Overview
Coughing is your body’s way of keeping germs, dust or other things out of your throat and lungs. Coughing also helps clear extra mucus from your airways. It is normal to cough sometimes, especially if you have a cold, flu or allergies. Most coughs will go away by themselves. A cough that lasts eight weeks or more may be a chronic cough.
A chronic cough can disrupt your life, but it isn’t always a sign of a serious health issue. Finding the cause of your chronic cough will help your healthcare team recommend the best treatment for you. Your healthcare team can help you manage your cough. There are also things that you can do on your own to help reduce the effects that chronic cough can have on your life.
Download Chronic Cough Fact Sheet
Living with Chronic Cough
It can be hard to live with a chronic cough. A chronic cough can cause physical symptoms as well as have an impact on you socially and emotionally.
Living with Chronic Cough
How chronic cough can affect you physically
- Feeling breathless or unable to catch your breath
- Wheezing
- Trouble sleeping
- Fatigue (weakness, tiredness) or exhaustion
- Problems with speech
- Gagging or vomiting
- Dizziness, lightheaded or even fainting
- Wetting yourself with cough
- Changing your voice
- Chest pain, broken ribs, hernia due to force of the cough
Living with Chronic Cough
How chronic cough can affect you socially and emotionally
Chronic cough can interfere with your life. It can make you anxious or scared that you have a serious health problem. People may comment on your cough, which can be embarrassing.
You may worry that people think you have a contagious disease or that you are a heavy smoker. You may feel isolated and lonely because you're worried that your cough bothers your family or friends.
Approximately 16% of Canadians between the ages of 45 and 85 are affected by chronic cough.
A cough lasting eight weeks or more is considered a chronic cough.
Identifying the cause of Chronic Cough
Your healthcare provider will ask you questions about your cough, your health and your lifestyle. They will also perform a physical exam and may order one or more different tests to find the cause of your cough.
Identifying the cause of Chronic Cough
Questions that your healthcare team may ask you
- Have you had a cold, bronchitis or other respiratory infection recently?
- How long have you had your cough? Is your cough getting worse over time?
- Is your cough different at different times of day? In different temperatures?
- Is your cough dry or wet/phlegmy? If you cough up phlegm, is it clear/gray or yellow/green in colour? Is it ever bloody or do you ever cough up blood?
- What triggers your cough (allergens, irritants, position, activity, etc.)
- Do you have any of the following symptoms: shortness of breath, chest pain, wheeze/tightness, weight loss, fever or sweating?
- Do you have any allergies?
- What medications do you take?
- What is your smoking history?
- What do you do for a living? This can indicate if you may have been exposed to something in your environment that could be causing your cough.
Identifying the cause of Chronic Cough
Tests that your healthcare team may order
Your healthcare team may order some tests to help find the cause of your cough.
A chest x-ray can be helpful to rule out more serious but rare causes of chronic cough, like pneumonia, tuberculosis (TB) or lung cancer.
They may also test how well your lungs are working. Spirometry is pulmonary function test (PFT) that your healthcare team may order if they suspect your cough may be caused by asthma or chronic obstructive pulmonary disease (COPD).
If your healthcare provider still isn’t sure what could be causing your cough, they may order a computerized tomography scan (CT scan). This will give a more detailed view of your sinuses, lungs and/or airway. They may also order testing to see if gastrointestinal issues are causing your cough.
Common causes of Chronic Cough
The most common causes of chronic cough are asthma, infection or post-nasal drip caused by either an infection or allergies. Smoking is also a common cause of chronic cough. There are common causes of chronic cough that aren’t related to your airway or lungs, like gastroesophageal reflux disease (GERD) or certain medications. Your healthcare team will recommend the best treatment for you depending on its cause.
Postnasal drip happens when extra mucus from your nose drips down the back of your throat. PND is usually a symptom of allergies or an infection like a cold.
If your cough is caused by PND because of allergies, you may be asked to take antihistamine (allergy) pills. Decongestants (pills or spray) can help, however they should only be used for a few days. Nasal sprays with corticosteroids or ipratropium bromide can be helpful to treat PND. Some people also find nasal rinses with saline helpful.
