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Chronic cough

A chronic cough is more than just an annoyance. A chronic cough can ruin your sleep and leave you feeling exhausted. Severe cases of chronic cough can result in vomiting, lightheadedness, depression, even rib fractures.

Chronic cough is defined as lasting eight weeks or longer in adults, four weeks in children.

While it can sometimes be difficult to pinpoint the problem that's triggering a chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux — the backflow of stomach acid that can irritate your throat. Chronic cough typically disappears once the underlying problem is treated.

Symptoms Causes Risk factors Complications

A chronic cough can occur with other signs and symptoms, which may include:

  • A runny or stuffy nose
  • A feeling of liquid running down the back of your throat
  • Frequent throat clearing and sore throat
  • Hoarseness
  • Wheezing and shortness of breath
  • Heartburn or a sour taste in your mouth
  • In rare cases, coughing up blood

When to see a doctor

See your doctor if you have a cough that lingers for weeks, especially one that brings up sputum or blood, disturbs your sleep or affects your work.

An occasional cough is normal — it helps clear foreign substances and secretions from your lungs and prevents infection. But a cough that persists for weeks is usually the result of an underlying problem. In many cases, more than one cause is involved.

Major causes

  • Postnasal drip. When your nose or sinuses produce extra mucus, it can drip down the back of your throat and trigger your cough reflex. This condition is also called upper airway cough syndrome.
  • Asthma. An asthma-related cough may come and go with the seasons, appear after an upper respiratory tract infection, or become worse when you're exposed to cold air or certain chemicals or fragrances. In one type of asthma (cough-variant asthma), a cough is the main symptom.
  • Gastroesophageal reflux disease (GERD). In this common condition, stomach acid flows back into the tube that connects your stomach and throat (esophagus). The constant irritation can lead to chronic coughing. The coughing, in turn, worsens GERD — a vicious cycle.

Studies have shown that the above three causes, alone or in combination, are responsible for 90 percent of cases of chronic coughs.

Other causes

  • Infections. A cough can linger long after most symptoms of a cold, influenza, pneumonia or other infection of the upper respiratory tract have gone away. A not uncommon cause of a chronic cough in adults is pertussis, also known as whooping cough.
  • Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.
  • Chronic bronchitis. This long-standing inflammation of your major airways (bronchial tubes) can cause congestion, breathlessness, wheezing and a cough that brings up discolored sputum. Most people with chronic bronchitis are current or former smokers.

Less common

  • Aspiration
  • Bronchiectasis
  • Bronchiolitis
  • Chronic bronchitis from an infectious disease
  • COPD
  • Cystic fibrosis
  • Foreign body aspiration — children
  • Laryngopharyngeal reflux
  • Lung cancer
  • Nonasthmatic eosinophilic bronchitis
  • Sarcoidosis

Being a current or former smoker is one of the leading risk factors for chronic cough. Frequent exposure to secondhand smoke also can lead to coughing and lung damage.

Women tend to have more-sensitive cough reflexes, so they're more likely to develop a chronic cough than are men.

Having a persistent cough can be exhausting. Coughing attacks can disrupt your sleep and cause a variety of other problems, including:

  • Headache
  • Dizziness
  • Excessive sweating
  • Urinary incontinence
  • Fractured ribs
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