Ah, yes. It’s that special time of year when cold and flu symptoms give way to nonstop hacking, and you might have a persistent cough that seems intent on sticking around until springtime. But let’s be honest, coughing—regardless of the season—can be maddening, from that first tickle in your throat to dealing with the stuff that might come up with each heave. Not to mention that persistent coughs can be a pain in your throat and your core muscles.
Having a lingering cough can be inconvenient, but having a persistent cough can be especially worrisome. So how do you know the difference? And how do you know when to see a doctor for a cough? If you’re dealing with a cough and you’re starting to suspect something more serious is at play, here’s a rundown of when you might want to wait it out and when you should check in with a medical professional ASAP.
What actually counts as a persistent cough?
Coughing is a totally natural way for your body to try to eject irritants and secretions like mucus from your lungs, according to the Mayo Clinic. Living with a frequent cough for even a few days can feel like an eternity, but you have to surmount a pretty high bar in order to technically have a persistent cough: Doctors don’t actually consider a cough chronic until it lasts for eight weeks or more, according to the Mayo Clinic.
With that in mind, if you've hit that eight-week point, you should absolutely see a doctor, Joseph DePietro, M.D., an otolaryngologist with ENT and Allergy Associates in Sleepy Hollow, New York, tells SELF. The thing is: Eight weeks is a long time. So it's completely within reason to get checked out before then if you're concerned.
You should also check in with your doctor if your persistent cough comes with other side effects; although, as a heads-up, certain side effects are totally normal when you’re dealing with a chronic cough. Those include a runny or stuffy nose, feeling like liquid is running down the back of your throat, a sore throat, hoarseness, wheezing, heartburn, and a sour taste in your mouth, the Mayo Clinic says.
Coughing up blood, on the other hand, always warrants a trip to the doctor. So does weeks of coughing up sputum (a mix of mucus and saliva). Other doctor’s appointment-worthy symptoms include a fever, struggling to breathe, and wheezing, which can all signal a dangerous respiratory infection.
If you have a history of smoking and can't shake a cough, you should see your doctor to check on the state of your lungs, Alex Li, M.D., deputy chief medical officer for L.A. Care Health Plan, tells SELF. You should also chat with your provider if your cough is causing fatigue by keeping you up at night, or if it’s otherwise affecting your ability to function normally.
Here are the common causes of a persistent cough.
1. A respiratory infection
You might expect that your cough from the cold or flu should clear up around the same time that you start to feel better. It’s actually normal for it to continue for weeks after that as your body works to get back to full health, Flavia Hoyte, M.D., an allergist at National Jewish Health, tells SELF.
However, if you have chest pain when you breathe or cough, and you’re also dealing with a fever, fatigue, sweating, shaky chills, nausea, diarrhea, and shortness of breath, you could have pneumonia, which happens when the air sacs in your lungs become infected. Pneumonia can be life-threatening, so head to the doctor if you experience these symptoms.
Pertussis (whooping cough) is another respiratory infection to keep on your radar, even though it seems like a 19th-century disease you shouldn’t have to worry about. Unfortunately, this contagious infection is still around. You were probably vaccinated against this as a child, but your immunity can fade over time, according to the Mayo Clinic. So it’s worth having a general awareness of the symptoms that come along with whooping cough.
At first, pertussis can seem like the common cold, causing symptoms like a runny or stuffy nose, red, watery eyes, a fever, and a cough. Then it can progress into an uncontrollable cough ending in a high-pitched intake of breath that sounds like "whoop,” hence the condition’s nickname. These coughing bouts can cause exhaustion, make your face look blue or red, and even make you vomit. Even if you don’t have the signature whooping sound (it’s not as common in milder cases, the Centers for Disease Control and Prevention says), if your cough feels this extreme, see your doctor.
2. Asthma and allergies
Frequent coughing—especially at night—is a common symptom of asthma, according to the American College of Allergy, Asthma & Immunology (ACAAI). People with asthma usually make a whistling or wheezing sound in their chest when they cough, but there’s also a form of the condition called cough-variant asthma. The only symptom is chronic coughing, the ACAAI says.
Just like people with “regular” asthma, people with the cough-variant kind typically have triggers that make their symptoms flare-up. Those can be things like pollen, pet dander, dust, mold, cold air, air pollution, perfume, stress, and exercise. If you’re thinking that a lot of these sound like allergy triggers, you’re exactly right. Allergies and asthma often go hand in hand, with an allergic reaction to a substance triggering asthma symptoms including coughing. (Allergies can also cause coughing all on their own as your body tries to get rid of whatever’s bothering it.)
If you’re battling a cough and your doctor suspects it’s due to asthma (either newly discovered or previously diagnosed but poorly controlled), they may have you see a specialist like an allergist. Once you know your triggers, it’s best to try to avoid them as much as you can, but your doctor can help you flesh out a whole treatment plan to better manage your asthma.
