My Cough Won't Go Away! Common Causes of Chronic Cough

Many patients with COPD or other lung problems, such as asthma, struggle with pesky cough that just won’t seem to go away. This seems to be more common during the winter months, when viruses run rampant and leave patients with long-lasting coughs.  Though not always, it is common for patients, particularly those with COPD or asthma to have a cough that can last up to 8 weeks (at which point it is called a "chronic" cough).   

During the winter months, post-viral cough is a common problem for patients with COPD and/or asthma, and can result in chest tightness or muscle aches in addition to the constant coughing for up to 2 months! This seems like a really long time to have a cough and can be quite bothersome for patients.  This type of cough usually is “non-productive”, which means mucus is generally not coughed up.  It sounds like a raspy, dry, wheezy cough. 

If the cough is especially bothersome, sometimes clinicians will prescribe inhalers such as albuterol or lose dose corticosteroid inhalers that may provide some symptomatic relief.  Over the counter cough medications may work too, with variable results.  Codeine is generally avoided, although is most commonly prescribed when cough prevents patients from sleeping.  

If the cough turns productive, meaning you’re coughing up green or yellow mucus, this may be a sign of a secondary bacterial infection and you should notify your healthcare provider of the change in the type of cough.

If the cough doesn’t seem to be related to a recent viral infection, there are certainly other reasons why patients often have chronic coughs. The good news is, that while cough is a very bothersome symptom, it rarely signifies a life-threatening disease.  In fact, the top three causes of chronic cough are:

1.  Upper airway cough syndrome (a fancy name for post-nasal drip)

2.  Asthma (which sometimes has the only symptom of cough!)

3. Gastroentestinal esophageal reflux disease (GERD), sometimes referred to as ‘heartburn’.

Other causes of cough include COPD (usually chronic bronchitis type of COPD) other infectious diseases (such as pneumonia, tuberculosis), interstitial lung diseases, or cancer.

The Bottom Line:

The most common cause of cost is post-nasal drip, asthma, GERD (reflux or heartburn) and cough that persists after a viral infection.  When cough becomes chronic (lasting over 8 weeks), lung doctors will often start treatment for whichever of those three causes seems most likely in your situation.  Although cough alone is rarely a sign of a severe disease, it certainly warrants discussion with your healthcare provider, and if necessary, referral to a lung doctor.

Read more about cough here.


Here is a nice article from the ACCP Clinical Guidelines regarding Upper airway cough syndrome and also reviews other causes of cough. 

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