Have you ever had this happen to you? You got over a cold and got better, but your cough just won't stop. You've been coughing for weeks. Sometimes, you wake up in the middle of an important meeting or during a quiet night and start coughing. This is really annoying and uncomfortable. Although coughing is a defense mechanism in our body, it's not normal for it to continue like this. Today, we'll talk about this persistent cough, or what we medically call 'Chronic Cough'.
What is this chronic cough?
Simply put, a chronic cough is a cough that lasts for more than 8 weeks in an adult and more than 4 weeks in a child . Coughing is actually a good thing. It helps clear out dust and germs that enter our respiratory tract. Everyone coughs from time to time. But a long-term cough like this is often a symptom of another underlying health problem. This is the main reason people visit a doctor.
Therefore, it is not good to ignore this. Coughing frequently is very tiring for the body. Also, it makes it difficult to walk in public, and one wonders, "When will this cough come back?" Therefore, it is very important to find the cause of this and manage it properly.
Other common symptoms that accompany a cough
Depending on the cause of your chronic cough, other symptoms may occur along with the cough. Check the table below to see if you have any of these.
| Symptom | Description |
|---|---|
| Fever | Increased body temperature. |
| Heartburn | Inflammation caused by stomach acid coming into the throat. |
| Chest pain | Pain when coughing or during normal activities. |
| Hoarseness of voice | A change in voice, a hoarseness. |
| Difficulty breathing | Feeling short of breath or difficulty breathing. |
| Runny or stuffy nose | Nasal discomfort, like a cold. |
| Frequent throat clearing | Frequent throat clearing because it feels like something is stuck in the throat. |
What are the main causes of this persistent cough?
There are a few main "culprits" that can cause a chronic cough. 90% of the time, the cause can be one or more of these three.
| Main reason | A simple explanation |
|---|---|
| Asthma | The most common cause of chronic cough. Sometimes, exposure to cold/dry air, dust, smoke, etc. can make the cough worse. |
| Postnasal drip | This is also called 'Upper Airway Cough Syndrome (UACS). Simply put, this is the accumulation of mucus from the nose to the throat . Allergies cause excess mucus to build up in the nose, which then travels down the throat and irritates the airways and lungs, causing coughing. |
| GERD (Gastroesophageal Reflux Disease) | This is when stomach acid flows back up into the esophagus. These acids burn the delicate tissues of the throat, which can cause a cough. |
| Other lung diseases | Other lung diseases such as bronchitis, COPD, and pneumonia can also cause a long-term cough. |
Other reasons
In addition to the main causes above, several other factors can also cause chronic cough.
- Some blood pressure medications: Some people taking certain medications, especially those called ACE inhibitors, can develop a dry cough. But remember, never stop taking these medications without your doctor's advice.
- Allergies: Allergies to things like dust, pollen, etc.
- Heart Failure: Coughing can also occur due to weak heart function.
- Smoking: It's no wonder that smokers develop a chronic cough called "smoker's cough."
- Respiratory infections: Infections like whooping cough can cause a cough to persist for weeks after recovery.
Sometimes, despite all the tests, no cause can be found for a cough. In such cases, doctors call this condition "Chronic Refractory Cough."
How is this treated?
The most important thing is that treatment depends on the cause of the cough. This means that it is more important to treat the underlying condition that is causing the cough than to take a cough suppressant.
Your doctor will give you a treatment plan that is right for you. This involves a combination of medication and lifestyle changes.
Types of drugs
- For GERD: Control stomach acid with medications such as `(antacids)`, `(H2 blockers)`, or `(PPIs)`.
- For bacterial infections: `(Antibiotics)`.
- For allergies and rhinitis: Antihistamines and nasal sprays.
- To expel mucus: Medicines such as ``Expectorants`` that thin the mucus and help it come out more easily.
- To reduce swelling: In conditions such as asthma, reduce swelling in the airways with steroids or inhaled bronchodilators.
