Despite considerable advance in the understanding of cough, the effective management of patients with a chronic cough can be difficult. For the patient, a cough which persists can be associated with considerable distress and impaired quality of life. For the physician, failure to obtain a treatment response may lead to the mistaken belief that the cough is functional or psychogenic. There are a number of reasons why the cough may be difficult to treat.

There are many reasons why a cough may not improve, and that can be frustrating for people and their doctors alike.

Reason 1: Irritated Airways After a Cold or Flu

The most common cause of chronic cough is  aftermath of a cold or other viral infection of the Lung. Most cold symptoms may go away after a few days. Your cough, though, can hang around for weeks   because viruses can cause your airways to become swollen and oversensitive. This can last long after the virus is gone.

Reason 2: Allergies band Asthma

Allergies and asthma are common causes of a cough. A cold can even cause an asthma attack. Some people learn they have asthma during a cold.

Especially if you are having cough at night or just after exercise or running, it may be due to Asthma. A careful evaluation and diagnostic tests are required to rule this out.

Reason 3 acid Reflux

Yes if you have Acid reflux it may be the cause of your chronic cough. Fortunately, these conditions are treatable. See your doctor for diagnosis and treatment if you have symptoms of acid reflux, including:

• Burping
• Heartburn
• Ongoing cough
• Regurgitation

Reason 4: Nasal congestion and Post nasal drip and Overusing OTC Nasal Decongestant Spray

If you are suffering from nasal congestion it may lead to continuous dropping of your nasal secretions into your throat and can cause chronic cough.

Over-the-counter (OTC) nasal decongestant sprays may help with a stuffy nose. Don’t use them for more than 3 days, though. If you do, when you finally stop taking them, your symptoms may be worse — a rebound effect. Those excess sprays make your nasal membranes swell, which triggers more congestion, postnasal drip, and coughing.

Reason 5: Bacterial Infection

Sometimes, a cold can leave behind an unwelcome parting gift. When your airways are raw and irritated after a cold, it’s easier for bacteria to invade. Bacteria can cause sinus infections, bronchitis, and pneumonia. If you have a fever or pain along with your lingering cough, a bacterial infection could be the reason. See your doctor, as you may need to take an antibiotic.

Reason 6: Your Blood Pressure Medicine

Do you take an ACE inhibitor for high blood pressure? If so, that may be why your cough won’t quit. About 1 out of 5 people who take ACE inhibitors develop a chronic, dry cough as a side effect. If you have this side effect, don’t just stop taking it but do talk to your doctor. Another drug may work better for you.

Reason 7: Newer Diagnostic possibilities

Most important of these is eosinophilic airway syndromes . These conditions are characterized by the presence of eosinophilic airway inflammation but crucially the absence of the airway dysfunction (airflow variability or bronchial hyperreactivity) normally attributed to asthma. The best-described condition is eosinophilic bronchitis, which may account for up to 15% of patients referred to hospital with chronic cough. 

Reason 8 Chronic bronchitis ( COPD) due to smoking

Most smokers weather Cigarette or Sheesha have chronic cough with sputum especially during morning time. This may the earliest sign of this crippling disorder. Timely consultation with the specialist and quitting smoking can stop the progression of this disease.

If your cough is severe or isn’t getting better after a week, call your doctor. Chronic cough is a common disabling condition seen in clinical practice.  A disciplined and systematic approach with  coordination among specialty is essential to achieve a favorable outcome in most patients.

Dr.Mohit Garg,
Specialist Pulmonologist,
Thumbay Hospital Daycare, Rolla

For appointments contact us through

Phone: +971 6 5440555
Email: thdaycare.shj@thumbayhospital.ae
Online: www.appointments.thumbay.net
Location: Thumbay Hospital Daycare, Sharjah (Rolla), Opposite to Rolla Mall, Sharjah United Arab Emirates