Diseases A–ZChronic cough
Cough is the number one reason for family doctor visits. Your cough may be acute (it lasts a little while) or chronic (it lasts a long time) . If you have a cough, it's important to see your doctor and get the right diagnosis and treatment.
Acute (short-term) coughs
Just about everybody coughs sometimes. From time to time, you may get an acute (short-term) cough that lasts a short while, and then goes away. A main cause of acute coughs is the common cold. You may catch a cold then have a cough that lasts two or three weeks. If you get a cold and cough, and your cough does not go away after a few weeks, see your doctor. You may be developing a long-term (chronic) cough.
If you have an acute cough, follow this cough treatment advice.
Acute cough warning signs — if you have any of these signs, see a doctor right away
- you're short of breath
- it hurts to cough
- there's blood in your mucus (phlegm), or you cough up blood
Chronic cough
If you've had a cough for more than three weeks, it is considered a chronic cough. "Chronic" means it lasts for a long time.
If you have a chronic cough, you should not ignore it. Chronic cough can interfere with your daily activities and make sleeping and eating difficult. A chronic cough could be a sign of a serious lung disease.
If you have a chronic cough, you must see your doctor.
Luckily, doctors can usually diagnose the cause of your chronic cough and give you an effective treatment. To figure out why you are coughing, and to make the coughing stop, visit your doctor.
Causes of chronic cough
A chronic cough is not a disease in itself. It is a sign of something wrong with your breathing system. That's why it's important to see your doctor and find out what's causing your cough.
Some of the most common causes of chronic cough include:
- upper airway cough syndrome (also called "postnasal drip syndrome", when mucus drips down your throat from the back of your nose — it can be triggered by allergies)
- asthma
- bronchitis
- smoking
- COPD, a long term lung disease (COPD is the new name for emphysema and chronic bronchitis)
- viral infections like the flu or a cold
- gastro-esophageal reflux disease (sometimes called GERD or acid reflux — a condition in which acid from the stomach backs up into your throat)
- side effects of ACE inhibitors (medicines used to treat high blood pressure)
- or a combination of these causes
In rare cases chronic cough can be caused by serious diseases like tuberculosis (TB), lung cancer or cancer of the esophagus (the tube in your neck).
What about smoker's coughs?
Smoking can cause chronic cough. If you are a smoker, get help to quit smoking. Your doctor can explain different ways to quit including nicotine replacement therapy, medicines, counselling and support groups.
You may be so used to your "cigarette cough" that you can't tell when something new has been added. Are you coughing more than you used to? for longer at a time? or has your cough changed? Maybe you're coughing up streaks of blood or more phlegm (mucus). Any of these may be a sign that something is wrong. A nagging "smokers' cough" should not be ignored. A chronic cough in a smoker or former smoker may be a sign of COPD (chronic obstructive pulmonary disease, including emphysema and chronic bronchitis). Discuss your cough with your doctor.
Diagnosing a chronic cough
The first step in treating a chronic cough is to figure out what's causing it. Your doctor may do several tests to diagnose your cough.
First your doctor will ask about your medical history. He or she might ask you questions about subjects such as allergies, the medications you are currently taking, whether you smoke or smoked in the past, if you use chemicals at home or work, and/or your recent illnesses.
Your doctor may also order a chest X-ray. Depending on the X-ray results, the doctor may order lung function tests. To find a lung testing clinic in your area, search our online database.
Your doctor may refer you to a breathing specialist (respirologist).
Once the doctor knows the cause of your cough, he or she will recommend a treatment.
Most of the time, you can get effective treatment for your coughs. If you see the doctor and get help early on, it will be easier to treat your cough.
Treatment for cough
The treatment for cough depends on what's causing it. For example, if your cough is caused by asthma, the doctor may give you asthma medicine. If your cough is caused by smoking, your doctor will help you quit.
In general, doctors do not recommend many over-the-counter cough medicines for acute (short-term) or chronic (long-term) coughs1.
For coughs in children under 14 years of age: Children under 14 years should not take over-the-counter cough medicines (expectorants, cough suppressants). According to the American College of Chest Physicians cough guidelines, cough is very common in children. Cough and cold medicines are not useful in children and can actually be harmful. In most cases, a cough will go away on its own. Sometimes coughs are caused by an underlying problem, like asthma or another lung disease, or by something in the air (pollution, smoke, allergens). Doctors will treat the underlying problem.
For adults: Adults with acute cough or upper airway cough syndrome (also called postnasal drip syndrome) should take an older variety antihistamine with a decongestant. Adults should not take over-the-counter cough expectorants or cough suppressants, including cough syrups and cough drops. They do not treat the underlying cause of the cough.
References
1. These recommendations are based on the American College of Chest Physicians (ACCP) guidelines on diagnosing and treating cough, endorsed by the Canadian Thoracic Society.
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