
April 6, 2012
Dear Mayo Clinic:
What could cause a cough that lasts for months? I take antihistamine tablets and use nasal saline spray but still cough throughout the day and at night.
Answer:
Coughing is a normal reaction to irritants in your respiratory system. Coughing forcefully expels foreign bodies, mucus and other irritants, such as pollution, from your throat and clears them from your airway.
However, when a cough lasts too long, it may be a sign of an underlying problem or disease. Moreover, coughing itself becomes a problem. The forces exerted on your body by persistent coughing can result in direct physical problems — such as damage to your vocal cords, rupture of small blood vessels in your airway, fainting spells, hernias or even broken ribs. It can also harm the quality of your life, sleep and social life.
When a cough lasts longer than six to eight weeks, it's considered a chronic cough. Diagnosing the cause can be time-consuming, but is usually a critical first step which involves systematically eliminating probable causes through history taking, testing and trying different treatments. Common causes of chronic cough include:
In smokers, persistent cough and phlegm production (chronic bronchitis) is common. Throat or lung cancer may be suspected in a smoker or former smoker who has a chronic cough that changes abruptly or lasts for more than one month following smoking cessation, or if they cough up blood or note a change in their voice.
Usually, chronic cough can be stopped by treating an underlying cause. In about 90 percent of cases, the underlying cause is postnasal drip, asthma or GERD. If sinus disease or reflux is suspected, response to treatment may help determine the cause. Sometimes, there can be more than one cause that needs to be addressed.
Depending on your diagnosis, treatment may include:
If no cause for your cough is found, or if the cause can't be effectively treated, drugs may be prescribed to suppress the cough, loosen mucus or relax airways.
— Kaiser Lim, M.D., Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minn.
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