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Cough is one of the most common health problems we face. It is ubiquitous when we are suffering from a cold or flu. Regardless of the cause, coughing is not comfortable for anyone. It may keep us awake at night. In the daytime, it may cause nuisance for others and embarrassment for the patient. There are other complications as well, e.g. headache, hoarseness of voice, etc.
Most of the coughs usually go away in 2-3 weeks on their own. If it does not, then we might be suffering from what is called chronic cough. The exact definition is debated, but if the cough persists for between three to eight weeks, it should be identified as chronic. It could be dry, meaning no mucus is being produced. When there is mucus, the cough is known as wet.
There is a perception that chronic cough means something is seriously wrong with our lungs, and sometimes, it is related to cancer. But it is not really the case. Most causes are less serious and completely treatable.
Tobacco smoke is the most common reason for having a chronic cough, and many people are probably aware of it. The majority of smokers will eventually develop a persistent cough or smoker’s cough. People exposed to secondhand smoke for a long time may also be afflicted with something similar.
There are many other causes of a chronic cough. However, only a few account for most of the cases. These are postnasal drip syndrome, GERD/ gastroesophageal reflux disease, asthma, lung infections, COPD/chronic obstructive pulmonary disease and a group of medications known as ACE inhibitors.
Postnasal drip resulted from mucus being driven towards the throat. When foreign particles enter our nasal cavity, they produce mucus. Sometimes, this mucus moves back and tickles the throat. This leads to a wet cough, especially at night. But daytime cough is also not unheard of. Some home remedies can be applied for postnasal drip, e.g. inhaling steams or saline washing the nose.
Another potential suspect for chronic cough is GERD. It happens when stomach contents start to travel back into the chest instead of going down the usual route through the intestines. The acid reflux causes the most prominent symptom of GERD- heartburn, a burning sensation in the chest. The acid can also trigger the cough reflex by irritating food passages. To alleviate the symptoms, lifestyle modifications are required, along with medication. This includes avoidance of certain elements, e.g. peppermint, caffeine, onion, garlic, citrus fruit, fat, tomato sauce, chocolate, etc. The patients are advised to eat their food in small portions throughout the day, go to bed at least two hours after the meal and keep their heads elevated while sleeping.
A special variant of asthma, called the cough-variant, is another leading cause of chronic cough. It is characterised by a dry cough, usually at night, and precipitated by dust, allergens, exercise, cold air, etc.
Sometimes, the cause of chronic cough is the most obvious: a lung infection. There are instances when, despite recovery from flu or pneumonia, the cough persists for some time. Infections like Tuberculosis and pertussis can also give rise to chronic cough.
COPD is responsible for obstructing air supply to the lungs. The main symptom is breathlessness. But there could be a persistent cough, too.
Lastly, ACE inhibitors are a group of drugs prescribed frequently to patients with heart failure or high blood pressure. One of their commonest side-effects is cough. Not everyone suffers from it, but it does happen.
How should we take care of a chronic cough? According to pulmonologist Dr. Zeenat Safdar of Houston Methodist Hospital, an over-the-counter cough suppressant is often the first thing we can consider. However, they should only be used for temporary relief, and patients must contact the doctor to understand the root cause. Immediate help must be sought if the cough is mixed with blood, associated with breathing difficulty or chest pain, accompanied by unexplained weight loss, persistent problem with hoarseness, etc.
Usually, chronic cough disappears when the underlying problem is solved. But first, we need to ask the experts for help, and they can find out why the cough is persisting.