Coughing is a routine bodily function, but when it lasts for an extended time, it can get in the way of everyday life and be worrying. A chronic cough can be wet and produce phlegm or dry and tickle the throat.
A chronic cough is when a cough lasts longer than 8 weeks in adults or 4 weeks in children. Common causes include
asthma , allergies, gastroesophageal reflux disease ( GERD), or bronchitis. Less commonly, it can be a sign of a more severe condition, such as a heart cough or lung disease.
In this article, we take a close look at the causes and symptoms of a chronic cough, ways to treat it, and when to see a doctor.
What causes a chronic cough?
A variety of factors can cause a chronic cough. Sometimes, more than one factor may be responsible.
Common causes
When an adult has a cough that persists for more than 8 weeks, it is considered a chronic cough.
Some of the more common causes of chronic cough include:
Asthma. Asthma occurs when a person upper airways are especially sensitive t cold air, irritants in the air, or exercis One type of asthma, known as cough-variant asthma, specifically causes a cough.
Bronchitis. Chronic bronchitis causes loterm inflammation of the airways that can cause a cough. This can be a par of an airway disease called chronic obstructive pulmonary disease (COPD) that typically occurs as a side effect smoking.
Gastroesophageal reflux disease (GERD GERD occurs when acid comes back up from a person's stomach and into thei throat. The result can be chronic irritation in the throat that leads to cough.
Lingering after-effects of infection. If person has had a severe infection, suc as pneumonia or the flu, they might s experience lingering effects that includ a chronic cough. Even though most of their symptoms have gone away, the airways may still remain inflamed for so time.
Postnasal drip . Also known as upper airway cough syndrome, a postnasal dri the result of mucus dripping down the back of the throat. This irritates the throat and triggers a cough reflex.
Blood pressure-lowering medications . Medications known as angiotensin-converting enzyme (ACE) inhibitors ca cause a chronic cough in some people. These medications end in -pril and incl benazepril, captopril, and ramipril.
Less-common causes
Some less common causes of a chronic cough include:
Aspiration . Aspiration is the medical te for when food or saliva goes down th airway instead of the food pipe. The excess fluid can collect bacteria or viruses and may lead to irritation of t airway. Sometimes aspiration can lead t pneumonia.
Bronchiectasis. Excess mucus productio can cause the airways to become large than normal.
Bronchiolitis . Bronchiolitis is a common condition that affects children. It is caused by a virus that causes inflammation of the bronchioles, which small airways in the lungs.
Cystic fibrosis . Cystic fibrosis causes excess mucus in the lungs and airways, which can cause a chronic cough.
Heart disease . Sometimes coughing and shortness of breath can be symptoms
heart disease or heart failure . This is called a heart cough. A person with th condition may notice their cough worse when they are lying completely flat.
Lung cancer . While rare, persistent coughing can be a sign of lung cancer person with this disease may also experience chest pain as well as blood their sputum.
Sarcoidosis . This is an inflammatory disorder that causes small growths to develop in the lungs, lymph nodes, eye and skin.
Symptoms
A cough is typically the result of something that is irritating the airways causing the muscles in the chest and stomach to contract. The irritation also causes the glottis that covers the airways to open quickly, causing air to rush out. The result is a cough.
A cough can be 'dry' or 'wet'. A dry cough is a non-productive one, meaning the cough does not produce mucus. People who smoke cigarettes and those who take ACE inhibitors tend to have a dry cough. A wet cough is one that produces mucus or sputum. This is the case when, for example, a person has postnasal drip or cystic fibrosis.
When to see a doctor
A doctor will listen to a person's lungs to help determine the cause of a chronic cough.
A chronic cough can become a medical emergency. If a person experiences the following symptoms along with a chronic cough they should seek emergency treatment:
a fever greater than 103°F
coughing up blood
chest pain
shortness of breath or difficulty catch their breath
If a chronic cough interferes with a person's everyday activities, it often warrants further examination by a doctor. Other symptoms that may mean a person needs to see their doctor include:
appetite loss
coughing up a lot of mucus
fatigue
night sweats
unexplained weight loss
Diagnosis
To make a diagnosis, a doctor will begin by asking the person when their symptom first appeared, what makes the symptoms better, and what makes them worse. They will ask about the person's medical history and lifestyle habits, such as whether they smoke. A doctor will likely also listen to the person's lungs using a stethoscope.
Sometimes a doctor will require further testing to help with diagnosis. Tests may include:
taking a sputum sample and evaluating for the presence of blood or cancerou cells
imaging scans, such as X-rays or computed tomography scans to determ if there are signs of lung disease or inflammation
a bronchoscopy, where a doctor views lungs for signs of irritation or disease
Each of these tests, as well as a variety of other tests, can help a doctor identify the underlying causes of a chronic cough.
Treatment
Raising the head with extra pillows may help GERD-related coughs.
Treatments for a chronic cough depend upon the underlying cause. If a doctor cannot determine the exact cause straight away, they might decide to treat the most common contributing factors for a chronic cough.
Postnasal drip is a common cause, so a doctor may recommend the person takes decongestants or antihistamines. These medications can help to dry up secretions and reduce inflammation that can lead to postnasal drip. Decongestant or nasal steroid sprays may also help.
Other treatments may be more specific to a particular underlying medical condition. For example, a person may be able to control their GERD through making lifestyle changes and taking medications that reduce the effects of acid on the stomach. Examples of these changes can include:
eating several small meals a day
avoiding foods known to cause GERD, such as caffeine, citrus fruits, tomato-based foods, high-fat foods, chocolate or peppermint
refraining from lying down until two ho after eating
sleeping with the head of the bed rais or using extra pillows to elevate the head
taking medications, such as ranitidine (Zantac), cimetidine (Tagamet), or famotidine (Pepcid)
Those who have a cough related to ACE inhibitors may wish to talk to their doctor. There are some medications that may be able to reduce high blood pressure without causing a cough.
