Having a cough is a common physical complaint that causes people to go see the doctor. The cause of an acute cough starting within the last few days is usually diagnosed by clinical assessment. Chronic coughs, lasting several weeks and longer, however, can be challenging to determine the exact cause. Usually a chronic cough is a benign condition, however, it also can be due to advanced and severe disease.
The acute cough is typical in the winter with the onset of flu season. It also is common when there is a high allergen load in the air, such as in the spring or with the buildup of smog. The most common reason for these coughs is an inflammatory process such as acute bronchitis, upper respiratory infection, or asthma. Even a runny nose with post-nasal drip can cause the common cough. In some small children, and in the debilitated, an aspirated foreign body such as a toy or a coin should be considered as well.
Chronic coughs are more difficult to diagnosis because of the wide variety of possible underlying etiologies. Of most concern is a lung malignancy or a heart condition. Sometimes the chronic cough can also indicate pneumonia. This is true especially in the elderly, who may on occasion fail to run a fever in response to pneumonia. Asthma is a common cause of a chronic cough as well. Underlying cardiac conditions such as heart failure may also be the etiology of a chronic cough.
Thankfully, many of the conditions causing a cough, especially in those 45 years of age or younger, are self-limited viral infections. In these cases, time is often the cure and no pharmaceutical therapy is necessary.
At the same time, some of the severe diseases that cause a chronic cough can be completely cured with proper medical therapy. In other cases, the disease can be managed in a way that extends a person's healthy life span. Lung cancer, when caught early, can be cut out before it spreads to any other organ, and the result is a cure. Heart disease also frequently can be successfully treated, often with simple pharmaceuticals and lifestyle changes.
Keep in mind, a chronic cough can be a side-effect of something in the diet or in a pill. Some heart disease medications are particularly prone to cause a chronic cough. But if that happens almost always there is an alternative medication that will not have that side effect.
The best treatment for a chronic cough? Prevention. Eat right, exercise, and enjoy life. But if you get a cough, use some common sense and see a doctor if you have any concerns at all.
REFERENCES
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Cough. Can Fam Physician. 2007 April; 53(4): 690-691. This is a nice article on the common causes of a cough and how to diagnose them. Full text free online.
Redington AE, Morice AH. Acute and Chronic Cough (Lung Biology in Health and Disease) . Informa Healthcare; 1 edition (July 13, 2005). For the medical professional.
Domino FJ et al. The 5-Minute Clinical Consult 2012 . This is a top guide for primary care providers, and useful for any physician's reference shelf. Highly recommended.
