What is Chronic Cough?
A chronic cough is one that lasts eight weeks or longer in adults (four weeks in children). It is a symptom rather than a disease, and it can significantly affect sleep, work and quality of life.
Most chronic coughs have an identifiable and treatable cause. A structured evaluation by a pulmonologist helps avoid repeated courses of unnecessary antibiotics and cough syrups.
Common symptoms
- Dry or productive cough persisting for more than eight weeks
- Throat clearing, tickling or a feeling of mucus in the throat
- Hoarseness or heartburn
- Cough worsening at night, with talking or after meals
- Disturbed sleep, fatigue or urinary leakage with coughing
Possible causes & risk factors
- Asthma and cough-variant asthma
- Upper airway cough syndrome (post-nasal drip, sinusitis, allergic rhinitis)
- Gastro-oesophageal reflux disease
- Smoking and chronic bronchitis
- Medicines such as ACE inhibitors (used for blood pressure)
- Tuberculosis, bronchiectasis, interstitial lung disease or, less commonly, lung cancer
When should you consult a pulmonologist?
- A cough lasting more than three to eight weeks
- Cough with blood, weight loss, fever or night sweats
- Cough in a current or former smoker that has changed in character
- Cough that has not improved despite treatment
Diagnostic investigations
Your evaluation is tailored to your symptoms and history. It may include:
- Detailed history including medicines and exposures
- Chest X-ray
- Spirometry and FeNO
- CT scan of the chest when indicated
- Bronchoscopy in selected cases
Available treatment approaches
- Treatment directed at the specific cause identified
- Inhaled therapy for asthma-related cough
- Nasal treatment for post-nasal drip and allergic rhinitis
- Lifestyle measures and medicines for reflux
- Medication review and smoking cessation
- Cough control therapy for refractory chronic cough
Treatment is individualised. The options above are general information; your doctor will recommend what is appropriate for you after assessment. Outcomes vary from person to person.
Frequently asked questions
Usually not. Most chronic coughs are not caused by ongoing bacterial infection. Antibiotics are prescribed only when there is evidence of an infection that needs them.
Yes. ACE inhibitors (medicines whose names often end in '-pril') can cause a dry cough. Do not stop them yourself — discuss alternatives with your doctor.
