Children's Health Children's Health Basics

Quieting a Chronic Cough

Having a cough tends to be a nuisance—interrupting dinner, disturbing a quiet movie theatre or waking up your spouse in the middle of the night. But a prolonged, chronic cough—one that lasts for three weeks or more—may be a sign of something more serious.

Even for a short-term cough, it can be tough to figure out when to see a doctor. Since a simple cold can cause a cough, you don’t need to schedule an appointment with your family physician immediately. First, ask yourself if your cough may be tied to an underlying infection. Are you coughing up blood or discolored phlegm? Do you have a fever? These may be signs of a respiratory infection, and your doctor can prescribe an antibiotic to help.

But if you answered “no” to these questions and your cough has persisted for at least three weeks, it is still important to see your doctor. Once a doctor can accurately diagnose the cause of a chronic cough, he or she can prescribe a treatment to help you quiet the cough and treat its underlying cause.

“Chronic cough is a common reason for physician visits in the United States,” writes Dr. Robert Holmes from Southern Illinois University School of Medicine in the American Family Physician.

While smoking is one of the most common causes of chronic cough, for non-smokers, various conditions, such as asthma, postnasal drip and gastroesophageal reflux disease (GERD), tend to be the culprit. Figuring out which of these is causing your cough takes a little bit of investigating.

Postnasal Drip
Postnasal drip, when fluids from the nose drain into the back of the throat, is the most common cause of chronic cough in nonsmokers. This condition can be hard to diagnose, but comes along with symptoms of nasal discharge or frequent throat clearing. So, a physician will often try to treat postnasal drip first with a decongestant or antihistamine to see if the cough clears up. If the cough goes away after a week of these medications, then the doctor assumes that postnasal drip is the cause. However, if the cough persists, postnasal drip is probably not the cause.

Asthma
Asthma is considered the second-leading cause of chronic cough in nonsmokers and the most common cause of chronic cough in children. And, surprisingly, a chronic cough is the only symptom of asthma in up to 57 percent of patients with the disease, according to Holmes. To determine if asthma is the cause, your doctor will likely ask about when you tend to cough most often. If the cough is worse at night, after exercise or when it is cold, asthma may be the cause. To treat a chronic cough caused by asthma, your doctor will prescribe typical asthma medications, such as a bronchodilator, which opens your airway, or a corticosteroid, which helps to relax your lungs.

GERD
GERD is commonly associated with heartburn, but a chronic cough may be the only symptom of this disease. If you are experiencing some heartburn, be sure to tell your doctor. If GERD is the suspected cause of your cough, you doctor will prescribe antireflux medications to see if the cough subsides. A change in diet may help as well, so be sure you speak with you doctor about your eating habits.

Other Causes
If none of these conditions seem to be causing your cough, your doctor will begin to consider other causes. These rarer causes include:

• Bronchitis: often caused by exposure to cigarette smoke or other irritants.
• Postinfectious cough: a cough sometimes persists even after a respiratory infection is treated.
• Medications: ACE inhibitors, used to treat high blood pressure, often cause a cough, but other medications may as well.