Updated 24 August 2017

Causes of chronic cough

What are the most common causes of a chronic cough and what are warning signs that I should be aware of that something is really wrong?


What are the causes of chronic cough?

Upper airway cough syndrome (UACS) – previously known as Post-nasal drip

GORD (Gastro-Oesphogeal Reflux Disease)

Cough-variant asthma

Chronic Bronchitis

COPD (Chronic Obstructive Pulmonary Disease)


Lung Cancer



ACE Inhibitors (anti-hypertensive medication)


Interstitial Lung Disease

Heart Failure

When to see a doctor

Severe, ongoing loss of weight
– TB and lung cancer may present with cough and marked loss of weight. A doctor should definitely investigate this sign.

Cough up blood (Haemoptysis) – haemoptysis should always be investigated with at least a chest XR. Causes include lung cancer, TB and other infections

Drenching night sweats with fevers – one of the hallmarks of TB is drenching night sweats requiring you to change your bedclothes and sheets. These night sweats and fever are due to the hormones (cytokines) produced by your body in response to the TB infection

Worsening Shortness of Breath (Dyspnoea) – any form of shortness of breath should be assesses by a doctor particularly if it is getting progressively worse. This may only manifest during exercise, as you are not able to perform the activities that you could normally.

Chest Pain – a doctor should assess any form of chest pain. Causes include a wide range of diagnoses including angina, pulmonary emboli (clots in he lungs), acid reflux (GORD) to pneumonia thus professional assessment is a must!

 Compiled February 2011 by Dr. Greg Symons [MB. ChB, DipPEC, FCP (SA), Cert. Pulm. (SA)], Consultant Pulmonologist, Division of Pulmonology, Department of Medicine, Groote Schuur Hospital & Clinical Researcher, UCT Lung Institute (Pty) Ltd in George Street, Mowbray. Contact the UCT Lung Institute on ph 021 406 6850.  


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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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