How to Manage Your Chronic Cough

Most cases are from postnasal drip and will clear up on their own with patience.

Coughing is probably the most common symptom there is. No matter the environment you’re in, someone coughs some time during the day.

But there are nagging coughs that can last weeks, even months, that could be an indication of disease. Those kinds of coughs are hard to stop and often require the intervention of a doctor for a diagnosis that finds its origin.

“Coughing is a protective reflex that helps to clear the lungs and upper airways. It is a symptom, and not a final diagnosis,” says Andy Smith, MD, of Trinity Medical Associates in Knoxville, Tenn. “There are dry coughs, wet coughs, deep coughs, light coughs, wheezing coughs, racking coughs, chronic coughs, and once in a while, whooping coughs, just to name some of the varieties.”

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For many people, Smith says, a cough is just a few days of a nuisance tickle in their throat. But for others, the cough just doesn’t seem to go away. Weeks or months go by, and still there is that nagging cough.

The top three causes of a chronic cough are postnasal drip, asthma, and gastroesophageal reflux disease, or a combination of those symptoms, according to an American Family Physician study.

The most common cause of chronic cough is postnasal drip syndrome, the study says, “usually following viral infection of the upper respiratory tract. Other causes — chronic nasal inflammation, such as seasonal or allergic rhinitis, chronic sinusitis, medications, irritants, and excessive vasomotor responsiveness, can result in post-nasal drip syndrome and chronic cough.”

Typically, chronic cough is defined as lasting for at least eight weeks. The majority of coughs don’t last that long and giving them time to clear up on their own is usually the cure. On the average, a cough will last 18 days, according to a study.

Two kinds of coughs are common after a cold. One is a postnasal drip or mucus cough, which is caused by your body’s attack on the cold virus. Over-the-counter medicines can relieve the symptoms somewhat by drying up the mucus, but they won’t suppress your cough completely.

The second kind of post-cold cough is called post-inflammatory bronchospasm, and it’s like asthma. “It’s a tightening of the airways that restricts air flow and is accompanied by cough and wheezing,” Matthew Mintz, an internist with George Washington Medical Faculty Associates, told The Washington Post.

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He says it’s enough like asthma that a short course of treatment with asthma medicines — bronchodilators or steroids — can help. Coughing that’s worse at night or wheezing and shortness of breath are signs you have bronchospasm.

Otherwise, there’s some reasoning for home remedies because they can work. Honey might be at the top of the list.

“Most prescribed and over-the-counter preparations for cough in children are not effective and might carry the risk of adverse events. A single dose of honey before bedtime was shown in recent studies to diminish cough and the discomfort experienced by children and their parents,” according to the College of Family Physicians of Canada.

That’s because honey can soothe irritated mucous membranes that stimulate your cough reflex, although children under 1 should not have honey because it can cause botulism.

Other recommendations include warm air from a shower or vaporizer that will moisturize your airways, cough drops or lozenges that lubricate your throat and make you swallow, and nasal irrigation using a Neti pot or similar device that washes down the drip at the back of your throat.

One suggestion should be used with discretion: a sip of brandy or wine, which calms a cough, says Steven Meixler, MD, a pulmonologist and co-medical director of the Westchester Medical Group in White Plains, N.Y.

“I don’t want to encourage irresponsible drinking, but a small amount — just a sip or two — can have the effect of calming a cough,” Meixler says.

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