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Persistent Cough: Treatment, Procedure, Cost and Side Effects

Last Updated: Jul 22, 2021

What is the treatment?

When a cough lasts for eight weeks or longer in adults and for about 4 weeks in children, it can be characterized as chronic cough. A chronic cough may interfere with your sleep and also can make you feel exhausted. A person may even suffer from vomiting, lightheadedness and even rib fractures due to persistent cough. An occasional cough is normal but if a cough persists for weeks, it is usually due to some medical problem.

Common symptoms of chronic cough may include heartburn, hoarse voice, sore throat, stuffed nose, wheezing, shortness of breath, running nose and a feeling of liquid dripping down the back of your throat. Some of the serious repercussions of chronic cough may include: broken ribs if a person coughs too hard, headaches, dizziness, frustration and anxiety, urine leakage and sleep loss. If a person is suffering from persistent cough for a long time, some serious side-effects may appear. They are night sweats, coughing up blood, shortness of breath, unwanted weight loss, chest pain and high fever.

Chronic cough can happen due to a number of different causes. The treatment for chronic cough includes treatment for acid reflux, asthma, chronic bronchitis, infections and post-nasal drips. A cough suppressant which is generally available over-the –counter helps to relax the cough reflex.

What does a persistent dry cough mean?

Persistent coughing is a sign of underlying chronic illness. So your persistent cough may lead to:

  1. COVID-19:

    SARS-CoV-2 or coronavirus is still under research yet some of the symptoms like cough are common. The dry cough can be persistent for up to 3 weeks and more, and it can be associated with other symptoms like fever, fatigue, body ache, nasal congestion, difficulty in breathing, etc.

    Note:The disease is contagious and can spread through the air, it is advisable to maintain social distance and take safety protocols as per government guidelines.

  2. Asthma:

    Respiratory diseases that are long termed may lead to symptoms like a cough. In some cases, the cough is good as it keeps out the phlegm. In case of a dry cough, it can be associated with asthma varieties like cough-variant asthma. Other symptoms that may be associated with asthma are - shortness of breath, chest tightness or pain, and wheezing.

  3. Idiopathic pulmonary fibrosis (IPF):

    IPF is a type of illness where tissues in a person’s lungs start to scar which makes it difficult to process the air to the bloodstream. The cause of the condition is still idiopathic, although symptoms associated with IPF are confirmed, which may include persistent, dry cough, shortness of breath, clubbing, and rounding of the tips of the fingers or toes, fatigue, loss of appetite, and gradual weight loss.

  4. Gastroesophageal reflux disease (GERD):

    A condition where acid rides up from the stomach to the food pipe sometimes leads to persistent cough along with other symptoms like vomiting, nausea, bad breath, heartburn, pain, or difficulty when swallowing.

  5. Upper respiratory infections:

    Like common colds and the flu, may lead to temporary cough and other symptoms like muscle aches, runny nose, a fever, and a sore throat.

    It is advisable to seek medical attention if you are suffering from a cough for more than 3 weeks.

What is a persistent cough a sign of?

A persistent cough can be a sign of many underlying diseases related to your respiratory tract, circulatory system, or digestive system. Depending upon the illness which is associated with the persistent cough it can be dry or wet ( phlegm), specific to a situation (home, work, outdoors), or time (morning, night, after eating, etc.).

Here are some of the common illnesses that can lead to a persistent cough:

  1. Postnasal Drip:

    During allergy seasons, your sinuses may react to it by producing excess mucus. The mucus usually leads to a runny nose, and in some cases itchy throat and cough.

  2. Acid Reflux:

    Acid reflux is a condition in which stomach acid irritates your digestive system, especially your esophagus. The irritation caused by acid in the food pipe and throat may lead to a persistent cough. The cough may get worse when you lay down or during sleep.

  3. Asthma:

    Cough variant asthma (CVA) is a kind of asthma that may be consistent with changing seasons. Common symptoms of CVA are chronic, dry (non-productive) cough. Chronic cough can also be an early sign of asthma.

  4. Infection:

    Infections like flu, common cold, whooping cough, bronchitis or pneumonia, can have cough as one of the most common and initial symptoms. Depending upon the severity of the case, the cough might take weeks to cure.

    Unfortunately, the effects of antibiotics on persistent cough are not effective, so it might not reduce the cough but it helps you fight back from the bacteria caused by the infection.

  5. Cancer:

    The probability of your persistent cough being a sign of cancer is less than 2%. Lung cancer, lymphomas, or lung metastases have common symptoms like a persistent cough.

When should I be concerned about a persistent cough?

A persistent cough can be detected by the consistency of the cough. If your cough lasts longer than 8 weeks (and 4 weeks in children), it will be considered persistent. In most cases, persistent cough is a sign of an underlying chronic illness. Either it is dry or producing mucus, it needs to be taken seriously. It is advisable to seek a medical professional if you suffer from chronic cough along with:

  • Trouble swallowing
  • Wheezing noise while breathing
  • Difficulty in breathing
  • The sensation of something being stuck in the throat

How is the treatment done?

