Everyone coughs, and an occasional cough is nothing to worry about. In fact, by expelling germs, mucus, and dust from your respiratory tract, coughing plays an important role in protecting your lungs from infection. Many illnesses, such as the common cold, hay fever, and bronchitis, are accompanied by coughing, which usually resolves within a few weeks.
A chronic cough, on the other hand, can last for several months or even years. Chronic coughing can have significant consequences, including sleep disruption, exhaustion, impaired concentration, reduced productivity, urinary incontinence, and even broken ribs. So, what’s going on, and what can you do to quiet a cough that won’t go away?
Smoking is the leading cause of chronic coughing in smokers. Chemical irritation is responsible; with every puff, a smoker inhales a cocktail of toxic chemicals, including formaldehyde. These chemicals paralyze the tiny hair-like cells that line the airways (cilia), which normally trap toxins and move them upward so they can be expelled through the mouth. Instead, the toxins enter and settle in the lungs, where they create inflammation.
A persistent “smoker’s cough” develops as the body unsuccessfully attempts to clear these substances from the lungs. The best treatment for a chronic cough caused by smoking is to quit. This is important because the same noxious chemicals that cause coughing can also cause far more serious conditions, such as bronchitis, emphysema, pneumonia, and lung cancer.
As the gateway to the lower respiratory tract, the nose conditions the air that is inhaled before it reaches the lungs. Specifically, the nose warms cool air, adds moisture to dry air, and removes particles from dirty air. To accomplish all three tasks, the nasal membranes produce mucus, which is warm, moist, and sticky.
In the course of doing its job, the nose may become irritated by viruses, allergens, dust, or airborne chemicals. In response to the irritation, the nasal membranes may produce watery mucus. The excess mucus will then drip out of the nose and down the throat, triggering a cough.
The best way to treat a chronic cough caused by postnasal drip is to take an over-the-counter decongestant or antihistamine or use a saline nasal irrigation spray. Inhaling steam from a hot shower can also be helpful.
The most common symptoms associated with asthma are breathlessness and wheezing, but it can also cause coughing. Asthma results from bronchospasm, a temporary narrowing of the medium-sized tubes that carry air into the lungs. Bronchospasm can cause a persistent, dry cough that is often triggered by exposure to cold air, dust, or allergens.
If asthma is suspected as the underlying source of a chronic cough, a doctor may order a pulmonary function test as part of the diagnostic process. If an asthma diagnosis is confirmed, the doctor may suggest a bronchodilator spray to treat the asthma and, in turn, relieve the coughing.
Gastroesophageal Reflux Disease (GERD)
GERD occurs when the stomach’s contents travel upward and make their way into the esophagus. The most common symptom of GERD is heartburn, but if the nerve endings in the lower esophagus become irritated, they may trigger a cough reflex—even if there is no pain.
The diagnostic process for GERD can be inconvenient and expensive. The best way to determine whether a chronic cough is related to GERD is to attempt to control the GERD. The first step is to avoid common triggers, such as chocolate, peppermint, caffeine, alcohol, onions, garlic, citrus fruits, tomato sauce, and fatty foods. It is also important to eat small meals and wait at least two hours after eating before lying down. Additionally, it may be helpful to take a liquid antacid, especially at bedtime, and to use pillows to elevate the upper body and help prevent the stomach’s contents from flowing upward during sleep.
Chronic bronchitis is a persistent inflammation of the mucous membranes in the bronchial tubes, which leads to bronchospasm and a persistent cough. In many cases, the cause is tobacco use or long-term exposure to high levels of industrial air pollutants. The most effective treatment is to quit smoking and avoid air pollutants. Also, a doctor may prescribe a corticosteroid inhaler with a long-acting bronchodilator.
Getting to the Bottom of a Chronic Cough
While a chronic cough is not a reason to panic, it should also not be ignored. Usually, a doctor can determine the cause without performing any elaborate tests, then address the issue with appropriate treatment.
As a member of Optimum Direct Care in Orlando, FL, you have unlimited access to our primary healthcare services. Our board-certified family doctor, Dr. Toni “Muzzi” Muzzonigro, can get to the bottom of your nagging cough and help you get rid of it once and for all.
Contact Optimum Direct Care to learn more. Or, if you aren’t already a member of our DPC practice, find out why you should consider joining today.