Dr Zuze Matters of Health
If you have been coughing for a while it is important to try and figure out why. That is because a cough in itself is not a disease, but a symptom of something else going on in your body.
Coughing is how the lungs clear themselves of irritants like fluid and mucus and is classified as acute or chronic depending on whether or not it lasts more than four weeks. Below are a few situations that will give you a nagging cough that may last a long time.
Bronchitis: If you just get an acute cough without any obvious flu or cold symptoms (like a tickling throat or nasal congestion), then you might have acute bronchitis. This usually causes a wet productive cough with coloured mucus or sputum.
Most acute bronchitis is caused by viruses and antibiotics won’t help. Dark brown or bloodstained sputum maybe signs of a bacterial infection though. Cough caused by bronchitis usually lasts for about 18 days.
Pneumonia: This is a potentially serious condition that will require antibiotics.
Symptoms include a productive cough (often with discoloured or bloodstained sputum), fever, chest pain, fatigue and shortness of breath.
Sometimes you can pick up pneumonia the same way you catch a cold but it can also follow viral infections.
Drugs: A class of anti-hypertensive drugs called ACE inhibitors can give you a dry cough which may come in fits.
Drugs in this class include captopril and enalapril which a lot of people here are on. You can develop this cough even if you have been on these drugs for years without any problems.
If you are taken off these medications, it can take up to four weeks for the cough to disappear.
Post nasal drip: This is when drainage from your sinuses flows down the back of your throat instead of coming out through the nose.
When the drip gets to your throat, it irritates it, which triggers a cough. With post nasal drip you will usually feel worse at night because lying on your back helps sinuses drain more easily.
The cough from post nasal drip is usually wet sounding and maybe productive of mucus like stuff. This cough is treated with antihistamines which dry out the drainage.
Gastroesophageal reflux disease: This typically causes heartburn and stomach pain but is also a common cause of chronic cough.
The acid from your stomach travels to your voice box where it irritates and causes a dry sounding cough. People with reflux will often notice an increase in cough after eating a heavy meal. It’s also worse at night and early mornings since lying down allows acid to move more readily to your throat.
Limiting or avoiding alcohol, caffeine, late night eating, spicy foods and some pain medication can help relieve this condition and the associated cough.
Asthma: This is a common cause of chronic cough.
Symptoms include wheezing, shortness of breath and a dry cough. You won’t necessarily have all these symptoms.
In children, asthma might sometimes just present as shortness of breath on exertion.
There are multiple treatments for asthma which mostly work by opening up your lung passages and decreasing mucus secretions in there.
Chronic obstructive pulmonary disease (COPD): This is a progressive disease that makes it harder and harder to breathe due to injury to the airways usually caused by long term cigarette smoking or exposure to occupational irritants like smoke or dust.
There are two types of COPD: Chronic bronchitis and emphysema. In chronic bronchitis, the lining of your airways is constantly inflamed. This results in a chronic productive cough.
Emphysema gradually damages the air sacs in your lungs, reducing the amount of oxygen that gets to your blood.
This can cause dry cough, wheezing, and shortness of breath. There is no cure for this disease though medication can help reduce the severity of the symptoms.
Lung cancer: This causes a chronic cough associated with other signs of cancer like weight loss, coughing up blood, fatigue and chest pain.
If you have been treated several times for pneumonia with no improvement, lung cancer may need to be excluded.
Lung cancer is much more common in smokers and former smokers. Ultimately, if you are worried about a chronic cough you need to visit your doctor and get checked out.