When to see your doctor for a cough that won’t go away

A cough that won’t go away could be more than aggravating — it might be a clue to a health concern. Maybe it started as an occasional annoyance, but now your friends are making comments or you’re afraid to attend a movie for fear of bothering others.

“Fortunately, you can usually calm the cough if you address what’s irritating your airway,” says Deepak Sapkota, MD, an internal medicine specialist at Geisinger Danville. “It’s also important to mention persistent cough to your doctor because it can indicate a more serious health problem.”

Learn what causes chronic cough and how your healthcare provider can help.

What makes a cough chronic?

Chronic coughs are coughing lasting more than 8 weeks in adults and 4 weeks in kids. Unlike acute coughs, which usually clear up in a short time and are caused by temporary illnesses like colds or the flu, a chronic cough may signal a more lasting health problem. It can interfere with your life by causing discomfort and sleep problems.

“When you visit a doctor for a cough that won’t go away, note how long it’s lasted, when it started, if it’s worse at any specific time of day, place or after eating or drinking certain foods or taking medication,” advises Dr. Sapkota. “This will help your doctor make the best treatment plan.”

What causes a chronic, persistent cough?

Coughs that won’t go away have many causes, some are common, and others are more concerning. Your chronic cough may be caused by:

Respiratory infections

This cough may begin with a cold, flu or pneumonia. They can often leave lingering inflammation and mucus, resulting in a persistent cough even after other symptoms have subsided.

“COVID-19 can linger with nasty cough, especially if you have a more severe case,” says Dr. Sapkota. “Also, lately there have been more cases of whooping cough or pertussis in adults and one of the causes could be decreased vaccine use.”

Allergies and environmental irritants

Airborne particles like pollen, dust, dander, pollution and smoke can lead to ongoing throat and lung irritation. Scented candles and wildfire smoke — even from a fire hundreds of miles away — can irritate airways as well.

“If you’re sensitive, even a brief exposure can lead to a lingering cough,” explains Dr. Sapkota.

Asthma

You can develop asthma as an adult despite not having it as a child. Your airway can tighten causing that irritated cough.

“While it can progress slowly, an asthma flare can be scary,” says Dr. Sapkota. “If you suspect you are developing asthma, seeing your doctor is a priority.”

Gastroesophageal Reflux Disease (GERD)

GERD might irritate your throat with acid, especially after you eat. If you have heartburn or a sour taste in your mouth when you start coughing, it could be a sign that your digestive system, not your lungs, needs help.

Tobacco or e-cigarette use or exposure

Tobacco or e-cigarette use can lead to chronic cough. Secondhand smoke can also cause cough for those who live with or work in areas with tobacco smoke. E-cigarettes appear a little safer for those in the room, but they emit nicotine that others can inhale. Vapor exposure is still being studied.

“Talk to your doctor about smoking/vaping cessation options as well as cough treatment,” recommends Dr. Sapkota.

Post-nasal drip

Post-nasal drip happens when excess mucus builds up in your sinuses and drips down the back of your throat. It can be caused by allergies, infections or something in the environment irritating your airway. This is the most common cause of constant cough.

You can relieve post-nasal drip at home by using a humidifier, drinking plenty of water and propping yourself up on pillows to sleep. Your doctor can help you by recommending prescription and over-the-counter medications.

Chronic Obstructive Pulmonary Disease (COPD)

COPD keeps air from flowing into your lungs and slowly gets worse over time. Smokers and those exposed to secondhand smoke are at the greatest risk. Some people get COPD without exposure to breathing hazards. Of the 16 million people in the United States with COPD, about 60% don’t realize they have it. Share consistent coughing with your doctor so you can receive medication, make lifestyle changes and possibly use oxygen to improve your breathing and lengthen your life.

Blood pressure medication or ACE inhibitors

If you have high blood pressure or heart disease, you may be prescribed a drug called an angiotensin-converting enzyme (ACE) inhibitor. Drugs in this class are used to treat high blood pressure and include:

• Lisinopril
• Benazepril
• Enalapril

A common side effect is a cough — usually dry — that gets worse at night. The cough is more common in women and can start hours or even weeks after starting the medication. For some patients the cough can severely disrupt their sleep or cause weakness in the pelvic floor.

“Even if you think your cough is caused by taking an ACE inhibitor, don’t stop taking the medication on your own,” advises Dr. Sapkota. “First, talk to your doctor about the cough, lowering the dose or shifting medications.”

Larynx and throat cancer

With throat cancer, the larynx can swell or have growths called nodules,” says Dr. Sapkota. “As the nodules get larger, they can irritate your throat and lead to a long-lasting cough. For most people, this cough is a dry, hacking sort of cough.”

In addition to coughing, larynx growths can press on the vocal cords causing a hoarse voice or press on the esophagus and cause difficulty swallowing food. You may also notice swelling or pain in the front of your lower neck, and even into your ears. Your doctor will feel your throat and could perform an ultrasound or biopsy if they have concerns.

Chronic Refractory Cough

Also called unexplained chronic cough or cough hypersensitivity syndrome, this cough appears to be related to sensitive nerves that are triggering a cough reflex. 

“Your doctors will rule out all other conditions before they diagnose chronic refractory cough,” says Dr. Sapkota. “This may take a while but have patience and persistence. There are options from speech therapy to medications that can help.”

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