A cough is one of the most common symptoms people experience. Most of the time, it is temporary and goes away on its own after a cold or infection.

But when a cough refuses to leave and lingers for weeks or even months, it becomes more than just an irritation. It becomes a signal that something deeper may be going on. If your cough lasts more than eight weeks in adults, it is tagged as a chronic cough, one that requires medical intervention.

Many adults ignore chronic coughs or rely on over-the-counter syrups without understanding the underlying complications. This guide is here to set things straight and help you understand potential issues that your body may be trying to tell you.

1. Upper airway cough syndrome, aka post-nasal drip

Postnasal drip is one of the most common reasons behind chronic cough in adults. The condition usually occurs when excess mucus from the nose or sinuses drips down the back of the throat. When there’s persistent mucosal presence, it causes throat irritation and triggers the cough reflex.

Postnasal drip is often associated with:

• Allergic rhinitis
• Chronic sinusitis
• Non-allergic rhinitis
• Environmental irritants like pollution or strong odours

If you have postnasal drip, you are consistently going to experience a frequent need to clear your throat or feel a sensation of something “stuck” in your throat. Besides that, nasal congestion and runny nose is also common. Usually, treating postnasal drip involves the use of antihistamines, nasal sprays, saline rinses, or treatment for sinus infections.

2. Asthma

The most common “identifiable” symptoms of asthma involve wheezing and breathlessness. However, if you are suffering from cough-variant asthma, experiencing chronic coughing is also a common symptom.

When you have asthma, the airways become inflamed and overly sensitive and when exposed to common triggers like dust, cold air, exercise, pollution, or respiratory infections, it causes the airways to further narrow, causing coughing.

Some of the telltale signs that you might have asthma-related cough are:

• Cough that worsens at night or early morning
• Cough triggered by exercise or laughter
• Family history of asthma or allergies
• Improvement with inhaled medications

Since this type of asthma usually doesn’t cause the “typical” symptoms of asthma, it is often misdiagnosed, leading to further complications.

This is where expertise and experience of our specialists at Jindal Chest Clinic come into play because we prioritise comprehensive diagnosis to get to the root cause of the condition.

3. Gastroesophageal reflux disease (GERD)

You might not experience the classical symptoms of acid reflux but GERD is usually characterised by the rough cough that you might be brushing aside “as nothing.”

If you have GERD, it causes the stomach acid to flow backward into the esophagus and sometimes reaching the throat. This acid, in turn, causes irritation in the airways, further triggering the cough reflex. Also, if the acid enters into the lungs, it can further worsen the symptoms.

Some of the telltale signs that your chronic cough could be due to GERD are:

• Cough that worsens after meals
• Cough when lying down
• Hoarseness or frequent throat clearing
• Sour taste in the mouth or chest discomfort

Besides medical therapy, GERD-related cough also requires lifestyle modifications including dietary changes, weight management, timing meals all day, etc.

Also, at times, GERD can co-exist with asthma or postnasal drip, which is why expert and timely evaluation of the condition is a must.

4. Chronic bronchitis

Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD), which is characterised by a productive cough lasting at least three months in two consecutive years.

The primary reason behind this condition is due to long-term inflammation of the bronchial tubes, which contributes to excess mucus production. Triggers like prolonged air pollution exposure, smoking, occupational dust, chemical fumes, etc., are the reasons behind this condition.

If you experience:

• Daily cough with mucus
• Shortness of breath
• Frequent respiratory infections
• Fatigue

…these are common signs that you have chronic bronchitis and, if not treated on time, it can contribute to progressive lung damage and reduced oxygen levels. For prompt treatment and recovery, you need to get the condition diagnosed early.

5. Smoking and passive smoke exposure

Both active and passive smoking could contribute to the worsening chronic cough that you might have been dealing with all this while.

Tobacco smoke irritates the airways, damages the protective lining of the lungs, and impairs the natural clearing of mucus. Over time, this leads to persistent coughing, increased mucus production, and a higher risk of infections.

When it comes to secondhand smoke, especially in enclosed environment, the damage is equally bad and leads to chronic cough and other respiratory symptoms.

A smoker’s cough is often dismissed as “normal,” but it can be an early warning sign of serious conditions like COPD, lung cancer, or chronic bronchitis. Quitting smoking often leads to gradual improvement in cough, although medical support may be needed during recovery.

6. Post-infectious cough

Sometimes, the cause of a cough is a ghost of a past illness. A post-infectious cough is one that lingers for weeks after a viral respiratory infection (like the flu, a common cold, or COVID-19) has otherwise resolved.

A severe infection can temporarily damage the lining of the airways and leave the cough receptors in a state of "hyper-responsiveness." During this period, even minor irritants like dust or cold air can trigger intense coughing fits.

While these usually resolve on their own, a specialist can provide treatments to soothe the airway and speed up recovery.

7. Blood pressure medications, like ACE inhibitors

Another unsung reason behind your chronic cough could be the blood pressure medications that you are taking every day.

So, if you have recently started your hypertension medications and have developed a dry, hacking cough, your prescription might be the culprit in that case.

Angiotensin-converting enzyme (ACE) inhibitors, which are renowned for their benefits on the heart health, have a common side-effect. It causes the build-up of a substance called bradykinin in the lungs, which sensitises the cough reflex.

If you are experiencing a cough that keeps getting worse, you need to consult your doctor immediately to either switch to an alternative medication or lower to dosage until the cough resolves.

8. Serious underlying lung conditions

Beyond the above mentioned issues, experiencing chronic cough could also be a red alert by your body, indicating something more sinister that’s happening internally.

Some of the serious complications that could cause chronic cough are:

• Lung cancer
• Interstitial lung disease
• Bronchiectasis

So, if you are experiencing:

• Coughing up blood
• Unexplained weight loss
• Persistent chest pain
• Severe breathlessness

…it could be indicating towards something even worse, one that requires an in-depth analysis and evaluation. The earlier your issue is detected and treated, the better are the outcomes.

At Jindal Chest Clinic, our specialists thus emphasise on the need for timely consultations instead of brushing aside the symptoms “as normal.”

Don’t Ignore a Chronic Cough!

A chronic cough is rarely “just a cough.” It is often a symptom of an underlying condition that deserves attention. From allergies and asthma to reflux and serious lung diseases, the causes are varied, but the solution begins with proper diagnosis.

Under the guidance of our specialists, Jindal Chest Clinic utilises state-of-the-art diagnostic tools, to get to the root of your respiratory issues. We believe in a patient-centric approach that focuses on precise diagnosis and evidence-based treatment.

Schedule a consultation to address the cause today and prevent complications tomorrow!