If you have a cough, there’s a good chance that a common cold or some other type of respiratory infection caused it. These coughs may linger after your other symptoms clear up but they usually get better in one to three weeks.
But what if you’re still coughing weeks later?
A lingering cough can be frustrating, disruptive and sometimes confusing. It may keep you up at night, make it hard to talk or lead to discomfort in your chest.
What is considered a chronic cough?
“A chronic cough lasts more than eight weeks for an adult or more than four weeks for a child,” said Tara Carr, MD, an allergist and immunologist with Banner - University Medicine.
Once you figure out what’s causing a chronic cough, there’s a good chance that treatment will help.
Common causes of a chronic cough
Several familiar conditions can cause a cough that lingers for a long time.
Post-viral irritation
Sometimes, after an upper respiratory infection is gone, your airways are still inflamed and sensitive. The irritation can keep triggering a dry cough after you feel better. Cold air, talking or laughing may trigger coughing fits.
Postnasal drip (upper airway cough syndrome)
Postnasal drip happens when mucus drains down the back of your throat. You might not notice a runny nose, but this mucus can irritate your throat and cause a chronic cough. You may clear your throat a lot or feel a tickle in your throat.
Asthma or cough-variant asthma
Asthma does not always cause wheezing. In some people, a cough is the main symptom. This is called cough-variant asthma. This type of cold may get worse at night, with exercise or in cold air.
Allergies
During the spring and fall, pollen from trees, grasses and weeds is a common cause of coughing.
Air quality
Pollution or dust storms can irritate the lungs and cause a cough.
Smoking or environmental irritants
Irritants and smoke, including secondhand smoke, can inflame your airways and cause ongoing coughing.
Unexpected reasons your cough may not go away
Sometimes a chronic cough has a cause that’s not as obvious.
Acid reflux or GERD
Gastroesophageal reflux disease (GERD) happens when stomach acid flows back into your esophagus. That acid can irritate your throat and airway, triggering a cough. You may have silent reflux, which is where you don’t have heartburn. This type of cough may get worse after meals or when you’re lying down at night.
Blood pressure medications
ACE inhibitors, which are medications that treat high blood pressure, can cause a dry cough as a side effect.
If you recently started taking a new medication and you have a cough, talk with your health care provider. Do not stop taking your medication without medical guidance. Your provider may be able to recommend another medication or options that can reduce side effects.
Heart-related fluid buildup
In some cases, heart conditions can cause fluid to build up in the lungs. This may lead to coughing, especially when you’re lying flat. If you have a cough along with shortness of breath, swelling in your legs or rapid weight gain, get medical care.
Habit cough
Neurogenic cough (habit cough) happens because the upper airway and vocal cords are irritable. “It can come with dryness or a tickling sensation in the throat and can be triggered by talking, eating and laughing,” Dr. Carr said. Taking medicines like gabapentin for a short time may help calm down the overactive nerves that cause irritability.
How a persistent cough differs from a viral illness
“It’s common for people to cough during a viral illness because the illness can affect the nose, throat and lungs directly,” Dr. Carr said.
When you have a cold, fever, body aches and other symptoms usually get better first.
The cough usually improves within one to two weeks. A chronic cough may linger after those symptoms are gone.
How can I stop coughing?
Home remedies like herbal teas, soothing liquids and over-the-counter (OTC) cough medications may give you some relief. But they may only treat the symptoms of chronic cough, not the cause.
When to talk with a health care provider
Consider contacting your doctor if you have:
- A cough lasting more than eight weeks in adults or four weeks in children
- A cough that is not improving or is getting worse
- A cough that disrupts sleep or work
- Severe coughing fits that make you gag or vomit
- Shortness of breath or wheezing
- A new cough after starting medication
- A cough that is causing muscle pain or soreness
Reviewing your medical history and symptoms can help identify the cause. “Pay attention to whether the cough affects you during the daytime or at night, the sorts of activities or exposures that make it worse and other characteristics, like if it’s wet or dry and if your voice is changing with the cough. These are helpful for your doctor to determine the cause of the cough and help treat it,” Dr. Carr said.
When urgent care is appropriate
Get urgent care for:
- Trouble breathing
- Coughing up blood
- High fever
- Chest pain
- Bluish lips or face
These symptoms need to be checked right away.
What evaluation may include
Your provider may review:
- Your medical history
- Current medications
- Exposure to irritants
- Other symptoms
Testing may include chest imaging, breathing tests or trying medication to see if your symptoms improve.
If needed, your provider may refer you to a pulmonologist, gastroenterologist, allergist or ear, nose and throat (ENT) specialist.
Key takeaways
Most coughs are not serious. But a cough that lasts weeks or longer might be caused by something beyond the original infection. Some causes, like acid reflux or medication side effects, are easy to miss.
Identifying the reason behind your cough is the key to finding relief. If your cough is not getting better, talking with a health care provider can help. Make an appointment with a Banner Health provider for an evaluation.