Unless side effects are serious, a person should not stop taking medication without first speaking to their doctor.
Risk factors
Smoking cigarettes can increase the risk of developing a chronic cough. Exposure to second-hand smoke can also increase a person's risk. The smoke can irritate the airways and lead to a chronic cough as well as lung damage.
Exposure to chemicals in the air, such as from working in a factory or laboratory, can also lead to long-term coughing.
Taking ACE inhibitors is a significant risk factor for coughing. According to the
New England Journal of Medicine, an estimated 20 percent of people who take ACE inhibitors develop a cough.
Complications
Coughing can be problematic if it interferes with a person's daily life. A chronic cough can have the following additional effects:
affecting a person's ability to sleep w if coughing keeps them up at night
daytime fatigue
difficulty concentrating at work and school
headaches
dizziness
Although rare, very severe coughing can cause the following complications:
fainting
urinary incontinence
broken ribs
Outlook
Most cases of a chronic cough can be treated, typically with over-the-counter treatments. However, sometimes a chronic cough can indicate a more serious cause that a doctor should evaluate.
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Why do I cough after I eat?
It is not uncommon to cough after eating. Coughing is a typical reaction of the body trying to clear irritants from the airways. Irritants are sometimes introduced into the body when eating, and this can lead to coughing.
If coughing after eating happens frequently, people should consult a doctor to determine a cause. Once the cause is known, a person can make some lifestyle changes or take medications to treat it.
Some of the most common causes include the following:
food allergies
asthma
dysphagia
acid reflux ( GERD or LPR)
aspiration pneumonia
infections
Causes of a cough after eating
There are many potential causes of coughing after eating:
Food allergies
Food allergies may cause shortness of breath and coughing after eating.
Allergies are a common cause of coughing after eating. They can develop at any age but typically develop during childhood.
When someone has a food allergy, their body's immune system is overreacting to what it believes is a harmful substance. People may also experience:
wheezing
shortness of breath
a runny nose
anaphylaxis
Common foods people are allergic to include:
milk
soy
peanuts
tree nuts
eggs
shellfish
People can have an allergy to one or more foods. If a person coughs because of a food allergy, it is essential that they find out what foods trigger the coughing.
A doctor can help pinpoint the foods causing the reaction.
Asthma
Asthma affects the airways and develops after exposure to an irritant, which can include food.
Sulfite is a common additive found in many drinks and food that often cause asthma symptoms. Foods that contain sulfites and should be avoided include:
beers
wines
dried fruit
pickled onions
soft drinks
However, any food that causes a person to experience an allergic reaction may trigger an asthma attack as well.
In addition to coughing, a person may experience:
wheezing
tightness in the chest
trouble Breathing.
Dysphagia
Dysphagia causes difficulty when swallowing. When dysphagia occurs, a person's body has great difficulty moving food and drink from the mouth to the stomach. It can result in pain or discomfort.
Dysphagia may make a person feel as if food has become lodged in the throat. This feeling can lead to gagging or coughing after eating as the body tries to clear the perceived blockage from the throat.
Conditions such as acid reflux often cause dysphagia. A doctor can determine the underlying cause.
Acid reflux
Acid reflux may irritate the food pipe, causing coughing after eating.
Acid reflux occurs when acid from the stomach travels up the food pipe. The acid may make its way into the upper food pipe or throat through the opening of the stomach, known as the lower esophageal sphincter.
When a person is eating, the sphincter relaxes to allow food to travel to the stomach. In some cases, the sphincter does not close entirely. The resulting gap allows acid from the stomach to travel upward.
The acid can irritate the food pipe, causing coughing. People may also experience:
a sour or bitter taste
a sore throat
burning sensation in the chest
More frequent acid reflux can be caused by:
gastroesophageal reflux disease (GERD
laryngopharyngeal reflux (LPR)
GERD is a chronic condition that causes a more severe form of acid reflux. When someone has GERD, they are very likely going to experience a cough as well as:
trouble swallowing
wheezing
nausea vomiting
reflux occurring two or more times a week
excessive stomach gas
LPR does not have the same symptoms of GERD. When it occurs, stomach acid may travel as far up as the nasal passages. Similarly to GERD, it can cause coughing as well as:
post nasal drip
hoarseness
need to clear throat
A doctor can treat these two conditions with medications. A person can also control these conditions with diet modifications. However, there is no cure for them.
Aspiration pneumonia
It is possible to inhale small particles of liquid or food when eating. In healthy people, the lungs will expel these particles through coughing.
Sometimes, the lungs may not be healthy enough to remove the tiny particles. When this occurs, bacteria from the food may become trapped in the lungs, resulting in aspiration pneumonia.
People are at an increased risk for developing aspiration pneumonia if they have acid reflux or trouble swallowing.
Symptoms of aspiration pneumonia include:
a wet or wheezing cough following eati
painful swallowing
extra saliva
shortness of breath
fatigue
congestion after eating and drinking
heartburn
fever shortly after eating
When someone experiences these symptoms, it is essential they speak to a doctor. Aspiration pneumonia can cause serious medical problems, such as respiratory failure or lung abscess.
Infections
People might experience a cough caused by an infection in the upper respiratory system. If a cough does not clear up properly, it can lead to a person coughing immediately following eating or drinking.
This type of cough is difficult to treat as it irritates the throat, causing the person to cough more and preventing healing.
It is possible to develop an infection in the food pipe or larynx. This type of infection may be caused by a virus, fungus, or bacteria. The throat may become inflamed and irritated when infected. The inflammation causes a person to cough, particularly following meals.
Treating the infection will stop the coughing.
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