma: Chronic inflammation and narrowing of the airways can cause a persistent cough, especially at night or in response to triggers.
- Chronic Bronchitis: Inflammation of the bronchial tubes due to smoking, pollution or other irritants can lead to a persistent cough with phlegm production.
- Smoking: Smoking or exposure to secondhand smoke can cause irritation of the airways, leading to a chronic cough.
- Medications: Certain medications, such as ACE inhibitors used to treat high blood pressure, can cause a chronic cough as a side effect.
- Respiratory Infections: Previous respiratory infections like viral bronchitis or pneumonia can sometimes leave a lingering cough that persists after the infection has resolved.
- Interstitial Lung Diseases: Conditions like sarcoidosis or idiopathic pulmonary fibrosis can cause chronic cough due to lung tissue scarring and inflammation.
- Environmental Factors: Exposure to environmental pollutants, dust or chemicals can irritate the airways and lead to chronic cough.
- Other Conditions: Less common causes include lung cancer, congestive heart failure, primary laryngeal disorders or psychological factors such as habit cough (a persistent cough without an underlying physical cause).
Evaluation and Diagnosis
- History and Physical Exam: Your doctor will ask about the duration and characteristics of the cough, any associated symptoms and your medical history.
- Diagnostic Tests: Depending on the suspected cause, tests may include chest X-ray, pulmonary function tests, allergy testing, CT scans of the sinuses or chest, laryngoscopy or stroboscopy, reflux or esophageal testing, nasal endoscopy or bronchoscopy.
Treatment
- Addressing Underlying Causes: Treatment focuses on addressing the specific cause of the cough. For example, antihistamines for allergies, proton pump inhibitors for GERD or bronchodilators for asthma.
- Medications: Cough suppressants, expectorants or inhalers may be prescribed to alleviate symptoms.
- Lifestyle Modifications: Quitting smoking, avoiding triggers, staying hydrated and using humidifiers can help alleviate symptoms.
- Speech Therapy: In some cases, speech therapy may be recommended for conditions like habit cough or vocal cord dysfunction and may be a helpful adjunct to other medical treatments. Carolina ENT has a speech therapist that works in our office and has specific expertise in management of chronic cough.
Complications
Persistent coughing can lead to exhaustion, chest pain, hoarseness and disrupted sleep, impacting overall quality of life. It’s important to seek medical evaluation for a chronic cough, especially if accompanied by other concerning symptoms or if it does not respond to over-the-counter treatments.
Managing chronic cough involves a collaborative effort between the patient and healthcare provider to identify and treat the underlying cause effectively. Early diagnosis and treatment can help prevent complications and improve outcomes.
Call Carolina Ear Nose & Throat – Sinus and Allergy Center at (828) 322-2183 for more information or to schedule an appointment.