A cough is considered “chronic” when it lasts longer than 8 weeks in adults or more than 4 weeks in children. Chronic cough is common and can affect daily life — causing tiredness, trouble sleeping, and even embarrassment in social situations.

What Causes Chronic Cough?

Most chronic coughs are caused by one or more of the following conditions:

• Upper airway cough syndrome (sometimes called “post-nasal drip”): mucus from the nose or sinuses drips down the back of the throat, triggering a cough.
• Asthma: airway inflammation and tightening that can cause cough, sometimes without wheezing.
• GERD (gastroesophageal reflux disease): stomach acid backing up into the esophagus can irritate the airway and trigger cough.
• Nonasthmatic eosinophilic bronchitis: airway inflammation similar to asthma, but without airflow obstruction.
• Medications: certain blood pressure medicines (ACE inhibitors) are a well-known cause of chronic cough.
• Environmental or occupational irritants: smoke, dust, fumes, or other airborne irritants.

How Is Chronic Cough Evaluated?

Doctors usually start with:

• A detailed history and physical exam.
• A chest X-ray, to rule out structural or infectious causes.
• Breathing tests (spirometry), to check for asthma or other lung function issues.

If you take an ACE inhibitor for blood pressure, your doctor may recommend switching medications to see if the cough resolves.

How Is Chronic Cough Treated?

Treatment is directed at the underlying cause:

• Upper airway cough syndrome: nasal sprays, antihistamines, or allergy treatment.
• Asthma: inhaled medications to reduce airway inflammation and open the airways.
• GERD: dietary changes and medications to reduce stomach acid.
• Nonasthmatic eosinophilic bronchitis: inhaled anti-inflammatory medications.

If the cause isn’t clear or the cough doesn’t improve, a referral to a specialist may be recommended for further evaluation.

What If My Cough Won’t Go Away?

Sometimes a cough persists even after common causes are treated — this is called refractory chronic cough. In these cases, speech and language therapy can help retrain the cough reflex, and certain medications (such as gabapentin or low-dose morphine) may be considered to help calm an overly sensitive cough reflex.

What Can I Do to Help My Cough?

• Avoid smoking and secondhand smoke.
• Avoid known triggers, such as strong odors or allergens.
• Take medications as prescribed, even if you start feeling better.
• Keep your follow-up appointments so treatment can be adjusted as needed.

When to See Your Doctor Again

Schedule an appointment if your cough lasts longer than 8 weeks (adults) or 4 weeks (children), or if you notice any of the warning signs listed above.