A nagging, persistent cough can interfere with many aspects of daily life, including your ability to spend time with others, your ability to concentrate on tasks, and your ability to get quality sleep.
The grand majority of coughs are caused by an infection with a respiratory virus, and most will clear on their own after a few weeks. However, persistent coughs are another matter. If you have exhausted your supply of over-the-counter cough medications and you are still hacking, it’s time to troubleshoot. Read on to learn more about how to manage a cough that won’t quit.
A cough is a reflex triggered by irritation of your body’s cough receptors, which are present in the upper and lower respiratory tracts; in your esophagus, stomach, and diaphragm; and in the tissue sac that surrounds the heart. Irritation of these receptors can come from a particle (such as a piece of food or an allergen), mucous drainage, a temperature extreme, physical touch, inflammation, or infection.
If your daily atmosphere is too dry, it can exacerbate a coughing problem. Dry air is especially common during colder months, when your heater may be running continuously. A lack of moisture in the air can be particularly problematic in your bedroom, where you likely spend many horizontal hours. Try adding a humidifier; this can go a long way toward reducing a persistent cough.
When it comes to coughing, your internal environment counts, too. If you do not drink enough fluid, your airway may not be properly hydrated, causing irritation of the respiratory tract and more coughing. Consider increasing your daytime water intake to see if moisturizing your airway from the inside out makes a difference in your cough.
Other environmental factors that can cause persistent coughing include allergies or second-hand exposures. If you have a new pet, or your pet’s dander has accumulated in your home, this might be the cause of a persistent cough. Allergies to dust mites or mold may be at issue as well, so make sure to address any household cleaning to-do lists, and trial an allergy medication to see if this improves your condition.
Finally, if you smoke cigarettes or are exposed to second-hand cigarette smoke, this environmental trigger could be causing your persistent cough. Any amount that you can decrease your personal exposure can improve the situation.
One of the most common causes of a cough that won’t quit is actually a condition that has nothing to do with the pulmonary system. Acid reflux, otherwise known as GERD, is responsible for up to 40 percent of persistent coughs that continue beyond eight weeks.
A cough that is worse at night could be caused by acid reflux. Stomach acid can leak out of the stomach while you are lying flat, irritating the lower part of the esophagus and triggering a cough. If you experience heart burn, belching, stomach bloating, or stomach pain after eating, the likelihood that you have acid reflux is even higher.
To investigate, try eliminating common reflux triggers, such as spicy, greasy, or citrusy foods, as well as coffee and alcohol. It may also be helpful to try an antacid medication to see if this improves your symptoms.
If a cough and acid reflux symptoms persist despite diet modification and over-the-counter antacid trials—particularly if they are occurring with other symptoms, such as weight loss, nausea, severe discomfort, or appetite decrease—follow up with your healthcare provider as soon as possible.
If you are experiencing a cough that won’t quit, it may be worth your while to examine your medicine cabinet. Certain medications, or lack thereof, can cause a lingering cough:
- ACE-inhibitors: This class of blood pressure medication is known to have a dry cough as a side effect. If you have recently been prescribed this medicine and you have developed a persistent cough, make sure to check in with your healthcare provider.
- Asthma medications: If you have been diagnosed with asthma, and you have run out of your medication—or you have not been taking your medication as prescribed—this may be the cause of your persistent cough. Sometimes asthma comes in the form of a tight cough instead of the classic wheezing and shortness of breath. Follow up with your healthcare provider to make sure you are up to date with your supplies.
- Diuretics: If you have been diagnosed with heart failure and you are prescribed a diuretic, verify that you are taking your proper dose, at the prescribed interval (typically this is on a daily basis). If you have gotten behind on your regimen for any reason, and your heart failure has worsened, this could actually be the cause of your chronic cough. Follow up with your healthcare provider about this immediately. If he or she prescribes more medication, make sure to use a ScriptSave® WellRx savings card to find the lowest prescription price.
If the above troubleshooting does not alleviate your persistent cough, you likely need further evaluation. Your healthcare provider may do a physical exam and order lab work or lung imaging, particularly if your persistent cough is occurring with fevers, shortness of breath, severe fatigue, weight loss, night sweats, coughing up blood, leg swelling, weight gain, or trouble lying flat.
If your cough is occurring with any of these above symptoms and you feel you cannot wait to see your healthcare provider, seek emergency care immediately.
Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.