You were sick with an upper respiratory infection and now you are better, but the cough is still there. Cough is responsible for 30 million doctor visits a year in the U.S. and a cough that lasts for more than 3 weeks will start to get you worried. Headache, sleep disturbance, rib fractures, hoarseness, and concern that “something is wrong” are the known complications of a persistent cough.
So, why are you still coughing?
- This too shall pass: First, know that cough following viral or other respiratory tract infection can persist for more than 8 weeks after the infection. I know, that’s long but this will go away.
- Drip: Make sure you have ruled out post-nasal drip as the cause of your persistent cough. Nasal discharge, a sensation of liquid dripping down the back of the throat and frequent throat clearing are clues to this. An over the counter loratadine, cetirizine, or allegra should get rid of your post-nasal drip and thus your cough if this is the answer. An intranasal steroid spray or decongestant may also help, discuss that with your doctor.
- Can I ride it out? A post-infectious cough (the cough lingers but the other symptoms have dissipated) will resolve without specific therapy but there are options for shortening the duration.
- Asthma-like: Airway inflammation following infection causes an asthma-like picture. This means your cough is from airway hyperresponsiveness and constriction. We see this all the time in clinic. An oral inhaler (an inhaled steroid) will help resolve this cough and you may have to add a bronchodilator inhaler (albuterol) as well. A visit to your primary care doc is needed for this.
- Whoop: Pertussis (whooping cough) is a common and under-recognized cause of persistent cough in adults and adolescents. The problem here is unless caught very early there is no treatment for pertussis, it just resolves on its own but it takes time.
- Should I be worried? Anyone with a cough for more than 8 weeks needs a chest x-ray and evaluation by a doctor. Period.
- Dr. O.
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