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What is chronic cough in adults?
Chronic cough is a cough that persists over time. A chronic cough is not a disease in itself, but rather it is a symptom of an underlying condition. A persistent, chronic cough is a common problem and is one of the leading reasons for a doctor’s visit.  There are some common causes and risk factors attributed to chronic cough. Smoking, Asthma, GERD (Gastroesophageal reflux disease), Sinus problems, Lung Infections, and certain medications like ACE inhibitors for blood pressure are some of the common causes of chronic coughs in adults. 

In rare cases, a chronic cough can be due to a retained foreign body in the lungs. This is more common in children but is possible to happen to anyone. It is important to see a doctor who may order a chest X-ray if a chronic cough is present. 

What are the 7 major causes of chronic cough in adults?

Cigarette Smoking

Cigarette smoking is the most common (and most easily avoidable) cause of a persistent, chronic cough.

Asthma

Asthma is a disease of the airways, resulting in difficulty breathing or wheezing. It is often diagnosed by abnormal breathing tests and listening for specific lung sounds. Some asthma sufferers have chronic cough as their only underlying symptoms.

Asthma suffered may even have normal lung function tests, and this is often referred to as cough-variant asthma. Asthma symptoms can be aggravated by cold air, exposure to air pollutants, pollen, smoke, or perfumes. 

Gastroesophageal reflux disease or “GERD”

Gastroesophageal reflux disease or GERD refers to acid reflux (or backward flow) of stomach acid and other contents into the esophagus.

In some severe instances, acid reflux can be so severe that stomach contents can be inhaled (aspirated) into the lungs and cause infection and damage to the lung tissue.  In some individuals with GERD, have no sensation of heartburn or burning in their esophagus and their only symptom may be a chronic cough. 

Sinus Problems and Post Nasal drop

Sinus Problems and postnasal drip are also causes of chronic cough. This condition can be difficult to detect as this condition can be very subtle. Sometimes a Computed Tomography scan or CT scan is needed to diagnose sinus issues. Patients affected by sinus issues often complain of a frequent tickle in their throat and can be observed to frequently need to clear their throats. 

Lung Infections

Infections such as bronchitis or pneumonia can cause an acute cough that turns into a chronic cough. These infections can be caused by bacteria, viruses, or fungus. Viral infections do not respond to antibiotics, and fungal infections only respond to anti-fungal medications.

If you are short of breath or believe you have a lung infection, it is important to see a doctor and be formally diagnosed.

The common cold and the flu (viral illnesses) often produce a dry cough. Viral upper respiratory tract infections often result in a prolonged cough even after the viral infection has cleared. This is more common in the throat affected by asthma. 

Lung infections caused by Mycoplasma

A particular strain of bacterial pneumonia called mycoplasma may cause a chronic cough with fatigue, weakness, shortness of breath, and copious amounts of sputum production. This infection is sometimes referred to as “walking pneumonia” and commonly affects young and healthy people. A persistent cough can often time linger for a long time after a patient is affected by this walking pneumonia. 

Medications

Certain medications, particularly ACE inhibitors like enalapril or captopril, are used in treating high blood pressure. One of the most common side effects of this medication is a chronic cough that will only go away with the discontinuation of the medication. 

What are some of the treatments for chronic cough?  

The treatment of chronic cough is directed at the cause. Symptoms may be able to be relieved with over-the-counter (OTC) cough medications containing guaifenesin and/or dextromethorphan. These medications can be found as cough syrups or in tablet form. 

Gastroesophageal reflux disease (GERD) is treated by avoiding foods that increase reflux, avoiding meals before laying down or going to bed, and elevating the head while sleeping. Some medications such as famous die, cimetidine, ranitidine, omeprazole, lansoprazole, pantoprazole, and esomeprazole are often given to decrease stomach acidity. 

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Jennifer Billings is the Medical Editor at Medicwell. She is an Integrated medical doctor who has been published on Medicwell Blog, Medium.com and is a regular contributor at MedCity News, Physician Family, and Psychology Today.