What Causes a Cough

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8 Things That Make You Cough and What to Do About Them

by James Hubbard, MD, MPH

That nagging cough just won’t go away. You’ve had it so long you don’t even notice it at times, but it drives your co-workers, friends, and spouse crazy.  Is it just an annoying habit or a symptom of a more serious problem?

A medical definition of a chronic cough is one that persists for eight weeks or more. It that occurs, see your doctor for a workup.

There are many causes, but here are eight of the more common (eight weeks, eight causes. get it?), along with possible treatments and what to do until you can get to a doctor.

1. Allergic Rhinitis

Nasal allergies can result in a runny or stuffy nose, but it’s that drip down the back of your throat that triggers the cough.

What to do until you can get to a doctor: Find what you’re allergic to and stay away from it. Okay, that’s not so simple sometimes, so an over-the-counter antihistamine might help. You can use the nondrowsy form; however, the Benadryl type might work even better, depending on your tolerance to the drowsy side effect. You can also try nasal irrigation. Just do it safely.

More information: Here are tips for getting the most out of your allergy medicines (and even avoiding that drowsiness).

Books ad2. Asthma

Not everyone with asthma knows they have it. Sometimes the only symptom is a cough.

What to do until you can get to a doctor: Avoid any triggers. They’re different for different people. Some common ones are exercise, allergies, smoke, barometric pressure changes, or infections, which may trigger the asthma and hence the cough.

More information: Here are tips for treating and preventing asthma attacks for disaster situations when you don’t have an inhaler.

3. Gastroesophageal Acid Reflux (GERD, Heartburn)

The acidic contents of your stomach can come up, or reflux, into the back to your throat, irritating it. This may occur only when you’re lying down asleep, so you may never know it’s happening. However, as a result of the chronic irritation, you may develop the cough.

What to do until you can get to a doctor: Take the antacid of your choice—Tums, Rolaids, Maalox, cimetidine (Tagamet) ranitidine (Pepcid), etc. Avoid heavy meals before bedtime. Instead, eat a light, early evening meal. Avoid smoking and alcohol. If you’re overweight, get a few pounds off. You can try propping up the head of your bed on a book or two. Eating saltine crackers is a popular home remedy, but beware if you need to watch your sodium intake.

More information: The American Gastroenterological Association lists foods to consider avoiding (including coffee, fried foods and even peppermint) on their website.

4. Smoking

Is there anyone who doesn’t know smoking damages your lungs and throat? That includes tobacco, cigarettes, cigars, hookah (just another way to smoke tobacco), marijuana, or anything else you decide to suck down your windpipe.

What to do until you can get to a doctor: Do I have to spell it out? Okay, stop smoking … completely … now.

More information: Here are some websites that offer tips to quit smoking: Smokefree.gov, Cancer.org, Lung.org.

5. Medications

Never stop a prescription medication without talking it over with your prescribing doctor, but know that some can have the side effect of a chronic cough. One well-known culprit group is ACE inhibitors, used for heart or blood pressure problems and in diabetics. Examples are lisinopril (Prinivil) and enalapril (Vasotec), to name two of many. They’re fantastic and effective medications, but your doctor should be able to find a good substitute if the ACE is causing you to cough.

What to do until you can see a doctor: If you’re taking over-the-counter or herbal medicines, try stopping them. If the cough stops, you know it’s one of those. If you wish, you can then try adding one back every few days. If you start back coughing, you’ll know which one to avoid or substitute.

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6. Infections

Any respiratory infection can cause a cough. Some bacterial and fungal infections, even tuberculosis, can cause a chronic cough.

What to do until you can get to a doctor: For the cough, use a humidifier, or place a bucket of water in the room (heated, if that’s practical and safe). Try honey to suppress a dry cough.

7. Lung Cancer

This is rarer than most of the others but the one we all fear. Putting off the diagnosis will only decrease your potential benefit in treatment. There’s really nothing to do except see a doctor.

A CPAP machine, which treats sleep apnea—a disorder in which you stop breathing periodically throughout the night. (Sleep apnea can cause a chronic cough.)

