Unraveling the Mystery of a Lingering Cough
Nobody wants to be known as the person who constantly coughs. It’s not only irritating for your throat, but it also attracts glares from people in elevators, trains, and restaurants—particularly during cold and flu season.
Why do some coughs linger for so long? A lung specialist and an ear, nose, and throat doctor explain what causes a long-lasting cough and what you can do about it.
Understanding Chronic Cough
To understand the cause of a persistent cough, it’s helpful to note how long you’ve had it. There are specific durations that determine whether a cough is chronic.
According to , an ear, nose, and throat specialist at the Centers for Advanced ENT Care—Feldman ENT Division in Maryland and Washington, D.C., an acute or short-term cough lasts up to three weeks. She says these brief coughs are usually caused by a virus and will go away on their own.
On the other hand, Earl says that a persistent or chronic cough lasts for more than eight weeks, sometimes even with home treatments or over-the-counter cough syrups.
Dr. Soo Jung Cho, a lung specialist at Weill Cornell Medicine and NewYork-Presbyterian Hospital, says that subacute coughs fall in between, lasting three to eight weeks.
Causes of Persistent Cough
If your cough has persisted for eight weeks or more, it’s likely due to one of the following three reasons. Cho notes that approximately 90% of chronic coughs stem from these causes. (The remaining 10% involve uncommon conditions like chronic bronchitis, lung cancer, or medication side effects.)
Asthma
Cho suggests that if you can’t stop coughing, you may have cough-variant asthma, where coughing is the primary symptom.
The states that with asthma, you might cough more easily when exposed to irritants like pollen, perfumes, cold air, or even stress. You may also notice that your symptoms don’t improve much with over-the-counter cough remedies.
Cho says a lung specialist or allergist can evaluate you for possible asthma symptoms and take a chest X-ray or CT scan to check for underlying lung problems.
Postnasal drip
Earl says that ear, nose, and throat doctors (also known as ENTs) are very familiar with this cause of a stubborn cough, noting that it’s “the most common reason for a cough presented in an ENT office.”
She explains that postnasal drip happens when secretions from the back of your nose drip into your voice box, causing you to cough. “Typical causes of postnasal drip include allergies, viruses, sinus infections, and non-allergic rhinitis.”
You might suspect postnasal drip is the cause if you feel liquid running down the back of your throat, along with the urge to clear your throat but only producing a dry cough, she says.
Cho mentions that your doctor may use a laryngoscope, a camera on a thin tube inserted down your throat, to examine your voice box and determine if postnasal drip or another issue is causing your symptoms.
Acid reflux or GERD
Earl notes that sometimes, heartburn manifests as a cough instead of indigestion. “Instead, you might experience hoarseness, throat clearing, and a dry, unproductive cough.”
Cho says an ENT or lung specialist might send you to a gastroenterologist for imaging of your esophagus and stomach to assess the severity of your acid reflux. If it’s long-lasting and severe, you may be diagnosed with gastroesophageal reflux disease or GERD.
What To Do About It
You don’t have to just deal with persistent coughing. Cho advises seeking medical help immediately if you experience significant red flags along with your cough, such as shortness of breath, chest pain, unintentional weight loss, or coughing up blood—especially if you smoke.
If your cough isn’t causing major concern yet, you can try some home treatments. Cho suggests that over-the-counter cough medicines and remedies like tea with honey are worth a shot.
Earl suggests trying over-the-counter medications like guaifenesin (such as Mucinex) if you suspect postnasal drip, as they aim to dry up secretions. The advises that if you suspect acid reflux, over-the-counter antacids or proton pump inhibitors might provide relief.
Earl says that if your symptoms don’t improve or worsen after trying over-the-counter medications, it’s time to see a doctor. They may order imaging tests, refer you to a specialist, or start you on prescription medication.
Cho advises that if you have an existing lung condition like asthma or COPD that affects your breathing, you should see your doctor sooner than eight weeks if you’re coughing more than usual. She explains that you’re at a higher risk of an acute cough becoming chronic, but your doctor might be able to adjust your current medications to prevent that.