When To See a Doctor for a Cough

Having a cough that won’t go away can be more than just annoying — it can become debilitating.

“Patients often describe feeling dismissed by their healthcare providers,” shares pulmonologist Rachel Taliercio, DO. “Chronic cough is viewed as a symptom and not a condition that requires in-depth evaluation and management. Depression, anxiety and feelings of isolation are common.”

But what counts as a chronic cough? When should you be concerned, and what are your options? Dr. Taliercio explains what to look for and when to seek help for your coughing.

Coughing symptoms that need medical attention

No matter how long you’ve been coughing, you should always see a healthcare provider if you’re experiencing other symptoms, like:

• Severe coughing jags that last a long time and/or cause you to pass out or vomit
• Coughing up blood (hemoptysis)
• Wheezing, shortness of breath and other breathing trouble
• A cough accompanied by thick mucus
• Severe chest pains
• Other signs of illness, like a fever and/or chills

All of these can point to other health concerns, so share them with a healthcare provider ASAP.

But what if a chronic dry cough stands alone as your only symptom? Let’s get into that.

When a chronic cough warrants attention

If you’ve got a cough that you just can’t seem to kick, here’s how to tell when it’s time to see a healthcare provider.

1. You’ve had a cough for two months or more

“Chronic cough is defined as a cough that lasts for eight weeks or longer,” Dr. Taliercio clarifies. “A cough can linger for several weeks after a respiratory tract infection, and it should resolve within a month or two.”

Some people deal with a chronic cough for years before seeking treatment or receiving a diagnosis that helps them find relief.

“We commonly take care of people who have coughed for years or even decades,” Dr. Taliercio notes. “Many people go years without resolution of — or even an explanation for — their cough.”

2. You cough when you shouldn’t be coughing

A strong cold wind rustles up the air, and you start to cough. Someone steps into the elevator wearing a strong cologne, and you start to cough. You’re signing the national anthem at a baseball game, and you start to cough.

These things don’t seem to make other people cough, so why do they affect you so much? You could be dealing with cough hypersensitivity syndrome, also called neuropathic or neurogenic cough or an irritable larynx (voice box). This type of cough can be triggered by activities like talking or laughing — things that typically shouldn’t induce a cough.

“Patients describe a tickle in their throat, or the sensation of something stuck in their throat,” Dr. Taliercio explains. “This sensation often precedes a bout of coughing that can last for an extended period of time and be very distressing”

3. It’s impacting your quality of life

Chronic cough can take a toll on your social life, your self-esteem and your mental health, especially if it’s affecting other aspects of your health and getting in the way of things you love. In fact, studies show that living with a chronic cough can impact your overall quality of life — aka how good you feel, in general.

“In my experience, patients with chronic cough feel isolated”,” Dr. Taliercio says. “Sometimes, they’ve quit social activities like going out to dinner or to the movies. I’ve had patients ask me to write a letter they can show at work or in the airport, stating that they are not contagious.”

Chronic cough can also affect other areas of your health, causing issues like:

• Sore abdominal and rib muscles
• Insomnia, like if you’re waking up to cough or coughing keeps you from falling asleep
• Leaking urine when you cough (stress incontinence)
• Physical exhaustion from muscle pain and lack of sleep
• New or worsening mental health concerns, like stress, anxiety and/or depression

4. Other people in your life have mentioned your cough

You might feel like your chronic cough is something you just have to live with, or maybe you’re so used to it that you don’t realize how long it’s been going on — that is, until your partner or your sibling or your cubicle mate starts commenting on how frequent and unending it seems to be.

“Many people only seek help because a family member or friend has expressed concerns,” Dr. Taliercio says.

How long should cough symptoms last?

If you’ve had a cough that’s lingered for two or three weeks … or four … or five … you might be starting to worry: Is this normal? Or is something wrong?

“When you get a common cold, your cough should go away within days to weeks,” Dr. Taliercio explains. “It certainly shouldn’t continue to last after two months.”

Does a chronic cough mean lung cancer?

Let’s address the elephant in the room: You might’ve read that a chronic cough is one of the first signs of lung cancer — and yes, that can be the case. Lung cancer is the third most common type of cancer in the U.S., and a cough that doesn’t go away or that gets worse over time can be an early symptom.

But chronic coughing has other, more common causes, too.

“On Google, the first things that come up always seem to be the scariest or the most dangerous,” Dr. Taliercio acknowledges. “So, I always tell people to talk to their healthcare providers about what they’ve read and whether it applies to them.”

Chronic cough is often caused by one of four conditions:

• Cough-variant asthma. This type of asthma doesn’t come with symptoms like wheezing or shortness of breath. “There’s a subset of people with asthma who primarily just cough,” Dr. Taliercio explains, “and this cough can last throughout the day and night.”
• Postnasal drip. Technically known as “upper airway cough syndrome,” this common condition happens when sinus inflammation/mucus drainage leads to coughing.
• Chronic acid reflux. When you have gastroesophageal reflux disease (GERD), the acid in your airway can cause irritation that leads to chronic coughing.
• Non-asthmatic eosinophilic bronchitis (NAEB). Inflammation in your lower airways can cause a chronic cough. But unlike bronchial asthma, NAEB doesn’t cause any tightening of airways that would make it hard to breathe.

There are other possibilities, too, like cough hypersensitivity syndrome. “Cough hypersensitivity syndrome is a diagnosis of exclusion,” Dr. Taliercio says. “We consider it when our diagnostic workup doesn’t lead to one of the more common causes of chronic cough and the cough does not respond to treatment.”

What kind of doctor should you see?

Start with your primary care provider, if you have one, about your chronic cough. But if they can’t get to the bottom of it, it’s time to see a specialist — and don’t be surprised if you end up seeing a few.

“A team approach is the key to figuring out and treating chronic cough,” Dr. Taliercio notes. Providers involved in your care might include:

• A pulmonologist, who specializes in breathing (respiratory) conditions
• An otolaryngologist, also known as an ear, nose and throat specialist (ENT)
• A gastroenterologist, who specializes in the digestive system
• An allergist, who can diagnose and treat allergies and asthma

And then what? The treatment for your chronic cough, Dr. Taliercio says, depends on what’s causing it.

“Ideally, we try one therapy at a time and schedule a time to reassess and plan next steps,” she continues. “It’s critical that we get a detailed medication history that includes what you’ve tried — including dose and duration — and what has helped in the past.”

That could lead your provider to try a treatment that you think you’ve already proven doesn’t work. Let’s say, for example, that you’ve tried inhalers in the past, but they haven’t helped — but then your doctor learns that you tried one particular version and only used it for two days. They may want to try a different type of inhaler, or the same one for a different amount of time.

Can a chronic cough be cured?

There are lots of possible treatments to manage chronic cough, and your healthcare provider will work with you to figure out which works best for you. Still, depending on the cause, your cough may not go away entirely.

“I often ask patients to give me an idea of where they are right now, on a scale of zero to 10 — zero being no cough, and 10 being the worst cough of your life,” Dr. Taliercio shares. “The longer you’ve had a cough, the harder can be to get to zero.”

But significant, life-changing progress is still possible.

“Let’s say someone tells me they’ve been at an eight for five years. Our goal is to get to zero, but it might be hard to get there,” she illustrates, “so I ask them, ‘How would you feel if we got to a two or a three?’”

How to know if a cough is serious

Don’t think you have to just grin and bear it: Any cough that lasts longer than eight weeks should be discussed with a healthcare provider.

“A lot of people with chronic cough tell me they feel desperate for help,” Dr. Taliercio says, “I always tell my patients with chronic cough: You are not alone. We are here to help, and there is hope.”