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Chronic Cough: Just Bothersome or More Serious?

Personal Health

By Nancy Johnston Hall

I had not even begun to worry until a friend said, “You’d better have that cough checked out.” Then the dire thoughts began—the worst, of course, being cancer. So I turned to the Internet and was relieved to find that a chronic cough usually is not serious. For nonsmokers, cancer is way down the list.

A chronic cough is defined as one that hangs on for a month or more. My cough began about three weeks after we moved into our newly built house in the States. Chronic coughing is so common it is high on the list of reasons for seeing a doctor. The most common causes of chronic cough are:


Postnasal drip. Watery liquid and mucous can slip down the throat where they tickle nerves and trigger a cough. To find out if this is causing your chronic cough, try treatment with a nonprescription decongestant or antihistamine or try a home remedy of nasal irrigation.


Asthma. In one type of asthma (cough-variant asthma), a cough is the only symptom, making asthma the second-most common cause of chronic cough. Allergens, dust, cold air, or exercise often triggers the coughing. Your doctor can confirm with testing or medication whether asthma is the reason for your chronic cough.


Gastroesophageal reflux disease (GERD). GERD occurs when stomach contents go up the esophagus instead of down into the intestines. Heartburn is the usual symptom, but GERD can cause coughing without heartburn. Acid irritates nerves in the lower esophagus, triggering the cough reflex. Before opting for elaborate medical procedures to diagnose GERD, try lifestyle changes such as avoiding alcohol and certain acidic and fatty foods. It may also help to eat small meals several hours before bedtime, take liquid antacids at bedtime, and try elevating your head by adding extra pillows. You can also try over-the-counter acid suppressors or see your doctor for stronger medications.


Chronic bronchitis. Smoking or, less commonly, exposure to high levels of industrial air pollutants can cause a chronic cough. The best treatment is to quit smoking and avoid air pollutants. Warning symptoms of a cough that needs prompt medical care include fever, coughing up blood, weight loss, fatigue, and chest pain.


ACE inhibitors for blood pressure treatment. ACE inhibitors are also used for treating heart failure and heart attacks. One side effect is a persistent cough in about 20 percent of patients taking ACE inhibitors. If the cough is severe, your doctor can try a different type of antihypertensive medication.


Environmental irritants. Although a less common cause of chronic cough, environmental irritants turned out to be the source of my cough. When we discovered that the furnace filter in our newly built house was full of plaster dust, we replaced it. My cough quickly disappeared. Mystery solved!


Nancy Johnston Hall is a retired health writer with nearly 40 years of experience. She has a master’s degree in medical journalism. Last year Nancy and her husband became part-time residents of San Miguel.


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