Many of us have suffered from a cough at some time in our lives. Most coughs will resolve without treatment in two to three weeks, but a persistent or chronic cough is of greater clinical significance and should be fully evaluated.
Cough
A cough is a reflex action to clear the airways of mucus and irritants such as dust or smoke. A cough lasting less than two weeks is rarely a sign of anything serious.
A cough is described as a “dry cough” when it is tickly and does not produce any phlegm (thick mucus). A “chesty cough” means phlegm is produced to help clear the airways. Most coughs will resolve without treatment in two to three weeks and do not require any treatment. Coughs lasting more than three weeks should be fully evaluated by a qualified doctor so that the cause could be identified.
What are some causes of a cough?
There are many causes of a cough. These include the following:
• an upper respiratory tract infection (URTI) that affects the throat, windpipe or sinuses – examples are a cold, flu, laryngitis, sinusitis or whooping cough
• a lower respiratory tract infection (LRTI) that affects your lungs or lower airways – examples are acute bronchitis or pneumonia
• an allergy, such as allergic rhinitis or hay fever
• a flare-up of a long-term condition such as asthma, chronic obstructive pulmonary disease (COPD) or chronic bronchitis
• inhaled dust or smoke
Persistent coughs
A persistent cough may be caused by:
• a long-term respiratory tract infection such as chronic bronchitis
• asthma – this also usually causes other symptoms such as wheezing, chest tightness and shortness of breath
• an allergy
• smoking – a smoker’s cough can also be a symptom of COPD
• bronchiectasis – where the airways of the lungs become abnormally widened
• postnasal drip – mucus dripping down the throat from the back of the nose caused by a condition such as rhinitis or sinusitis
• gastro-oesophageal reflux disease (GORD) – where the throat becomes irritated by leaking stomach acid
• a prescribed medicine, such as an angiotensin-converting enzyme inhibitor (ACE inhibitor), which is used to treat high blood pressure and cardiovascular disease
In some cases, a persistent cough may indicate a more serious medical disorder. A persistent cough might be a symptom of lung cancer, heart failure, a pulmonary embolism (blood clot on the lung) or tuberculosis.
A chronic cough can interrupt your sleep and leave you feeling exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness and even rib fractures.
When to see the doctor?
If you have a cough that lasts for more than three weeks it is a good idea to see your doctor. You should also see your doctor if you have the following:
• your cough is particularly severe
• you cough up blood or experience shortness of breath, breathing difficulties or chest pain
• any other worrying symptoms, such as unexplained weight loss, a persistent change in your voice, or lumps or swellings in your neck
Your doctor will arrange for a series of tests and might also refer you to a specialist doctor for further management.
Treatment of persistent coughs
Treatment will depend on the underlying cause of the cough. It is very important that all individuals with persistent or chronic cough know the cause and receive appropriate treatment.
Cough medicines and remedies
Although some people find them helpful, medicines that claim to suppress your cough, or stop you bringing up phlegm, are not usually recommended. This is because there’s little evidence to suggest they are any better than simple home remedies, and they are not suitable for everyone.
Many experts recommend that over-the-counter cough and cold medicines should not be given to children under the age of six. Children aged 6 to 12 should only use them on the advice of a doctor.
A homemade remedy containing honey and lemon is likely to be just as useful and safer to take. Honey should not be given to babies under the age of one because of the risk of infant botulism.
Conclusion
While it can sometimes be difficult to pinpoint the problem that is triggering a persistent or chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux. Fortunately, a persistent cough typically disappears once the underlying problem is treated. Individuals with a persistent cough should see their doctor for a full evaluation.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
