If you have a persistent cough (referred to as a chronic cough) it’s important to get it checked out. While most chronic coughs are nothing to worry about, sometimes they can be an indication of something more serious so we recommend getting a medical diagnosis if you have a cough that’s lasted for three weeks or longer. In this article, we’ll look at common causes of a chronic cough and some possible treatment methods.

What is a chronic cough?

Coughing is a reflex action that occurs when your body is trying to clear the airways of irritants like smoke or dust, or phlegm (thick mucus made by the cells lining the lungs and upper airways). A ‘chesty cough’ produces phlegm whereas a ‘dry cough’ is more of a tickle. Most coughs are caused by a virus and will get better by themselves. It is a good idea to rest, take painkillers and drink plenty of fluids. If you’ve had a cough for three weeks or more we call this a ‘chronic cough’ and recommend you see a doctor to rule out a possible more serious cause.

Coughs may be accompanied by other symptoms including runny nose, sore throat, shortness of breath, fever or chest pain. A chronic cough can leave you feeling tired and self-conscious, particularly if you are experiencing sudden uncontrolled bouts of coughing.

What causes chronic coughs?

There are many reasons why you might develop a chronic cough. Some of the most common include:

• Postnasal drip: This occurs when mucus from your nose drips down your throat and irritates your windpipe and lungs, causing you to cough. Allergies, viruses or inflammation can all irritate nasal membranes and create runny mucus. Postnasal drip is particularly common at night when you lie down. Possible treatments include a nasal spray, decongestant or antihistamine.
• Asthma: This is where the muscles around the airways tighten and the lining of the airways swells, making it harder to breathe. Thick mucus exacerbates the problem and coughing occurs because your body is trying to clear the mucus and get air into the lungs. Asthma can be triggered by many different things including cold air, tobacco smoke, allergies, infections or exercise. If you have an asthma diagnosis, your doctor will normally recommend an inhaler to open up the airways and reduce inflammation.
• Gastroesophageal reflux disease (GERD): This occurs when the muscle around the lower part of your oesophagus becomes weak, allowing acid to move upwards from the stomach which can irritate your lungs and trigger coughing. If you have GERD you may have other symptoms as well, including heartburn and chest pain. Lifestyle changes are normally recommended – such as avoiding food and drink that increase acid reflux – and you may be given medication to slow the production of stomach acid.
• COPD (chronic obstructive pulmonary disease): This is actually a group of diseases, rather than a single condition, including emphysema and chronic bronchitis. With COPD it can be hard for the air to get in and out of your lungs and your body may produce an excess of mucus, causing you to cough. COPD is linked to smoking. Symptoms are controlled using inhalers or oral steroids.
• Other possible causes of chronic cough include rhinitis and sinusitis, chronic bronchitis, infections, bronchiectasis and upper-airway cough syndrome.

Diagnosing a chronic cough

To diagnose what is causing your chronic cough, your doctor will examine you and take a medical history. You may also be given blood tests, allergy screening, a CT scan or lung function test.  Once the cause of your cough has been identified, the next step is to come up with a management plan for controlling your symptoms.

Are chronic coughs more common in winter?

Winter is a peak time for many different types of illnesses including chronic coughs. This is because colder weather can irritate the airways causing inflammation and triggering coughing. Also, because we tend to spend more time indoors during winter, infections can spread more easily and we are more likely to be exposed to viruses. Lower levels of vitamin D from sunlight may also increase our susceptibility.

If you have a chronic cough and would like to discuss possible causes, as well as specialist diagnosis and treatment, contact us.

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Leading Respiratory Consultant in London

Dr Shalin Diwanji is a specialist in Respiratory Medicine offering personalised consultations and treatment at multiple easily accessible locations.

Visit one of his clinics today to receive top-quality care for a wide range of respiratory conditions.

The Harley Street Clinic – Devonshire Diagnostic Centre, 16 Devonshire St, London, W1G 7AF
The Platinum Medical Center – 15-17 Lodge Road, London, NW8 7JA
Cromwell Hospital – 164-178 Cromwell Rd, London, SW5 0TU
London Digestive Center – 41 Welbeck street, London, W1G 8EA
Syon Clinic – 941 Great West Road, Brentford, TW8 9DU
The Clementine Churchill Hospital – Sudbury Hill, Harrow, HA1 3RX
Department of Respiratory Medicine – Level 6, Northwick Park Hospital, Harrow HA1 3UJ
Department of Respiratory Medicine – Level 8, Ealing Hospital, Southall UB1 3HW