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A cough lasting over eight weeks rarely comes from a cold — often reflux, allergy or medicines.
Also known as: chronic cough · persistent cough · dry cough
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A cough lasting longer than about eight weeks. Usually the cause is not dangerous but treatable: over-sensitive airways (asthma), nasal secretions dripping down the throat (from sinus or allergy problems), reflux from the stomach, or the side effect of certain blood-pressure medicines (ACE inhibitors). Smoking is a common cause. Warning signs to check quickly: blood in the sputum, unintended weight loss or breathlessness. Chronic cough is a symptom, not an illness in itself — finding the cause is worthwhile.
The key step: identify the underlying cause, because treatment follows from it.
Smoking is one of the most common causes — quitting often clearly improves the cough.
Depending on the cause: asthma inhaler, nasal rinse/allergy treatment, reflux measures — and have an ACE inhibitor reviewed.
Blood in the sputum, weight loss or breathlessness need prompt medical assessment.
Let a teaspoon of honey dissolve slowly in the mouth, especially before bed with a cough; do not drink afterwards.
Hang a damp cloth over a chair back or set out a shallow bowl of water, keep the room on the cool side.
Raise the head end — with a wedge under the mattress or books under the bed legs, not with a stack of pillows.
A morning cough with sputum over years plus breathlessness uphill — then a lung function test is worth more than another cough medicine.
A cough counts as chronic from eight weeks in adults and four weeks in children. Three causes together account for about ninety in a hundred cases: postnasal drip, asthma and reflux — often several at once. An ACE inhibitor triggers cough in five to twenty in a hundred people, sometimes only after months; after stopping it takes one to four weeks to go. After an infection a cough can last eight weeks without anything being wrong.
Cough suppressants with codeine work hardly better than a dummy in chronic cough and cause drowsiness. What works in studies addresses the oversensitive cough reflex: low-dose gabapentin or amitriptyline over eight weeks, together with speech therapy that practises holding back the urge — the two together work better than either alone. An ACE inhibitor is stopped rather than treated; the cough goes one to four weeks later.
Whether dry or with phlegm helps narrow down the cause.
A hint of sensitive airways (asthma).
Points to the nose/sinuses as the trigger.
Rising stomach acid can trigger a stubborn cough.
A cough lasting more than eight weeks usually has one of three causes: reflux from the stomach, secretions from the nose or a form of asthma. This value belongs to the third track.
A shortage is rare but consequential: it explains lung disease in younger people and in non-smokers — and it is usually only looked for after years.
A cough at night when lying down that eases on sitting up can come from the heart. This value settles the question quickly.
Usually normal. Raised together with fever and weight loss, a persistent infection is looked for.
Low levels are common in chronic airway illnesses and go along with more infections. Correcting a deficiency is simple; for lung function itself it is no replacement for treatment.
Relaxes the smooth muscle of the airways — which is why it is also given as an infusion in an emergency. For everyday use the tablet replaces no inhaler.
Drinking enough keeps the mucus thin and easier to cough up. That is the simplest and most often overlooked lever with sticky sputum.
The breathing muscles are muscle too. With chronic breathlessness the need for energy and protein is raised, and a loss of weight clearly worsens what one can manage.
600 mg a day thins tough mucus; in chronic bronchitis the pooled studies showed fewer flare-ups. It does not act on a dry irritable cough.
With a low starting value the pooled studies showed fewer respiratory infections. But a cough lasting beyond 8 weeks usually has one of the three usual causes — reflux, nasal drip or asthma.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
An enlarged thyroid can press on the windpipe and cause an irritable cough that increases when lying down. It is rarely on the list of the three usual causes — but it belongs there once those have been worked through.
Reflux from the stomach is one of the three most common causes, and fatty evening meals favour it — this hormone relaxes the muscle at the lower end of the gullet. The cough then comes at night and without heartburn.
A third of chronic cough comes from the stomach, often without heartburn. The last meal 3 hours before lying down and smaller evening portions are the first attempt — judgeable after 4–8 weeks.
In an irritable cough with no findable cause, breathing and voice therapy is studied.
For a dry, irritable cough the most widespread plant there is, as tea or syrup.