Medicines for Chronic cough

What it is

A chronic cough is usually defined as a cough that has lasted more than about eight weeks in an adult (or four weeks in a child), as opposed to the short-lived cough of a cold or chest infection, which settles within a few weeks. A persistent cough is common and can be tiring, disruptive to sleep, and socially difficult, and it is important to assess because, while most causes are not serious, a persistent cough can occasionally be a sign of a serious condition. The most common causes in adults who do not smoke are often a few conditions, sometimes in combination: asthma (or related airway inflammation), acid reflux affecting the throat and airways, and post-nasal drip (mucus from the nose and sinuses dripping down the throat, sometimes called upper airway cough syndrome). Smoking is a very common cause, and stopping is important. Other causes include certain medicines (notably a specific type of blood pressure tablet, ACE inhibitors), chronic lung conditions (such as COPD or bronchiectasis), infections, and, importantly, though less commonly, lung cancer — which is why a persistent cough, particularly in smokers or with other warning features, is assessed. Sometimes no clear cause is found (a chronic cough that persists despite investigation).

How it is treated

Assessment aims to identify and treat the cause. A doctor will ask about the cough and associated symptoms, review medicines (for example stopping an ACE inhibitor if it may be responsible), examine the chest, and often arrange a chest X-ray, particularly to exclude serious causes. Because the common causes are treatable, a structured approach is often used — for example treating suspected asthma, acid reflux, or post-nasal drip, and seeing whether the cough improves, since these frequently overlap. Stopping smoking is essential where relevant and often improves the cough over time. Where a specific condition is found (such as asthma, COPD, or a chest infection), it is treated. Warning features — such as coughing up blood, unexplained weight loss, a change in a long-standing smoker's cough, breathlessness, or an abnormal chest X-ray — prompt more urgent investigation, sometimes via an urgent cancer pathway or referral to a chest specialist. For a persistent cough where no cause is found or that continues despite treatment, specialist assessment and specific approaches (including for "cough hypersensitivity") can help. The reassuring message is that most chronic cough has a common, treatable cause — often asthma, reflux, post-nasal drip, or smoking — and that assessment identifies the cause and, importantly, excludes serious conditions.