Persistent Cough: Causes and Cures

persistent cough lasting more than three weeks.

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Like any other type of cough, persistent cough also represents a defense mechanism implemented by the body in an attempt to protect the airways from foreign and / or irritating substances, from the attack of pathogens, etc. More precisely, it is a symptom that can be triggered by a great variety of causes and that must never be underestimated, in particular when it takes on the character of persistent cough - or worse, chronic cough - as it could indicate pathologies more or less serious not yet diagnosed.

. If not adequately treated, persistent cough can easily evolve into a chronic form, significantly affecting the patient's quality of life.

: also known as persistent productive cough, it is characterized by the presence of phlegm (sputum) whose characteristics can vary according to the cause that triggered it.

Dry: it is a very annoying type of cough in which there is no production of phlegm, so there is no type of expectoration.

Depending on the time of day in which the symptom occurs, it is also possible to distinguish:

• Persistent daytime cough: occurs mainly or exclusively during the day.
• Persistent nocturnal cough: tends to occur almost exclusively during night rest.

The onset of one type of persistent cough rather than another basically depends on the causes that give rise to the symptom. Of course, in order to establish a suitable therapy, it is absolutely necessary to identify which type of persistent cough afflicts the patient.

: disease typically caused by viral infections that can give rise to a self-limiting cough (tends to resolve within two weeks), or to a persistent cough, usually - but not exclusively - of the dry type;

Tuberculosis: it is a pathology caused by the bacterium Mycobacterium tuberculosis; it is characterized by the appearance of a persistent day and night cough associated with haemoptysis (coughing blood emission).

Pneumonia and pleurisy: these are inflammatory diseases that affect the lungs and pleura and can be caused by various types of microorganisms. Generally they cause a persistent dry cough which, over time, evolves towards a greasy form with the production of phlegm.

Bronchiectasis: these are pathological conditions characterized by an "excessive dilation of the airways caused by the formation of mucus plugs, in turn, due to the presence of infections. They can cause persistent cough of the fat type.

Chronic Obstructive Pulmonary Disease (COPD): mainly caused by smoking, COPD is characterized by a chronic inflammatory state of the bronchial tree which is associated with the appearance of various symptoms, including a persistent fat-type cough that tends to occur especially in the morning , after waking up.

Asthma: is a chronic inflammatory disease that affects the bronchi. It causes a persistent cough that is generally irritating, which tends to occur mainly during the night or upon awakening.

Cystic fibrosis: it is an autosomal recessive disease characterized by the obstruction of the respiratory tract by a thick and viscous mucus. It causes a persistent cough with production of sputum.

Gastroesophageal reflux: gastroesophageal reflux consists in the ascent of acidic fluids contained in the stomach towards the esophagus. The presence of this condition can lead to the appearance of a persistent nocturnal cough that tends to become chronic if the disorder is not treated (reflux cough). The symptom is triggered by the irritating action exerted by gastric fluids during their ascent from the stomach.

Heart failure: this is a condition in which the heart is unable to pump the right amount of blood necessary for the body to carry out normal physiological activities. It can cause various symptoms, including persistent cough.

Lung and airway tumors: these are neoplastic diseases of a malignant nature that affect the respiratory system. They can cause a persistent cough that tends to become chronic and to vary its characteristics (intensity, presence of sputum, etc.) as the tumor grows and expands.

Continuous exposure to irritants, such as, for example, cigarette smoke or other substances present in particular workplaces (gases, aerosols, dusts, etc.).

(typical, but not exclusive, of pathologies of an infectious nature);

Nasal congestion and rhinorrhea (these are symptoms that can occur both in the presence of flu diseases and in the presence of allergies);

Muscle and bone pain (typical of the flu);

Sore throat (typical symptom of airway infections);

Hoarseness (can derive from the continuous tussigenous reflex that lasts for weeks);

Swollen lymph nodes in the neck

Swollen ankles and legs (a typical symptom of heart failure);

Tachycardia and heartbeat;

Unintentional weight loss

Gastrointestinal symptoms, such as, for example, stomach acidity and pain (could be due to the presence of gastroesophageal reflux);

In case of persistent cough with phlegm, presence of blood - in trace amounts or in large quantities - in the sputum (it is a rather severe symptom that can indicate various pathologies, such as serious infections - tuberculosis - and lung or airway cancers) .

Of course, the above are just some of the many symptoms that can arise in association with or following the onset of persistent cough. Symptoms can be much broader and can vary from patient to patient.

, etc.);

What other symptoms appear in association with persistent cough (for example, fever, sore throat, green or yellow phlegm, phlegm with blood, etc.);

In the presence of phlegm, its color and consistency (for example, thick, yellow-green phlegm is typical of infections, white and foamy phlegm is typical of COPD, and so on).

In addition to the collection of anamnestic data, the doctor can carry out more in-depth investigations to investigate the triggering cause of the persistent cough using means such as blood tests, CT scans, magnetic resonance imaging, electrocardiograms, gastroscopy or specialist visits (for example example, gastroenterological visit, otolaryngological examination, cardiological examination, etc.).

Obviously, the choice to carry out a certain type of analysis, diagnostic examination or specialist visit rather than another is up to the doctor alone and depends on the diagnostic suspicion formulated by him on the basis of the medical history and the medical examination carried out on the patient.

of asthmatics in the presence of asthma; administration of gastroprotectors and antacids in case of reflux cough; administration of antibiotics in the presence of bacterial infections; surgical therapy, radiotherapy and / or chemotherapy in the presence of tumors; etc.).

In fact, once the triggering factor is eliminated, the persistent cough should disappear.

However, in some cases - in addition to therapy aimed at eliminating the triggering cause - the doctor may decide to prescribe drugs for the symptomatic treatment of persistent cough, in order to relieve the patient from this annoying and persistent symptom.

Clearly, the treatment varies according to the type of cough experienced by the patient.

Dry persistent cough

To treat persistent dry cough, it is possible to resort to the use of so-called antitussive drugs or cough sedatives, if you prefer. These are active ingredients capable of "turning off" the tussigenous reflex directly at the central level where it originates ( cough nerve center).

• Codeine (Paracodina®);
• Dextromethorphan (Aricodil Tosse®).

Persistent oily cough

For the treatment of persistent oily cough it is necessary to resort to drugs that are able to facilitate the expulsion of the phlegm. For this reason, in similar situations we resort to the use of active ingredients with expectorant, mucolytic and mucoregulatory action, including remember:

• L "N-acetylcysteine ​​(FLuimucil®);
• Bromhexine (Bisolvon Linctus®);
• L "ambroxol (Mucosolvan®);
• Guaifenesina (Bronchenolo Sedativo e Fluidificante®).

The phlegm that characterizes persistent cough of the fat type must necessarily be expelled; in no case, therefore, it is possible to resort to the use of sedative drugs as is the case for persistent dry cough.

In any case, for more in-depth information about possible cough treatments, we recommend reading the dedicated article: Calming the Cough.