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Nobody wants to be the individual who can’t control their coughing. It not only causes discomfort in the throat but also elicits disapproving glares from people in elevators, subways, and restaurants—especially during respiratory virus outbreaks. Why do some coughs persist for what feels like an eternity? A pulmonologist and an otolaryngologist shed light on the reasons behind a chronic cough and offer solutions.
Defining a chronic cough
To understand the root of a persistent cough, it’s essential to track how long you’ve been experiencing it. Different timeframes categorize a cough as chronic or acute. Dr. Natalie Earl, an otolaryngologist at the Centers for Advanced ENT Care—Feldman ENT Division in Maryland and Washington, D.C., explains that an acute or short-lived cough typically lasts up to three weeks and is often linked to a viral infection that will resolve on its own. Conversely, a chronic cough persists for more than eight weeks, sometimes despite attempts with home remedies or over-the-counter medications. Subacute coughs fall between three to eight weeks in duration, according to Dr. Soo Jung Cho, a pulmonologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital.
Causes of a chronic cough
If you’ve been coughing persistently for eight weeks or more, you’re likely grappling with one of three prevalent causes. Cho notes that approximately 90% of chronic coughs stem from these sources. Asthma, characterized by cough-variant symptoms, may be the culprit if you find yourself unable to stop coughing. Cho highlights that coughing is a primary indicator of this respiratory condition, which can be exacerbated by triggers such as pollen, fragrances, cold air, or stress. Postnasal drip, where nasal secretions flow down the throat, leading to a persistent cough, is a common issue addressed by otolaryngologists. Earl emphasizes that postnasal drip, often triggered by allergies, viruses, sinus infections, or non-allergic rhinitis, is a prevalent cause of chronic coughs. Acid reflux or GERD can also manifest as a cough instead of typical heartburn symptoms. Earl notes the presence of hoarseness, throat clearing, and a dry cough as potential signs of acid reflux. Gastroenterologists may conduct imaging tests on the esophagus and stomach to evaluate the severity of acid reflux if chronic and severe symptoms are present.
If you have been diagnosed with gastroesophageal reflux disease (GERD), there are steps you can take to address it. Don’t endure coughing fits without seeking help. Seek immediate medical attention if you experience any concerning symptoms such as shortness of breath, chest pain, unintentional weight loss, or coughing up blood, advises Cho, especially if you are a smoker.
If you are not experiencing severe symptoms, you can try some home remedies. Over-the-counter cough medicines and remedies like tea with honey are worth a shot, according to Cho. If you suspect your cough is related to postnasal drip, consider using over-the-counter medications like guaifenesin (Mucinex) to help dry up the secretions, suggests Earl. For acid reflux-related coughs, antacids or proton pump inhibitors may provide relief, as recommended by the National Institute of Diabetes and Digestive and Kidney Diseases.
If your symptoms persist or worsen after trying over-the-counter medications, it’s essential to consult a healthcare provider, advises Earl. They may recommend imaging tests, referral to a specialist, or prescription treatments. If you have an underlying lung condition such as asthma or COPD, it’s important to speak to your healthcare provider sooner than eight weeks if your cough worsens, as you may be at higher risk of developing a chronic cough. Adjusting your existing medications may help prevent this outcome.
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