When To Worry About That Nagging Cough

You’ve been over a cold now for weeks, but that nagging cough isn’t going away. Should you be alarmed?

Most likely, no. A persistent cough is a common side effect not only of respiratory illnesses such as colds, bronchitis and pneumonia.

The question you might be asking is when you should see a doctor about it. The answer depends on a variety of factors.

Why Do We Cough?

Often, it’s your body trying to expel some kind of irritant. Smoke you’ve inhaled. Food that’s gone down the wrong way. Mucus or phlegm that’s obstructing an airway. Coughing can either be reflexive or voluntary.

Either way, you gasp in a breath of air through the trachea and into the lungs. Your diaphragm contracts and then expels the air at an impressive rate, rivaling the speed of a tropical storm-force wind! 

Reasons for Coughing

The causes behind chronic coughing make for a long list. Some are benign while others may be serious. Most are a response to irritants in the airways of lungs. 

Common causes include:

• Bronchitis: After this lung infection subsides, you may find yourself with a dry cough lasting weeks.
• Postnasal drip: This can stem from any number of things, including sinus infections, and can lead to a wet, persistent cough. 
• Asthma: A narrowing of the airways that can cause coughing or wheezing.
• Allergies: Any number of allergens -- from perfumes to dust to pet dander -- can lead to coughing.
• Gastroesophageal reflux (GERD): Stomach acid can irritate the esophagus and trachea. GERD is a common cause of chronic coughing.
• Medications: Blood pressure medications, particularly those known as ACE inhibitors, are a well-established cause for coughing in many people.
• Smoking: Tobacco smoke damages the tiny hairs in airways, resulting in a chronic, phlegmy cough.
• Pneumonia

Less common causes:

• Interstitial lung disease
• Hypersensitivity pneumonitis from inhalation injuries from smoke, chemicals or other irritants exposure
• Lung cancer

When To Seek Help

If you’re experiencing persistent cough, it may be time to see your doctor or a pulmonologist. Here are some additional signs that you may need medical attention:

• Wheezing
• Chest pain
• Fever
• Blood mixed in the sputum
• Change in color of the sputum
• Shortness of breath

Your doctor’s workup likely will include questions about recent illness, family respiratory history, environmental conditions at work, allergy history and whether your own pets and what medications you are taking. For older patients, your doctor may also attempt to find out if you’ve been exposed to asbestos or having history of cancer in the past.

Tests to evaluate your condition include a chest X-ray, which can detect conditions like pneumonia, or pulmonary function test, which can help evaluate your lung function. In some instances, your doctor might recommend a bronchoscopy, which is a procedure where a small fiberoptic tube is inserted in your airway to detect abnormalities.

What You Can Do

As with many things, you can avoid or at least mitigate the symptoms of chronic coughing by adopting healthy lifestyle habits.

Topping that list is to avoid inhaling harmful chemicals and irritants into your lungs. That includes smoking or vaping both tobacco products and marijuana. If you work in a job where you’re exposed to toxic fumes, chemicals or dust, try to wear a mask that’s designed to filter the air you are breathing.

If you have animal allergies or lung conditions, try to create designated areas where pets aren’t allowed, starting with your bedroom.

And yes, exercise, maintaining a healthy weight and staying hydrated are going to help you breathe better in nearly any situation.