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My Cough Won’t Go Away: Should I Be Worried?

December 23, 2015

Cough is the most common complaint to primary care doctors, according to the Centers for Disease Control and Prevention, and more than 30 million people visit the doctor every year because of it.

But when is a cough serious? It is when you’ve had a dry, hacking cough for more than two weeks or when you’re coughing so much that it interrupts your sleep?

The answer could vary depending on your symptoms. However, most doctors agree that the average cough lasts 18 days. Most people tend to get worried when their cough has been ongoing for a week, but two weeks is pretty common for most viral infections, such as the cold and flu.

If you’ve had a persistent cough that seems to be getting worse or one that doesn’t seem to go away even with over-the-counter medication, here are some helpful tips about what you can do and when it may be time to see a doctor.

What’s Causing Your Cough

Several things can cause a persistent cough, including a prolonged infection, post-nasal drip (upper airway cough syndrome) or even a chronic cough.

Prolonged Infection

If you suffered from an ongoing cold or flu, or got sick again after recovering from a viral infection, this could be prolonging your cough. Unfortunately, you can still have a cough even after all the other symptoms you experienced went away. Sometimes this can last for up to four weeks after your illness. This is because infections cause airway inflammation that can take longer to clear up compared to other symptoms associated with the cold and flu.

Post-Nasal Drip (Upper Airway Cough Syndrome)

Post-nasal drip, also known as upper airway cough syndrome, can lead to a lingering cough. It occurs when mucus builds up in the back of the nose and drips down into the throat.

Allergies or sinusitis, which is inflammation or an infection in the sinus, can cause post-nasal drip. Sore throat and trouble swallowing are all byproducts of post-nasal drip, as is the incessant need to clear mucus from your throat, which can lead to a chronic cough. If you suffer from a cough related to post-nasal drip, it typically will be worse at night or when you’re lying down.

GERD

GERD, gastroesophageal reflux disease or acid indigestion, is the most common cause of a persistent cough. It can be responsible for between 20 to 40 percent of chronic coughs. Symptoms of GERD-induced cough include a cough that occurs mostly during the day when you’re sitting upright; an ongoing cough that occurs without asthma or post-nasal drip, and one that occurs without any other symptoms or because of things like smoking or side effects from medication.

Asthma & Chronic Cough

Sometimes a persistent cough could indicate an underlying health issue, such as asthma.  If you have a dry, hacking cough that gets worse after exercise, you may have cough-variant asthma. People with cough-variant asthma also exhibit other symptoms like wheezing and shortness of breath. Their symptoms often get worse around allergy-related triggers such as dust and pollen.

Cough-variant asthma can turn into a chronic cough if it lasts at least six to eight weeks. Chronic cough can be accompanied by symptoms such as a runny nose, sore throat, hoarseness and heartburn or a sour taste in your mouth. GERD, asthma and allergies cause more than 90 percent of these cases.

When to See a Doctor

If your cough has lasted past the 18-day mark, it may be time to see a doctor.

Your doctor can perform a pulmonary function test if he or she suspects asthma, and can prescribe asthma medication to relieve your symptoms.

Your doctor also can do a chest X-ray to determine whether post-nasal drip is the reason for your persistent cough. You may be prescribed decongestants and nasal steroids to combat the coughing.  Your doctor also can perform a barium swallow or others tests to find out whether your cough is related to GERD. If so, you’ll likely be prescribed proton pump inhibitors, such as Nexium or Prilosec, for three months to see if your symptoms go away.

Stress and dehydration can worsen your cough, so you also should drink plenty of fluids, try to avoid stress and use a saline nasal spray in moderation to moisten your airways. However, if these methods don’t work and you have a prolonged cough, visit your doctor as soon as possible to determine the underlying reason and to get the appropriate treatment.

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