One cause which is responsible for the majority of the occurrences of persistent cough is postnasal drip – This happens when nose or sinus secrete extra mucus and it triggers the cough reflex by dripping down the back of a person’s throat. Asthma related cough may become worse when a person is exposed to cold air, chemicals or fragrances. Cough is the main symptom in one o asthma. Gastroesophageal reflux disease is a condition where stomach acid flows back into the tube that connects the stomach and throat which causes constant irritation. This irritation can lead to chronic coughing. Some other factors that may trigger chronic cough are infections, blood pressure drugs and chronic bronchitis. Bronchiolitis, cystic fibrosis, aspiration and other factors can also cause persistent cough.

Reflux medicines like H2 receptor blockers, proton pump inhibitors and antacids help to reduce or block production of acids. Chronic cough due to asthma can be dealt with the help of medications like inhaled steroids and bronchodilators. Antibiotics can help to treat pneumonia or any other bacterial infection that may cause chronic cough. Persistent cough due to postnasal drip can be treated with the help of decongestants, antihistamines, and steroid nasal sprays which help to thin and remove extra mucus and also helps to reduc swelling in the nasal passages.

Who is eligible for the treatment? (When is the treatment done?)

If medications to treat common causes of persistent cough do not yield any results, a doctor can recommend a number of tests to find out the actual cause. There can be imaging tests including X-Rays and computerized tomography scans, lung function tests, lab tests and scope tests. For children, a chest X-Ray and spirometry are usually recommended to find out the root cause. A person becomes eligible for treatment if a doctor is able to find out the cause of his cough by means of his test. Conversely, if a patient responds to the treatment for the common causes of persistent cough, he/she is eligible.


Who is not eligible for the treatment?

People who can suffer serious side-effects due to the intake of antibiotics, glucocorticoids, acid blockers and asthma drugs are not eligible for the treatment. A person is eligible for treatment of persistent cough only after a doctor has pinpointed the exact cause of the ailment and has provided him/her with appropriate treatment measures. Children below 4 years should ever be given over-the-counter cough suppressants as it may have serious effects on the child’s health.

Are there any side effects?

Some of the side-effects of H2 receptor blockers are constipation, diarrhea, dry mouth and skin, runny nose, ringing in the ears and difficulty in sleeping. Proton pump inhibitors may cause side-effects like constipation, diarrhea, flatulence, fever, abdominal pain, vomiting and nausea. Inhaled steroids used to treat persistent cough due to asthma have side-effects like sore mouth and throat, fungus infection in the mouth, decreased bone thickness in adults and spasms of the large airways. Antihistamines, used to treat persistent cough due to post-nasal drip can cause drowsiness, dizziness, confusion, vision problems, nausea, restlessness in children and trouble urinating.

What are the post-treatment guidelines?

A patient, who has undergone treatment for bronchial asthma, should follow the doctor’s advice so that the condition does not flare up again. A person should drink more fluids as they help to thin the mucus in the throat. Your throat will get some relief if you intake warm liquids like broth, juice or tea. Dry cough and an irritated throat can be taken care of with the help of cough drops or hard candies. A person should keep the air in their place of residence moisturized by using a humidifier. One of the most important precautions that a person can take is to avoid smoking and also to stay away from second-hand smoke.

How long does it take to recover?

Persistent cough can happen due to a number of different reasons. Genera medications can treat the outward symptoms and provide temporary relief. But it will take a much longer time to treat the underlying cause. Persistent cough may even occur due to infection or inhalation of secondary smoke. So the time required to recover from this condition will depend on the time required to deal with the underlying cause. In most instances, this takes a lot of time.

What is the price of the treatment in India?

The price of proton pump inhibitors can vary between Rs 500 and Rs 28,000. Anti-histamines, which help to treat persistent cough due to postnasal drip can cost anything between Rs 500 and Rs 2500. Inhaled steroids, which are used to treat persistent cough due to asthma are available for something around Rs 9000.

Are the results of the treatment permanent?

For the same reason as to why the recovery from persisting cough may require a long time, permanent treatment is also not always possible. Medications and other post-treatment guidelines can help to address the symptoms of this condition. But a cured person may again develop chronic cough if he/she comes in contact with allergens that act as triggers or it may happen as a cause of some other medical complication. Treatment can help you to overcome this condition completely. But extra care is required to ensure that it does not come back. Treatment for the underlying cause may help you to get rid of this ailment once and for all.

What are the alternatives to the treatment?

Using a humidifier in your bedroom will help to keep the environment of the room moist by removing dry air. This will help you to keep your airways clear. You can also add a shallow pan of water to the room if there I no humidifier. It is of utmost importance to avoid allergens like pollen, dust, grass and other things that may trigger the condition. Fruit contain high content of fiber and flavonoids that can help to prevent chronic cough. Thus a person should incorporate more fruits into his/her diet.


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Written ByDr. Ashok Mishra MBBSGeneral Physician
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