Acute Coughs and Their Causes
Acute coughs usually only last up to about 3 weeks. This cough may be either productive (produces mucus) or non-productive (dry, no mucous). Acute cough is usually caused by the following illnesses:
Most treatments for acute cough have not been shown to be effective. In fact there is a movement away from even using cough suppressants unless the cough is causing other problems. If the cause is a treatable infection like pneumonia, then antibiotics would be the proper treatment to help fight the underlying cause of the cough. Speak to a doctor about your case.
Conditions Causing Subacute Cough
Subacute coughs typically last between 3 to 8 weeks. The subacute cough may need to be evaluated by a physician depending upon the severity of symptoms, as 60% of subacute coughs spontaneously resolve. In other words, there's a pretty good chance of a subacute cough going away on its own. Common causes of a subacute cough include:
- post-infectious cough (most common)
- post-nasal drip
- cough-variant asthma
- eosinophilic bronchitis
If your physician suspects that the cause of your subacute cough is post-infectious cough or postnasal drip, he may prescribe antihistamines plus a decongestant (such as chlorpheniramine and pseudoephedrine) for approximately 3 weeks to see if the cough will clear up.
Conditions Causing Chronic Cough
Chronic coughs last for greater than 8 weeks. Causes of the chronic cough can sometimes be difficult to isolate. To help isolate the cause of your chronic cough, your doctor may find it necessary to run several tests or even recommend that you see another specialist. Common causes of chronic cough include:
- post-nasal drip
- gastroesophageal reflux disease (GERD)
- medications, notably ACE inhibitors
- heart failure
- lung cancer (rare)
Treatment is targeted to the specific cause of the cough. Your physician will take a thorough history to look for likely causes of a cough.
If you are on ACE inhibitors for blood pressure, your physician may have you try an alternative medication to see if your cough resolves.
Unfortunately there are not many physicians willing to specialize in chronic cough. Initially, you may find that you are referred to a pulmonologist to "work-up" or diagnose the chronic cough, but many of the best pulmonologists may be unwilling to see patients for chronic cough and refer you to either a gastroenterologist or back to your primary care physician (PCP). Finding a physician you like that is willing to be patient is probably the key to success in finding a physician to treat your chronic cough.
Irwin, R.S., Baumann, M.H., Bolser, D.C., Boulet, L., et. al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines. Chest 2006;129;1S-23S. Accessed: September 4, 2010 from http://chestjournal.chestpubs.org/content/129/5/1142.full.pdf
Kwon, N., Oh, M., Min, T., Lee, B., and Choi, D. Causes and Clinical Features of Subacute Cough. Chest 2006;129;1142-1147. Accessed: September 4, 2010 from http://chestjournal.chestpubs.org/content/129/5/1142.full.pdf
National Heart Lung and Blood Institute. Cough. Accessed: September 4, 2010 from http://www.nhlbi.nih.gov/health/dci/Diseases/cough/cough_whatis.html