Very important:Do not give over-the-counter cough/cold medicines to children under 6 years of age without the recommendation of a pediatrician.
Lifestyle changes
Although these may seem like very simple things, they are a great help in controlling cough.
- Get enough sleep .
- Eat a balanced diet .
- Drink plenty of water.
- If you think you have GERD, sleep with the head of the bed slightly elevated .
- Talk to your doctor about your cough triggers (e.g., smoke, strong odors, certain foods), and then make a plan to avoid them.
What happens if left untreated?
Chronic cough can cause insomnia. The fatigue and stress it causes can affect your entire day. You may also become socially withdrawn due to the embarrassment of constantly coughing.
In some severe cases, a cough can also cause:
- Eye bleeding
- Rib fractures
- Dizziness and headache
- Hernia
- Loss of bladder control (leaking a small amount of urine when coughing)
- Chest and abdominal muscle pain
When should you see a doctor?
The simplest rule is, if you have a cough for more than 10 days, and you don't know the exact cause, you should definitely see your doctor.
Moreover, if you have any of the following warning signs , seek medical advice immediately. If necessary, go to the Emergency Department (ETU) of the nearest hospital.
| Warning signs that require immediate medical attention | |
|---|---|
| Coughing up blood | Bloody or dark red blood mixed with mucus. |
| Excessive sweating at night | Sweating so much that the bed sheets get wet. |
| Hoarseness of voice that does not improve | The hoarseness of the voice did not diminish for several weeks. |
| Difficulty breathing | Shortness of breath or rapid breathing. |
| Difficulty swallowing | Feeling pain or choking when swallowing food or drink. |
| Unexplained weight loss | Losing weight without you trying. |
| Wheezing | A whistling sound from the chest when breathing. |
A chronic cough is not something you should have to suffer through. There are treatments that can help. Getting an accurate diagnosis is the first step on this journey. So don't delay and see your doctor.
Take-Home Message
- A cough that lasts for more than 8 weeks in an adult or 4 weeks in a child is called a 'Chronic Cough'. Never ignore this.
- The most common causes of this are conditions such as asthma, postnasal drip, and gastroesophageal reflux disease (GERD).
- Treatment depends on the cause of the cough, so it is very important to get an accurate diagnosis.
- If you experience warning signs such as coughing up blood, difficulty breathing, or weight loss, seek medical advice immediately.
- Talk to your doctor and get the best treatment plan and advice for you.
👩🏽⚕️ Additional questions (FAQs)
💬 What disease is Timolol (Timolol Systemic / Blocadren) tablets used for?
Although it is best known for its eye drops for glaucoma/eye pressure, this 'pill' is the most powerful type of (Non-selective Beta-blocker) drug in the world! Doctors use it to prevent 'High Blood Pressure', severe migraines, and to reduce the risk of dying a second time after surviving a 'Heart Attack' by 100%.
💬 How do you stop yourself from having another heart attack/migraine after taking this terrible pill (Timolol)?
The rhythm of your heart and blood vessels in your head changes because of the message 'Adrenaline (Epinephrine). As soon as this pill enters the body, all the gates in the heart (Beta-1) and blood vessels/lungs (Beta-2) are blocked/closed 100% and locked forcibly (Non-selective). Since there is no way for the message to pass, the heart simply slows down, and the blood vessels in the brain stop dilating unnecessarily, eliminating the risk of migraine/heart attack.
💬 Why is it said not to stop taking this medicine (Timolol) suddenly? What are the Black Box Warnings?
If you take this pill for months and forget about it or 'stop it suddenly', all those blocked adrenaline receptors will suddenly open up uncontrollably! Then, within minutes, you will have a severe heart attack and your heart will stop (Myocardial Infarction / Sudden Death) which is so deadly that you can die! Also, since this also blocks the lungs, if you give this to people with 'Asthma', they can suffocate and die (drinking is prohibited!).
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