8. Sleep Apnea

This is usually not in the list of causes for a chronic cough, but it is in mine since it was my reason for a cough that persisted over three years without a diagnosis. I slept with my mouth open. The diagnosis was made after a sleep lab study, and the treatment is sleeping with a CPAP machine (basically, a mask and a machine that delivers oxygen). With sleep apnea, when you go to sleep, the back of your throat relaxes so much you can’t get air. This wakes you up just enough for you to breathe. This happens tens if not hundreds of time during the night, but you rarely wake up enough to know it’s happening. One clue is feeling as tired in the morning as when you when to bed. If you sleep with someone, they may complain of your loud snoring or that you seem to periodically hold your breath while sleeping.

What to do until you see a doctor: Sleep on your side or stomach. If you’re a back sleeper, try a prop, or sew a rubber ball in the back of your shirt to make lying on your back uncomfortable. Long term, exercising and losing weight (if you need to) can help a lot. Sleep apnea may increase your risk for a heart attack and other major problems, so whatever you do, don’t ignore it.

 

For all these cough causes, don’t put off seeing a doctor when you can. And eight weeks is not a magic number. Don’t wait that long if you’re having other problems, such as fever, weight loss, fatigue, coughing up blood, or shortness of breath, or if you’re just worried.

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Coughing photo by Sarah Fagg on Flickr. CPAP photo by Pete Prodoehl on Flickr.

  • Kat27

    I’m stuck. Been coughing for YEARS now. (4 or so). I’ve been checked out at the hospital for polyps etc (I am a fitness Instructor so use my voice a lot) but nothing came of that.I’m fine. I was then referred to a voice therapist – nothing is ever wasted is it?(knowledge), but I was travelling miles making no real progress. I gave up dairy and THOUGHT I’d sussed it as I got improvements, so cancelled all appts with her. She was happy for me but thinks there’s multifarious reasons as to why I get this problem. In the past I’ve even had costochondritis from it all.(SO painful). I also get tight neck and chest muscles so have to constantly stretch these area out to stay on top of my game. At it’s worst (other than the costochondritis) I can’t even take a full in-breath so then have to work hard to stretch my scalenes (scalenes attach to 1st rib – lung fascia attaches sub first rib which keeps lifting so the lungs are unable to function to full capacity). In short I’m in a mess. All the above (acid reflux etc) – don’t quite resonate with me and I am a huge believer in nutrition being at the root of MANY problems. Having said that – I’m now starting back on dairy though as I am STILL coughing so feel this is not the answer.
    I snore as I have a deviated septum (!). I love red wine most nights. (but always put the cork back in), I noticed tea MIGHT make me cough. I drink lots of fluids. Coughing is 24/7 and seriously getting on my nerves as well as compromising my pelvic floor (even more annoying as I teach how to avoid this issue!).
    HELP!!!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sorry, I don’t have an answer, if you’ve been checked thoroughly for the causes listed in the post.

  • Pingback: Lingering Cough: When You Need Antibiotics

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  • http://SurvivalDoctor Theres

    Great Article!!!!!!!

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Theres.

  • susy b

    i use and really like horehound lozenges. work great. one every night @ bed in winter.

  • http://www.practical-parsimony.blogspot.com Practical Parsimony

    I coughed day and night with no relief, so hard I almost passed out and sometimes threw up. I felt like someone had punched me in my stomach. Finally, I took advice I thought was ridiculous. I rubbed Vicks Salve on the soles of feet once I got in bed and wore socks to bed. I did not cough all night and got my first sleep in about five days.

    I had been coughing for two months, following a bad sinus, ear, and lung infection.

  • lisa

    Thanks so much, Nurse Lisa. Comments like that are what keep me posting.

  • sheila

    Lisinopril —–>I coughed for weeks, then months. My family doctor said it was something going around. His N.P. said a “deep sinus infection”, though I had no symptoms, other than the horrid, horrid cough. The cough made my throat clamp down, my eyes water and my nose run. Sometimes, the coughing was so hard that I gagged. All the “symptoms” just were the product of the cough caused by the prescription LISINOPRIL
    He put me on pricey brand name Diovan. After weeks, the cough stopped.
    If I ever am told that i have to go back onto an ACE inhibitor, the thought of coughing almost nonstop makes me sad. Very sad.

    • lisa

      Lisinopril can definitely cause a cough in some people. Diovan is an ACE II (fancy version of ACE that doesn’t usually cause a cough.

  • Nurse Laura

    I continue to love your site. I sure wish there were more physicians like you..practical, open, willing to listen, yet discuss options that might be the solution (rather an one option fits all). Thank you for offering such good information for WTSHTF, too. I especially find your site one which could help the folks who haven’t had the medical training you, or even I as a nurse have had.