Chronic cough - is it serious?

Written by: Dr Shanthi Paramothayan
Edited by: Nicholas Howley

Do you have a cough that just won’t go away? We spoke to expert pulmonologist Dr Shanthi Paramothayan to find out what it could mean, and when to see a doctor.

What is a chronic cough?

A chronic cough is one that lasts for more than 3 weeks. A cough may be dry or it may be productive, which means that you cough up sputum.

What are the most common causes of chronic cough?

The common causes of a dry cough in a non-smoker include asthma, post nasal drip, gastro-oesophageal reflux disease and some medication taken for high blood pressure called ACE inhibitors. A productive cough in a non-smoker is usually due to a respiratory infection. These coughs can persist for weeks if the correct antibiotics are not prescribed.

A persistent cough in a smoker must always be investigated, as a chronic cough is a common symptom of lung cancer. Therefore, individuals with a current or past medical history of smoking with a cough lasting more than 3 weeks should see their GP and have a chest X-ray.

What other symptoms often come with chronic cough?

A cough may be associated with other respiratory symptoms, depending on the cause. This includes breathlessness, coughing up blood (called haemoptysis) and chest pain. If the cough is due to an infection, then the individual may experience fever, night sweats and weight loss.

How can a chronic cough be treated?

The treatment of a chronic cough depends on the underlying reason for it.

After investigations a diagnosis will be made and then the correct treatment must be prescribed. If the patient has asthma, then inhalers will be given.

If the reason for the cough is post nasal drip, then nasal sprays can be helpful, and for acid reflux medication to suppress acid (called proton pump inhibitors) can be helpful.

What is the outlook for chronic cough?

This depends on the cause. Most chronic coughs will get better with the right treatment.

However, a significant number can be difficult to clear completely as it may be due to a combination of factors or due to a rare condition. Some patients with a persistent chronic cough may require referral to a specialist cough clinic.

Dr Shanthi Paramothayan

By Dr Shanthi Paramothayan
Pulmonology & respiratory medicine

Dr Shanthi Paramothayan is one of London's leading consultants in respiratory and general medicine. Well-respected in her field, she specialises in asthma, chronic obstructive pulmonary disease (COPD) and lung cancer.

Dr Paramothayan is committed to education and training of medical students and junior doctors, and was an honorary senior lecturer at St George's University of London and associate Dean (foundation) for Health Education South London. In addition to these roles she is a member of a number of associations and has contributed to many publications.

Dr Paramothayan has conducted several Cochrane systematic reviews, is an examiner for the Royal College of Physicians and a member of MRCP Part 1 board, she is an active member of the British Thoracic Society, having contributed to the education and training committee and a professional and organisational committee member.

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