A cough from a cold or flu does not usually last more than a few weeks. A post-infection cough can last longer and could be causing your chronic cough. Chronic infection of your airways, called chronic bronchitis, is another possible cause.
There are other, less common infections that can cause chronic cough, for example tuberculosis (TB) or whooping cough (pertussis). Many adults think whooping cough only affects children, but adults can also get it.
You may receive antibiotics if a bacterial infection is causing your cough. Vaccination is a good way to prevent flu and other common causes of lingering coughs.
GERD, which some people call heartburn or acid reflux, can cause stomach acid to back up into the throat, which can cause you to cough.
It is often possible to manage GERD by changing your diet or eating habits. If this doesn't work, you may be prescribed a medication called a proton pump inhibitor.
When you have asthma, things like certain chemicals or scents or cold air can cause you to cough. Asthma can also make it more likely that you will get an infection like a cold or flu. Taking regular medication to control your asthma can prevent the cough in most cases.
You will be given inhalers to take if your cough is due to asthma. It is important to take them daily or as directed to treat the cause of the cough.
Angiotensin-converting enzyme medication, often called ACE inhibitors, are prescribed for high blood pressure or heart failure. This medication can cause coughing for some people. Your healthcare team will ask you about what medications you are taking. Changing your medication can stop the cough.
Researchers and healthcare providers are beginning to talk about something called “cough hypersensitivity syndrome”. This occurs when the upper airway (throat and voice box) is more sensitive to things that don’t usually cause coughing. It can be the cause of your cough, or it could be making your cough worse. Some of the things that can trigger a cough for people with this syndrome include:
- Cold air or changes in temperature
- Certain odours
- Stress or fatigue
- Talking, laughing or crying
Managing your Chronic Cough
If your cough is getting in the way of you living as you would like, speak to your healthcare team. It is still possible for you to get relief from chronic cough even if your healthcare team is not sure of its cause. There are also things you can do on your own to help control your cough and keep it from getting worse.
Prescription medication
There are different prescription medications that your healthcare team may recommend. These may be in a pill or tablet form, or the medication may come in an inhaler or puffer. Often you will be asked to take medication for a couple of months to see if there is any change in your cough.
Speech and language therapy
Speech and language therapy is another option to help you manage your cough. The goal of this treatment is to increase your control of your cough and reduce your urge to cough. The therapist will teach you ways to suppress your cough, using swallowing or relaxed breathing. They will also help you identify what causes you to cough and how you can avoid these triggers and help you deal with any anxiety you feel because of your chronic cough.
Prevent sickness
You should do what you can to keep yourself from getting infections that can make your cough worse.
- Ask your healthcare team about recommended vaccinations, for things like flu or COVID-19.
- Wash your hands or use hand sanitizer.
- Avoid being around people who may be sick. Consider wearing a mask if you’ll be around groups of people.
- If you do get sick, stay home so that you don't get worse.
Drink fluids
Water or other fluids can help thin mucus and soothe your throat. Honey or lemon (or both) in hot water and tea is also soothing.
Suck on cough drops or hard candy
Sucking on hard candy or cough drops can soothe your throat. Hard candy may work as well as cough drops, so choose whatever drops or candy you prefer.
Quit smoking and avoid smoke
If you smoke, the best thing you can do is quit. There is help available for you. Start with your healthcare team. You can reach a "quit coach" by calling 1-866-366-3667.
Smoke from tobacco, wood fire or other sources can irritate your lungs and cause you to cough. Make your home smoke free and avoid sources of smoke outside your home.
A note about cough medicines
There is no evidence that cough medicines (cough suppressants or cough expectorants that you can buy at a pharmacy) help with a cough. They do not treat the underlying cause of the cough and they can actually be harmful for children.
Questions about Chronic Cough?
Call the Canadian Lung Association Health Information Line at 1-866-717-2673 to speak to a certified respiratory educator.
You can also email info@lung.ca or visit www.lung.ca.