01 August 2019

Chronic cough has many possible causes, including these 3 that are often missed

That lingering cough is not only distressing and annoying, but can have a severe impact on your quality of life.

While an acute cough usually occurs as a result of a common cold and resolves itself within a few days, chronic cough is defined as cough lasting for more than three weeks, interfering greatly with one’s normal daily activities.

According to a previous Health24 article, the most common causes of a chronic cough are post-nasal drip, acid reflux, asthma, and chronic obstructive pulmonary disease (COPD). However, in rare cases, other problems could be the cause of a nagging cough. According to Harvard Health, these are:

Airborne environmental irritants

Coughing can be triggered by environmental irritants such as air pollution and cigarette smoke. A 2009 study looked at the reaction inside the lungs when a person is exposed to specific irritants in the air, and after having “cracked the mechanism”, the researchers hoped to investigate whether they could stop people from coughing by blocking the receptor protein that triggers the cough.

A 2016 report assessed the impact of air pollution of public health in the UK, and found that every year outdoor pollution is linked to around 40 000 deaths. Air pollution, it further noted, can have a damaging effect on a baby in the womb, and can continue throughout life and later be linked to conditions like asthma, heart disease, and cancer.

According to a Health24 article, the World Health Organization (WHO) found that South Africa ranks 30th in the world for bad air quality, with Johannesburg ranked as the 99th most polluted city in the world. A Mail and Guardian article also reported on information from the World Bank, stating that air pollution kills 20 000 people in South Africa every year, costing the economy nearly R300 million. 

Some studies suggest that indoor air purifiers can have significant health benefits for people living in polluted areas. 

Heart failure

Heart failure is a serious condition and occurs when the heart fails to pump enough blood to the organs. One in three men and one in four women will develop a heart condition before the age of 60.

The Heart Rhythm Society identifies persistent coughing or wheezing as one of the symptoms appearing as heart failure gradually progresses. This is explained by a fluid build-up in the lungs, called fluid congestion, which is referred to by doctors as congestive heart failure (CHF).

If your coughing produces white or pink blood-tinged mucus, it’s time to get it checked out by a medical professional.

Aspiration during swallowing

Aspiration occurs when something enters your airway or lungs by accident, such as food or liquid, causing trouble with normal swallowing.

Trouble swallowing normally is called dysphagia, and coughing or wheezing after eating, or coughing while drinking liquids or eating solids, is one of the symptoms of dysphagia. Stroke is a common cause of the condition, but it can also be caused by other health issues.

Cedars-Sinar explains that the symptoms of dysphagia can be managed by certain behaviours, including not talking while eating, eating smaller bites of food, and using special swallowing methods. If you suspect you may have a problem with aspiration, be sure to contact your healthcare provider.

Image: iStock

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Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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