Updated 24 May 2017

When that cough just won’t go away . . .

After more than eight weeks a cough can be regarded as chronic and it becomes advisable to seek medical advice as it could be indicative of more serious illnesses.

A cough is a rapid expulsion of air from the lungs to clear the throat airways of mucus, foreign particles, fluids, microbes and various irritants.

Average of 18 days

As such it has a positive function, but if it carries on for too long it can become more than just a nuisance.   

A cough that won’t go away is referred to as a chronic cough. Many people get worried if a cough lasts more than a week to ten days, but a 2013 review found that the average cough actually lasts around 18 days.

After more than eight weeks a cough can be regarded as chronic and it is advisable to seek medical advice as it could be indicative of more serious illnesses like TB and some cancers.

A chronic cough can be exhausting, disrupt your sleep, cause headaches and even lead to urinary incontinence (especially in women). 

What causes a cough?

People who smoke or used to smoke have the greatest risk of chronic cough. Second-hand smoke also increases one’s risk.

A recent study identifies a group of people who are more sensitive than the rest of us to things that cause one to cough. This is called chronic cough hypersensitivity syndrome. Women are also more sensitive to cough triggers than men.

According to Harvard Health Publications, the following are the most common causes of chronic cough:

  • A postnasal drip can trigger your cough reflex.
  • Asthma can cause chronic coughing.
  • Infections. Pneumonia, whooping cough, flu and colds for example may leave a lingering cough even after the infections have cleared up.
  • Chronic bronchitis. Inflammation of the bronchial tubes can cause chronic coughing. This may be related to chronic obstructive pulmonary disease (COPD) and emphysema, especially in present or former smokers.  
  • Blood pressure drugs. Some high blood pressure drugs can cause chronic cough. 
  • Gastroesophageal reflux disease (GERD). This causes stomach acid to flow back into the oesophagus. This irritation can cause chronic coughing.
  • A smoker’s cough is caused by chemical irritation and can lead to other more serious conditions like lung cancer.

Some less common causes of chronic cough are:

  • Lung infections
  • Heart failure
  • Aspiration during swallowing
  • Airborne environmental irritants   

When things become serious

A chronic cough is usually not serious, but according to Harvard Men’s Health Watch, the following symptoms may indicate the need for medical intervention:

  • Chest pain
  • Coughing up blood
  • Fever
  • Lots of sputum
  • Night sweats
  • Shortness of breath
  • Weakness, fatigue, loss of appetite
  • Weight loss
  • Wheezing

 Read more:

Is your child’s cough keeping you up at night?

Winter is on its way, bringing along colds and flu

That lingering cough could be bronchitis


WebMD: Cold, Flu & Cough Health Centre.

NHS Choices: Cough.

Washington Post: When should you start worrying about that lingering cough? Give it time.


Ask the Expert

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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