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Chronic coughing

Updated: February 2020

Chronic coughing may lead to a significant restriction of the quality of life of those affected. It is not only visiting public events, like concerts and cinemas which is difficult. Even a simple conversation, normal working life or sleep are persistently disturbed.

The term chronic refers to a cough that lasts longer than 8 weeks in adults and 4 weeks in children , with many of those affected suffering from chronic coughing for years.

Causes

The causes may be extremely varied and are not always determined. Frequent respiratory tract infections often cause chronic coughing. If the coughing persists for more than three months, this may indicate a smokers’ cough (COPD) or asthma.

The most significant causes of chronic coughing are:

  • Bronchial asthma
  • Allergies
  • Chronic bronchitis and COPD (frequently in smokers)
  • Chronic inflammation of the sinuses (sinusitis)
  • Bronchopneumonia
  • Tuberculosis
  • Destruction of the pulmonary alveoli (Pulmonary emphysema)
  • Chronic scarring of the lung tissue (pulmonary fibrosis)
  • Side effects of medication (e.g. ACE inhibitors, betablockers, cortisone)
  • Lung cancer (such as bronchial tumour and bronchial carcinoma). Chronic coughing is the most common symptom in the initial diagnosis of bronchial carcinoma.
  • Vocal cord paralysis
  • Blood congestion in the lungs in the case of heart failure (cardiac insufficiency). Here, coughing usually occurs during physical exertion or while laying down.
  • Heart attack or heart muscle inflammation
  • Food intolerances (e.g. milk protein intolerances)
  • Reflux of stomach contents into the oesophagus (gastro-oesophageal reflux)
  • Aspiration of foreign bodies
  • Croup
  • Whooping cough (pertussis)
  • The hereditary disease, cystic fibrosis, leads to the formation of abnormally viscous mucous membrane in the lungs, pancreas and small intestine, which blocks the bronchi and the digestive tract. Consequences of this are respiratory distress, chronic coughing, as well as impaired digestion and susceptibility to infection
  • An hereditary metabolic disturbance, which causes damage primarily to the lungs and pancreas through the production of viscous mucous
  • Permanently impeded nasal breathing

Diagnosis

Diagnosis of chronic coughing can be difficult as this symptom could have many causes.

In addition to a detailed medical history, the doctor is able to make use of various procedures which can detect or rule out serious diseases. Diagnostic procedures include listening and tapping, x-rays, computed tomography, pulmonary function testing, bronchoscopy and blood gas analysis.

Treatment

The therapy will depend upon the causative disease. Until the cause is known, chronic coughing should not be suppressed.

Cough expectorants and cough suppressants are available to alleviate the symptoms of chronic coughing. Cough expectorants usually are used in the case of acute respiratory tract infections, because they liquefy the mucus. The active ingredients, acetylcysteine (ACC), bromhexine and ambroxol, also are available as essential oils which have an anti-bacterial and expectorant action. They can be used in the form of tablets, ointments or as an inhalation.

Cough suppressants

If the cough is dry, i.e. does not promote mucus ejection, it may contribute to damage to the mucous membrane. In this case, cough suppressants may be used. They also are used to enable to those affected to get a better, undisturbed night’s sleep.

Home remedies

Proven home remedies for chronic coughing are warm drinks, which will help to liquefy the mucus in the respiratory tracts. Inhalations moisten the respiratory tracts and help to eliminate the mucus.


References:

https://www.mayoclinic.org/diseases-conditions/chronic-cough/symptoms-causes/syc-20351575

https://www.lungenaerzte-im-netz.de/krankheiten/husten-chronisch/was-ist-chronischer-husten/

https://www.netdoktor.at/krankheit/chronischer-husten-6679626