What is causing this chronic cough?

Cough is a normal reflex to protect the airways/lungs. With a cold it is not uncommon to cough for a week or so before it resolves spontaneously. However, when a cough persists longer than 4 weeks, it is considered chronic and should be evaluated. There are 4 main reasons to have a chronic cough.

• Asthma: sometimes a cough is the only symptom; you may not wheeze, have chest tightness or shortness of breath. The cough may worsen with exercise and occur at night.

• Allergies: the drip of mucus from the nose into the throat can easily trigger cough and throat clearing. There may be associated nasal stuffiness, sneezing and eye symptoms (red, itchy)

• Sinus problems: With a sinus infection, thick mucus can drain from the sinuses into the back of the throat leading to cough. With nasal or sinus irritation from smoke, chemicals or other air pollution, post-nasal drip can lead to cough.

• Gastro-esophageal reflux: when stomach acid flows upward into the esophagus (food tube), this can trigger a cough. Frequently there is no “heartburn” or pain. This is somewhat controversial in children. In individuals with neurological problems, stomach contents may be aspirated into the lung, leading to pneumonia.

There are numerous other reasons to have an ongoing cough with some being serious and others less serious, but still very annoying. Especially in individuals who smoke, lung cancer can present with chronic cough. A number of infections can present with cough including pertussis (whooping cough); infants whoop, but the rest of us just cough….for months! Aspiration of a “foreign body” can lead to cough— this is more common in children. Chronic infections in the lung are less common, but important to exclude. Some uncommon causes of cough don’t originate in the lungs. These include ear wax triggering a nerve on the ear drum, heart failure, habit cough or even tics. The list goes on and on.

If you are experiencing a chronic cough, check with your doctor so you can have an appropriate evaluation and specific treatment.