Deborah Evans, Fellow of the Royal Pharmaceutical Society and mother of four, explains how to tell if your cough could be the sign of something more serious.
Although coughs can be highly irritating, they’re usually harmless.
But a cough can also be a symptom of an underlying condition. A normal acute (short-lasting) cough should clear up by the three-week mark. But if you have a cough that is proving hard to shift and has been hanging around for eight weeks or more, it has transitioned to a chronic cough and shouldn’t be ignored. Any cough that has lasted for more than three weeks and has no obvious cause should also be investigated.
You may want to speak to your pharmacist in the first instance. As a pharmacist, I can often suggest treatments and can recommend when someone should see their GP. In case you’re suspicious of your cough, this guide will help give you an idea of whether something else could be causing it.
If you’re a smoker or have just quit
Due to the long-lasting impact that smoking has on the respiratory system, smokers – and also ex-smokers – might find their cough takes longer to clear up after a cold than non-smokers. In general, smokers are more likely to develop a persistent cough due to the irritants in smoke.
But in some cases, ex-smokers actually develop a chronic cough because their body is starting to repair. As it does so, it becomes better at clearing mucus and phlegm from the lungs. This type of cough can last for several months, so stay hydrated and soothe it with a teaspoon of honey or some medicine from your pharmacy.
While a smoker’s cough is common in smokers, a chronic cough could be a sign of asthma or something more serious, so it’s important to make an appointment with your GP.
If you have a persistent dry cough
Asthma can sometimes cause a chronic dry cough. This is called cough-variant asthma. It’s often difficult to recognise because the person suffering with it may not display the usual symptoms of asthma, such as wheezing or shortness of breath – the cough may be the only sign.
If you find the cough is more prominent at night and during exercise, and can be irritated by dust, strong fragrances and cold air temperatures, it may be cough-variant asthma. Once diagnosed by a doctor, this can be treated with an inhaler, which may help it to improve.
If you are overweight or pregnant
You may be surprised to learn that a cough can be a symptom of chronic acid reflux, a condition known as gastroesophageal reflux disease (GERD). In fact, GERD is one of the most common causes of a persistent cough, and those most likely to be affected are those who smoke, are overweight or are pregnant.
This is another cause of a chronic cough that can be difficult to recognise because people who suffer with a chronic cough due to GERD don’t display classic symptoms of the disease, such as heartburn.
Other signs that you may be suffering include coughing mostly at night, after a meal, or when lying down.
After taking blood pressure medication
A chronic cough can also be a side-effect of some clinical treatments, particularly those for high blood pressure and ACE inhibitors prescribed for hypertension can cause a dry cough in some people. The onset of ACE inhibitor-induced cough ranges from within hours of the first dose to months after the initiation of therapy. Resolution typically occurs within 1 to 4 weeks after the cessation of therapy, but cough may linger for up to 3 months. Have a medication review with your pharmacist if you think your medicine is causing your cough.
If you have an allergy or irritation
Even if you don’t have asthma, it’s still possible for environmental factors to irritate your airways.
Dust, pollen, pollution and pet fur are all irritants in the air that can trigger an allergic reaction, resulting in a post-nasal drip. This is when your body produces excess mucus that can build up in the back of your throat, and can cause a persistent cough.
Try to understand your cough patterns to discover what it is that is triggering it. Usually, allergies can be easily treated, so be sure to speak to your pharmacist.
If the sound of the cough is different from normal
Whooping cough is a condition that often affects young children although adults can contract it too. The cough is characterised by the ‘whooping’ sound it causes and it can last for two to three months or more. The cough can also bring up mucus and may be followed by vomiting. The strain of the coughing can be seen on the face and can even cause slight bleeding under the skin or eyes.
Make an appointment with your doctor if you think you or your child may have whooping cough.
Antibiotics can help stop you from spreading the infection further. Meanwhile, it’s important to get plenty of rest and drink fluids.
When you need to visit your doctor
If you have any concerning symptoms it is worth booking an appointment with your GP. Coughing can sometimes indicate conditions such as, tuberculosis (TB), chronic obstructive pulmonary disease (COPD) and even lung cancer. The symptoms for these conditions vary, but you should see your doctor immediately if you’re coughing up blood.
Book an appointment with your GP if:
But remember, in most instances, a cough is just a cough, and some rest and advice from your pharmacist should help you to recover.
Deborah Evans is considered a national pharmacy leader and is an elected member of the English Pharmacy Board and Fellow of the Royal Pharmaceutical Society. Deborah does not endorse any medicine brands or products.
This blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding your own or your family’s health.
