Chronic Cough: Persistent cough can be a sign of problems like asthma, allergy or acid reflux. If simple remedies do not provide relief, timely examination is necessary so that serious diseases can be prevented.

Chronic Cough: Persistent coughing can sometimes be a cause of embarrassment, especially when people around you start thinking that you have COVID-19. Frequent coughing exhausts the body, prevents sleep and sometimes can also cause urinary problems. As a doctor, I have also seen patients whose ribs broke due to repeated forceful coughing.

In such a situation, the question arises that why do some people have a cough for so long? This article tries to explain some common causes of persistent cough, and also tells when you should get yourself checked by a doctor in case of any serious illness.

Why do we cough?

Coughing is a natural defense mechanism of the body that helps protect the lungs from dust, germs and other harmful substances. This process forces air out to keep the airways clear. Coughing is more common in chronic lung diseases such as chronic bronchitis or bronchiectasis because the cilia that clean the lungs do not work properly. There are two types of cough — a wet cough, which produces mucus, and a dry cough, which is caused by increased sensitivity of the throat or airways without mucus.

Reasons for prolonged cough: 

A cough is considered a long-term or chronic cough if it lasts for more than 8 weeks in an adult or 4 weeks in a child. It has three common causes:

• mucus dripping from the nose into the throat
• Asthma
• Acid reflux (stomach acid reflux)

Sometimes these problems occur together. Some people also have conditions like "cough asthma" or "eosinophilic bronchitis", in which there is inflammation in the lungs, but these do not get cured quickly with common asthma medicines.

Cough may persist even after infection

A cough can persist for several weeks even after a viral or bacterial infection such as the common cold has healed. This is because the airways become swollen and more sensitive after an infection, causing a cough to begin even with the slightest irritation. Mucus also becomes more viscous, which is difficult for the cilia of the lungs to clear. Also, allergens can enter the vulnerable lining of the throat and worsen the cough. This can take time to heal.

Is this a sign of some new disease?

When cough persists for a long time, people often fear that a new bacterial infection has developed after the viral infection, for which antibiotics are needed. But this cannot be determined by yellow or green phlegm alone.

Your doctor will thoroughly evaluate your symptoms — such as difficulty breathing, high fever, or strange noises in your lungs — to rule out any serious infection. They will also check if you have asthma or any other undiagnosed allergies.

What is the treatment?

If someone has a persistent cough but is otherwise well, antibiotics are usually not necessary because coughs are often caused by irritation, not infection. Simple remedies such as saline sprays, steam inhalation, throat sprays and honey are helpful in reducing cough. Cough medicines are not very effective and may have side effects. Sometimes coughs can also be a sign of serious illness, such as lung cancer - although this is very rare. So, if cough persists for a long time, a chest X-ray and lung function tests (spirometry) should be done.

When should one consult a doctor?

• If your cough is accompanied by any of these symptoms, you should consult a doctor immediately
• Coughing up blood
• too much phlegm
• shortness of breath, especially while resting or at night
• Difficulty swallowing
• Weight loss or persistent fever
• Recurrent pneumonia
• New onset of cough in smokers over 45 years of age

What if the reason is not known?

Sometimes it happens that the cough does not get cured even after complete examination and treatment. Such a condition is called refractory chronic cough, that is, chronic cough that persists despite treatment.

When no specific reason for cough is known, it is called unexplained chronic cough. Earlier such cough was considered to be caused by mental stress or habit, but now medical science takes it seriously and this perception has changed.