Coughing is normal. When the nerve endings in your airway become irritated, you cough to clear your throat of irritants or allergens. Often, a cold or upper respiratory infection results in a cough that can last a few weeks, which is also normal.
Characteristics of chronic cough — also called persistent cough — include the following:
- It lasts at least eight weeks for adults and four weeks for children.
- It can leave you feeling tired and worn out because coughing makes it hard to sleep or rest.
- It can interfere with all aspects of everyday life.
Chronic cough is not a disease by itself. And it may have more than one underlying cause. The goal is to find out what is causing your chronic cough and provide effective treatment so that you experience relief
Causes of chronic cough
Chronic cough is caused by many different conditions, including some that are not part of the respiratory system. These are some reasons you or your child may develop a chronic cough:
- Allergic rhinitis and chronic sinusitis: Allergies and sinus infections are two of the most common reasons for chronic cough in children. Both can cause excess mucus that drains down the throat; this postnasal drip can lead to a cough.
- Asthma: When the airway becomes inflamed and narrowed, shortness of breath and wheezing can trigger a chronic cough.
- Gastroesophageal reflux disease (GERD): Stomach acid can travel up to the throat causing irritation; this irritation is called laryngopharyngeal reflux (LPR).
- Smoking: Smoking is a major throat irritant.
Other less common causes of chronic cough include the following:
- Aspiration: Coughing that occurs while eating or drinking could be a sign of aspiration, when swallowed foods or liquids pass below the level of the vocal cords and into the lungs. Aspiration can be due to vocal cord paralysis or other neurologic conditions that cause decreased sensation in the upper airway.
- A blockage in the airway: In some cases, chronic coughing could be a sign that a foreign object has become stuck in the airway. This is more common in children but can happen to anyone. After a choking event, there is an asymptomatic period (a time when there are no symptoms) that can last up to two weeks before complications, such as pneumonia, begin to appear.
- Blood pressure medications, such as ACE inhibitors and beta blockers.
- Chronic bronchitis
- Chronic obstructive pulmonary disorder (COPD)
- Cystic fibrosis: In rare cases, a continued cough may be a sign of cystic fibrosis, a progressive genetic disease that causes persistent lung infections.
- Habit cough: Sometimes a cough will develop in response to an irritant in the airway, but persist after the original cause is gone. This type of cough usually has a "honking" sound to it.
- Pertussis (or whooping cough): A "whooping" cough from pertussis can last for months, and complications can be serious, including apnea (not breathing), decreased oxygen, pneumonia, seizures and even death.
How can I get help for chronic cough?
Call your primary care doctor or your child's pediatrician if you are concerned about a cough that won’t go away. Call 911 or go to an ER right away if you or your child is having problems getting enough air to breathe easily.
Your doctor may order tests to help diagnose the underlying cause of your chronic cough, which may include one or more of the following:
• Imaging tests such as a chest or sinus X-ray, or a CT scan to look for sinus infection
• Lab tests to check for infection
• Lung function tests to see how well you are breathing
Your doctor may refer you or your child to an adult or pediatric specialist at Rush for further evaluation. This may include getting a close-up look at your throat and airway via an endoscope.
Chronic cough care at Rush
Medications for chronic cough
To help ease your coughing, your doctor may prescribe medications, including one or more of the following:
- Suppressants to help you sleep
- Expectorants to help you expel mucus
- Bronchodilators to help you breathe
Coughing is a vital function and an important symptom, so suppressing a cough entirely is not a treatment goal.
Specialists who treat chronic cough
Depending on the nature and severity of your cough, and what’s causing it, your doctor may refer you or your child to one or more of the following specialists for further treatment:
- Allergy and immunology doctors identify and treat allergies, asthma, sinusitis and bronchitis, all of which can cause chronic cough.
- Ear, nose and throat (ENT) doctors treat conditions of the airway that may cause persistent coughing, including laryngopharyngeal reflux (LPR), asthma, allergies and sinus issues.
- Gastroenterologists evaluate and treat conditions related to the digestive system, including GERD.
- Pulmonologists are experts in diseases and conditions of the lungs and the airway that may cause chronic coughing, including asthma, bronchitis, COPD and, rarely, lung cancer.
- Pediatric specialists with Rush's Pediatric Aerodigestive Program – including ENTs, pulmonologists, gastroenterologists and speech-language pathologists. These experts provide multidisciplinary, family-focused care for children with complex conditions of the upper airway, lungs and upper digestive tract, including those that cause chronic cough.
These specialists can help address both your cough and the underlying cause.
Because chronic cough can be caused by many different conditions, and many conditions are interrelated, you or your child may need to see more than one specialist. For instance, if you have GERD, you may see both a gastroenterologist and an ENT.
Complex, chronic conditions like cystic fibrosis and COPD are treated by teams of specialists through comprehensive programs, such as the Rush Cystic Fibrosis Center.
Your doctor can point you in the right direction so you or your child can get the care you need.
Why choose Rush for care of chronic cough
- Expertise you can trust: Doctors at Rush have expertise diagnosing and treating the conditions that cause chronic cough, including complex health issues like COPD and cystic fibrosis.
- Specialized care for children: At Rush University Children's Hospital, children from newborns to teenagers receive compassionate, expert care from board certified pediatric specialists, like those in Rush's Pediatric Aerodigestive Program.