A chronic cough is a cough that lasts longer than eight weeks in adults, or longer than four weeks in children. Although many lung diseases may cause a cough, a chronic cough usually can’t be linked to another disease or illness. It often does not respond to treatment and can impact a person’s quality of life.
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What Is Chronic Cough?
A cough that lasts eight weeks or more in adults, or four weeks in children, is considered chronic. At that point, it's less likely to be caused by a cold or typical respiratory infection. What matters most is how disruptive it becomes to your quality of life.
A long-lasting cough might point to an undiagnosed lung condition. But not all chronic coughs come from lung problems. Since coughing is a natural reflex, it shouldn’t continue without a clear reason. Your doctor may refer you to other specialists — such as an allergist, ENT, cardiologist, or digestive system specialist — to explore other possible causes.
How common is chronic cough?
Chronic cough affects 3% to 18% of adults worldwide. How common it is depends on things like age, smoking habits, and where people live. In the U.S., about 18% of adults who smoke have a chronic cough.
It’s more common in places like Europe and North America than in Asia or Africa, but this difference isn’t due to genetics or ethnicity. Instead, it’s likely caused by environmental factors — especially in urban areas where people breathe in more air pollution and irritants.
What causes chronic cough?
Common causes of chronic cough include:
- Asthma.
- Blood pressure medications.
- Gastroesophageal reflux disease (GERD).
- Postnasal drip.
- Viral or bacterial infections.
Chronic cough risk factors
Current or previous exposure to tobacco smoke can put you at a higher risk of developing a chronic cough. Women may also be more likely to develop a chronic cough than men because women tend to have more sensitive cough reflexes.
Complications of chronic cough
Having a chronic cough can be exhausting. Not only is coughing annoying and uncomfortable, but it can also cause other health concerns.
Other issues that coughing can cause include:
- Broken ribs.
- Dizziness.
- Excessive sweating.
- Headache.
- Sleep disturbances.
- Syncope (fainting).
- Urinary incontinence (loss of control).
- Vomiting.
How can I prevent chronic cough?
Although you may not be able to prevent all causes of a chronic cough, there are a few things you can do to lower your risk. If you have allergies or asthma, avoiding triggers may help prevent chronic cough. You should also avoid exposure to tobacco smoke.
What Are the Signs and Symptoms of Chronic Cough?
Although the main symptom is a cough, people who have a chronic cough may also experience other related symptoms that can sometimes point to an underlying medical condition.
Other related symptoms may include:
- Frequent throat clearing.
- Heartburn or a bad taste in the mouth.
- Nasal congestion.
- Postnasal drip.
- Shortness of breath.
- Sore throat.
- Wheezing.
When should I see a doctor about my chronic cough symptoms?
Most coughs that last less than eight weeks are caused by upper respiratory infections (URIs), such as colds. URIs go away on their own within a few weeks. If you have a cough that has not gone away for more than eight weeks, see your health care provider for a diagnosis.
How Do You Diagnose Chronic Cough?
Getting a chronic cough diagnosis can be both a relief and a source of frustration. It’s helpful to name what’s been causing your symptoms for so long, but getting the diagnosis doesn’t guarantee that the cough will go away. Managing chronic cough requires a partnership with your health care provider to determine the right combination of medications and lifestyle changes for you to manage the condition effectively.
Tests to diagnose chronic cough
Your doctor may order testing, including:
- Blood tests to check for signs of infection or allergies.
- Imaging tests, including a chest x-ray or CT scan, to look for the cause of your cough.
- Methacholine challenge test — Breathing test often used to diagnose or rule out asthma.
- Pulmonary (lung) function tests — Noninvasive tests that provide information about how well your lungs are working. After your first round of lung function testing, your health care provider may give you an inhaled medication called a bronchodilator and ask you to repeat the test(s). Your provider will compare your test results to determine if the medication was effective. There are several types of lung function tests, including:
- Lung volume test — Measures the volume of air in your lungs and how much air is left in your lungs at the end of a normal breath.
- Spirometry — Measures how much air your lungs can hold and how forcefully you can breathe out.
- Skin testing – Also called scratch testing, this test exposes your skin to small amounts of allergens (allergy-causing substances) and can identify environmental allergy triggers, such as pollen, dust mites, pets, and mold, that may be related to your chronic cough.
- Sputum (phlegm) sample collected after a deep cough.
- Throat swab — Usually taken with a long cotton swab to check for infection.
How Do You Treat Chronic Cough?
Medications may help treat your chronic cough if it is caused by post-nasal drip, asthma, infection, or acid reflux. Your health care provider will let you know what type of medication is right for your condition.
Why Choose UPMC for Chronic Cough Care?
At UPMC, we recognize that a chronic cough can affect your sleep, energy level, and overall quality of life. That’s why we conduct a complete evaluation to look for underlying conditions that may be causing your chronic cough.
