Published: 18 Jun 2025

ICD9: 786.2      ICD10: R05.3      ICD11: MD12

A chronic cough is a cough that lasts for eight weeks or longer in adults or four weeks or longer in children.
It's not just a passing annoyance; it can disrupt sleep, cause chest pain, and even lead to more serious complications.

Here's a breakdown of what you need to know about chronic cough:

Key Characteristics:

Duration: The defining feature is its persistence. It's not a short-term cough associated with a cold or flu.
Disruptive: Chronic cough can significantly impact quality of life.

Common Causes:

Identifying the underlying cause is crucial for effective treatment. Common causes include:

Postnasal Drip (Upper Airway Cough Syndrome - UACS): Excess mucus dripping down the back of the throat irritates the airways.
Asthma: Coughing may be the primary symptom of asthma, especially cough-variant asthma.
Gastroesophageal Reflux Disease (GERD): Stomach acid flowing back into the esophagus can irritate the throat and airways.
Chronic Bronchitis: Inflammation of the bronchial tubes, often caused by smoking.
ACE Inhibitors: These blood pressure medications can sometimes cause a chronic cough as a side effect.
Other Respiratory Infections: Infections like whooping cough or even prolonged effects from a regular cold or flu.
Bronchiectasis: A condition where the airways become widened and scarred, leading to mucus buildup and chronic cough.
Interstitial Lung Disease: A group of disorders that cause scarring in the lungs.
Lung Cancer: Less common, but a possible cause, especially in smokers.
Cystic Fibrosis: A genetic disorder that causes a buildup of thick mucus in the lungs and other organs (more common in children and young adults).
Environmental Irritants: Exposure to smoke, dust, allergens, or other irritants.

Symptoms Associated with Chronic Cough (besides the cough itself):

The associated symptoms depend on the underlying cause, but can include:

Runny or stuffy nose
Feeling of liquid dripping down the back of your throat (postnasal drip)
Frequent throat clearing
Hoarseness
Wheezing and shortness of breath
Heartburn or acid taste in the mouth
Coughing up blood (see a doctor immediately)

Diagnosis:

A doctor will typically perform the following to diagnose the cause of a chronic cough:

Medical History and Physical Exam: Asking about symptoms, medications, smoking history, and potential exposures.
Imaging Tests:
Chest X-ray: To check for lung abnormalities.
CT Scan: Provides more detailed images of the lungs.
Pulmonary Function Tests (PFTs): To assess lung capacity and airflow.
Sputum Tests: To check for infection or abnormal cells.
Bronchoscopy: A procedure where a thin, flexible tube with a camera is inserted into the airways to visualize them and collect samples.
pH Monitoring: To check for acid reflux.
Allergy Testing: To identify potential allergens.

Treatment:

Treatment focuses on addressing the underlying cause:

Postnasal Drip: Antihistamines, decongestants, nasal corticosteroids, nasal saline rinses.
Asthma: Inhalers (bronchodilators and corticosteroids).
GERD: Lifestyle changes (avoiding trigger foods, eating smaller meals), antacids, H2 blockers, proton pump inhibitors (PPIs).
Chronic Bronchitis: Smoking cessation, bronchodilators, pulmonary rehabilitation.
ACE Inhibitors: Switching to a different blood pressure medication.
Infections: Antibiotics or antiviral medications.
Cough Suppressants: May provide temporary relief, but usually not a long-term solution.
Expectorants: Help to loosen and clear mucus.

When to See a Doctor:

It's important to see a doctor if you have a cough that:

Lasts for more than 8 weeks (adults) or 4 weeks (children).
Produces blood.
Is accompanied by fever, shortness of breath, chest pain, weight loss, or night sweats.
Interferes with your daily life.

Important Considerations:

Smoking: Smoking is a major risk factor for chronic cough. Quitting smoking is crucial.
Secondhand Smoke: Exposure to secondhand smoke can also cause or worsen chronic cough.
Environmental Irritants: Avoid exposure to known irritants.
Medication Review: Discuss all medications with your doctor, as some can cause chronic cough.

In summary, a chronic cough is a persistent cough that requires medical evaluation to identify and treat the underlying cause. Don't ignore it – seek medical attention to get the right diagnosis and treatment plan.