Chronic Cough: Causes, Symptoms, and Treatment Options

Persistent cough

Hello Doctor, I would like to ask you about my mother's persistent cough.
I can hear her coughing during the day and especially at night when it becomes more severe (with phlegm, and sometimes she coughs continuously for a long time).
This condition seems to have lasted for years (at least several months).
Do you have any suggestions? Thank you for your response.

Jason, 20~29 year old female. Ask Date: 2010/03/29

Dr. Zhou Ziguang reply Pulmonology

Hello, there are many causes of chronic cough, such as bronchiectasis, tuberculosis, chronic bronchitis, psychogenic factors, and asthma, among others.
I recommend that you visit a pulmonology department for further evaluation, including a chest X-ray.
Thank you for your understanding.
Sincerely, Dr.
Chou Tzu-Kuang, Chief of Pulmonary Medicine.

Reply Date: 2010/03/29

More Info

Chronic cough is a common condition that can significantly impact a person's quality of life. It is defined as a cough that lasts for eight weeks or longer in adults. Given your mother's situation, where she has been experiencing persistent coughing for several months, it is essential to consider various potential causes, symptoms, and treatment options.

Causes of Chronic Cough
1. Postnasal Drip: This is one of the most common causes of chronic cough. It occurs when mucus drips down the back of the throat, often due to allergies or sinus infections, leading to irritation and coughing.

2. Asthma: Asthma can manifest as a chronic cough, particularly if it is associated with wheezing or shortness of breath. In some cases, coughing may be the only symptom.

3. Chronic Bronchitis: This condition, often linked to smoking or long-term exposure to irritants, leads to inflammation of the bronchial tubes and persistent cough with mucus production.

4. Gastroesophageal Reflux Disease (GERD): Acid reflux can irritate the throat and lead to a chronic cough, especially when lying down.

5. Infections: Chronic cough can also result from lingering effects of respiratory infections, such as bronchitis or pneumonia.

6. Medications: Certain medications, particularly ACE inhibitors used for hypertension, can cause a chronic cough as a side effect.

7. Lung Conditions: More serious conditions, such as chronic obstructive pulmonary disease (COPD) or lung cancer, can also present with chronic cough.

Symptoms to Monitor
In addition to the cough itself, it is important to monitor for other symptoms that may accompany it, such as:
- Presence of phlegm or sputum (color, consistency, and amount)
- Wheezing or shortness of breath
- Chest pain or discomfort
- Fever or chills
- Unintentional weight loss
- Night sweats

Treatment Options
1. Identify and Treat Underlying Causes: The first step in managing chronic cough is to identify its underlying cause. This may involve a thorough medical history, physical examination, and possibly diagnostic tests such as chest X-rays, CT scans, or pulmonary function tests.

2. Medications: Depending on the cause, various medications may be prescribed:
- Antihistamines for allergies or postnasal drip.

- Bronchodilators for asthma or COPD.

- Corticosteroids to reduce inflammation in the airways.

- Proton pump inhibitors for GERD.

3. Lifestyle Modifications:
- Avoiding Irritants: This includes quitting smoking, avoiding secondhand smoke, and steering clear of other environmental irritants.

- Hydration: Staying well-hydrated can help thin mucus and make it easier to expel.

- Humidifiers: Using a humidifier can help keep airways moist and reduce irritation.

4. Cough Suppressants and Expectorants: Over-the-counter medications may help manage symptoms. Cough suppressants can reduce the urge to cough, while expectorants can help loosen mucus.

5. Follow-Up Care: Regular follow-ups with a healthcare provider are crucial to monitor the condition and adjust treatment as necessary.

When to Seek Medical Attention
If your mother experiences any of the following, it is important to seek medical attention promptly:
- Coughing up blood or rust-colored sputum
- Severe shortness of breath or wheezing
- Persistent fever
- Unexplained weight loss
- Symptoms that worsen or do not improve with treatment
In conclusion, chronic cough can stem from various causes, and addressing it requires a comprehensive approach. It is essential to consult with a healthcare provider for a proper diagnosis and tailored treatment plan. Your mother's symptoms should not be ignored, especially given their duration, and a thorough evaluation will help determine the best course of action.

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