What causes chronic cough?
Chronic cough can be caused by many different things; it’s not always the sign of a serious health issue.
Chronic infection of your airways, called chronic bronchitis, can cause chronic cough for some people. There are other, less common infections that can cause chronic cough, for example tuberculosis (TB) or whooping cough (pertussis). Both children and adults can get whooping cough.
If an infection is causing your cough
You may receive antibiotics if a bacterial infection is causing your cough. Remember that antibiotics do not work against viral infections, however getting vaccinated against infections is a good way to prevent flu, COVID-19 and other common causes of lingering coughs.
When you have asthma, things like certain chemicals or scents or cold air can cause you to cough.
Asthma can also make it more likely that you will get an infection like a cold or flu. Taking regular medication to control your asthma can prevent the cough in most cases.
If asthma is causing your cough
You will be given inhalers to take if your cough is due to COPD or asthma. It is important to take them daily or as directed to treat the cause of the cough.
Postnasal drip happens when extra mucus from your nose drips down the back of your throat. This can cause you to cough. PND is usually a symptom of allergies or an infection like a cold.
If PND is causing your cough
You may be asked to take antihistamine (allergy) pills if your PND is caused by allergies. Decongestants (pills or spray) can help, however they should only be used for a few days.
Nasal sprays with corticosteroids or ipratropium bromide can be helpful to treat PND. Some people also find nasal rinses with saline helpful.
People who smoke may have a “smoker’s cough”. This is your body trying to get rid of the chemicals in your lungs and airways after long-term use of tobacco.
Even if you smoke, a chronic cough is not normal. It may be a sign of chronic obstructive pulmonary disease. Quitting smoking will improve your lung health and help you get rid of your cough.
If smoking is causing your cough
If you need help to quit smoking or are worried about your cough caused by smoking, there are supports available to you. Speak with your pharmacist or other healthcare provider about how you can quit smoking.
COPD is a lung disease associated mainly with smoking (although smoking is not the only cause of COPD). Symptoms include breathlessness and chronic cough.
If COPD is causing your cough
Quitting smoking and treatment for COPD can help improve chronic cough. There are supports available to you. Speak with your pharmacist or other healthcare provider about how you can quit smoking.
You may also be given inhalers to take if your cough is due to COPD or asthma. It is important to take them daily or as directed to treat the cause of the cough.
GERD, sometimes called heartburn or acid reflux, can cause stomach acid to back up into the throat, which can cause you to cough.
If GERD is causing your cough
Ask your healthcare provider about lifestyle changes you can make that can help prevent or treat GERD. If this doesn’t work, you may be prescribed a medication called a proton pump inhibitor (PPI). PPIs work by reducing the amount of acid your stomach produces.
ACE inhibitors prescribed for high blood pressure or heart failure can cause coughing for some people. There are also other types of medications known to cause chronic cough.
If your medication is causing your cough
Speak to your healthcare provider about the medications you’re taking. They will help you find a different medication that will control your condition without causing cough.
People with no obvious illness or infection can experience chronic cough. Cough hypersensitivity syndrome (CHS) describes various cough-related conditions or unexplained cough.
CHS is a new concept in healthcare, and its cause is not yet fully understood. It is thought that the nerves that trigger the body’s urge to cough are overly sensitive to certain triggers. These triggers could be things like perfume, cold air, exercise, stress, singing or talking. People with CHS often feel the urge to cough, like a sensation of irritation or itching in the throat before they cough.
If CHS is causing your cough
Behaviour modification therapy, typically provided by speech language therapists, is sometimes recommended to treat CHS.
How will my provider find the cause of my cough?
Before your healthcare provider can treat your chronic cough, they will try to find out what is causing it. They’ll start by asking you questions about your health. It is good to prepare for your appointment by reviewing the list of questions they could ask you.
Your provider will do a physical exam and testing including listening to your lungs. They will likely order tests such as a chest x-ray and/or spirometry.
A chest x-ray is a two-dimensional image of your lungs. Chest x-rays are helpful to rule out more serious but rare causes of chronic cough, like pneumonia, tuberculosis (TB) or lung cancer.
Spirometry is a kind of pulmonary function test (PFT). It is the most common test to measure how well your lungs are working. You will be asked to blow into a mouthpiece that is attached to a small device called a spirometer. A spirometer will tell you how much and how fast you can move air in and out of your lungs and if there is something blocking your airway. This test can be used to diagnose COPD or asthma.
It is possible your cough is unrelated to a disease or condition of your airway or lungs. Your healthcare provider may refer to you an ear, nose, throat specialist (ENT), or someone who specializes in treating conditions of the stomach or esophagus. They may refer you for more testing, like a CT scan or endoscopy.
What should I bring to my appointment?
There are several things that you can bring to help you get the most out of your appointment.
A list of questions
Write your questions down, with the most important ones at the top of your list. Let your provider know that you have questions for them. Take notes or ask your friend or family member to take notes when your question is answered. Ask for more information or clarification if you need it.
A friend or family member
Bring someone who can help you remember important information and take notes for you.
A list of your symptoms
Be honest and open. Consider making a diary of symptoms over several days so that you don’t forget anything.
A list of medications
Bring all your medications or a list of all your medications, including any herbal remedies, vitamins or supplements. Ask for a review of when and how to take your medications if you aren’t sure.
What questions will my healthcare provider ask me?
Your healthcare provider will ask you questions about your health history and your symptoms. This list includes some of the questions you may be asked. Writing down your answers before your appointment will make it easier to recall important details about your health and your cough.
Questions about your health history
- What medications are you taking?
- How much are you taking each day and how often?
- When did you start taking this medication?
- What vitamins and/or supplements are you taking?
- What vaccines have you received? When did you receive them?
- Do you currently smoke?
- Have you smoked in the past?
- For how long have you smoked?
- How much do you smoke?
- Have you tried to quit smoking in the past? If you weren’t successful, why not?
Questions about your symptoms
- When did your cough start?
- How often do you cough?
- How often do you cough at night?
- How does coughing affect your sleep?
- How does coughing affect you socially? Emotionally?
- What triggers your cough or makes your coughing worse?
- What makes your coughing better?
- Have you been prescribed any medications in the past to treat cough? If so, what medication(s)?
- When were they prescribed?
- How long did you take them?
- What physical affects are caused by your cough? For example, does your cough cause pain in
your chest or stomach? A change in your voice? Loss of bladder control? - How often does your cough interfere with daytime activities?
- How often do you cough up phlegm? What does it look like?