3. Upper airway cough syndrome
Sometimes your nose and sinuses get a little overzealous with the mucus production, like if you have hay fever or a sinus infection. That excess mucus can drip down the back of your throat in a phenomenon known as upper airway cough syndrome, the Mayo Clinic says. This is sometimes called postnasal drip, and unsurprisingly, it might trigger you to cough.
There’s quite a bit that doctors don’t yet know about how best to diagnose this condition (and some don’t even consider it a condition in the first place). That doesn’t really help if you’re constantly swallowing mucus, though. See a doctor who can try to find and treat the cause of your excessive mucus production.
4. Acute bronchitis
As if having a cold or other respiratory infection isn’t grueling enough, sometimes it can turn into acute bronchitis, also known as a chest cold. Acute bronchitis involves inflammation of the bronchial tubes that transport air to and from your lungs, according to the Mayo Clinic. This inflammation can force you to cough regularly in an effort to try to get irritants and mucus out of there, Dr. DePietro explains. It can also cause your airways to narrow and swell, making it tough to breathe, he says.
Acute bronchitis typically gets better in 10 or fewer days. Unfortunately, the cough can stick around for weeks, according to the Mayo Clinic.
5. Chronic obstructive pulmonary disease (COPD)
This is an umbrella term for long-term lung diseases including chronic bronchitis and emphysema. “Chronic bronchitis is notorious for causing a chronic cough,” Dr. Hoyte says. If you have this condition, you’ll experience relentless airway irritation that causes a mucus-producing cough for at least three months, with recurring attacks for at least two years. When chronic bronchitis suddenly gets worse, it could be because you have an infection that causes acute bronchitis on top of the chronic form.
Though chronic bronchitis most often happens due to smoking, things like air pollution, dust, or exposure to lung irritants can also cause it, according to the Mayo Clinic.
Then there’s emphysema, which also occurs most frequently among people who smoke. It happens when your alveoli (air sacs in your lungs) become damaged, so you can’t breathe as well. Beyond coughing that produces sputum, you might experience shortness of breath, wheezing, chest tightness, lack of energy, and frequent respiratory infections, among other symptoms.
COPD sounds really scary, but with adequate treatment, the disease is manageable. If you think you have COPD, see a doctor for help.
6. Gastroesophageal reflux disease (GERD)
When you have gastroesophageal reflux disease, stomach acid flows back into your esophagus, the tube that connects your stomach and throat. That backflow can eventually reach and irritate the lining of your throat, which can make you cough, Dr. DePietro says. “The skin lining of the esophagus is used to at least some degree of acid exposure as a result of being near the stomach, [but] the skin lining of the throat rarely sees acid reflux,” he explains.
In an awful cycle, the persistent coughing can make your GERD even worse, the Mayo Clinic says. The good news, however, is that treating the condition can help tame your cough.
7. A side effect of certain blood pressure medications
Angiotensin-converting enzyme (ACE) inhibitors are often prescribed to treat things like high blood pressure as well as conditions like heart disease, diabetes, certain chronic kidney diseases, heart attacks, migraines, and scleroderma (which is a disease that results in hardening of the skin and connective tissues), the Mayo Clinic says. ACE inhibitors work by blocking the enzyme that produces angiotensin II, which causes the blood vessels to narrow.
Though ACE inhibitors only cause side effects on rare occasions, when they do cause them, those side effects can include fatigue, dizziness from low blood pressure, headaches, loss of taste, increased potassium levels, and—you guessed it—a persistent cough, the Mayo Clinic says. (In this case, the cough is usually dry.) That doesn’t mean you should automatically stop taking your medication if you think ACE inhibitors are behind your persistent cough. Since so many things can cause a persistent cough, check in with your doctor to see whether ACE inhibitors are even really the source of your coughing in the first place. You and your doc can chat about possible alternatives if necessary.
8. Lung cancer
Let’s address the giant coughing elephant in the room: Yes, a persistent cough can be a symptom of lung cancer. With that said, there are far more common cough culprits, like the ones listed above. That said, if you have risk factors like a history of smoking, a history of secondhand smoke exposure, exposure to radon gas, a family history of lung cancer, or exposure to asbestos or other carcinogens, you might want to check in your provider, the Mayo Clinic says.
If you have a chronic cough, don’t sit on it.
It might be tempting to try to wait for your cough to sort itself out, whether because you don’t have time to visit a doctor or because you’re a little scared of what they might find. But long-term coughing can lead to complications like fractured ribs or even fainting, so you really don’t want to risk it. Instead, see your doctor about a cough, figure out the cause of your cough, and get yourself on the road to feeling better.
Related:
