Causes of a Persistent Dry Cough
A persistent dry cough can be caused by a number of different problems. Sometimes the cause isn't too worrisome -- for example, in a post-infectious cough -- but sometimes the cause is quite serious, as in cases of heart failure or cancer. In general, a persistent dry cough can originate from your lungs, your heart, your sinuses or your gastrointestinal system 14. It can also result from medication side effects 4. While all persistent coughs ought to be evaluated by a medical professional, there are a few warning signs that should prompt earlier attention.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Respiratory Conditions
If you have asthma, your dry cough may represent an asthma flare, even if it isn't accompanied by shortness of breath or wheezing. Finally, sometimes more serious diseases are to blame. These include:
- chronic obstructive pulmonary disease
- or COPD
- interstitial lung disease
- or ILD,
- cancer
Of these diseases, COPD and cancer are principally caused by a long history of exposure to cigarette smoke, while ILD can occur spontaneously, or result from exposure to a variety of toxic materials -- for example, mold, or some medications, such as amiodarone (Cordarone).cause
- Of these diseases
- COPD
- cancer are principally caused by a long history of exposure to cigarette smoke
- while ILD can occur spontaneously
- or result from exposure to a variety of toxic materials -- for example
- mold
- or some medications
- such as amiodarone (Cordarone)
Cardiac Conditions
Constant Dry Throat
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If your heart isn't pumping properly, a condition called congestive heart failure, or CHF, can develop. CHF results in blood backing up into the lungs. The fluid component of blood then seeps out of your circulation and into spaces in the lung which are normally fluid-free, which causes coughing. CHF usually results from years of high blood pressure or coronary artery disease. Interestingly, a class of medications called angiotensin-converting enzyme, or ACE, inhibitors, which are often given to patients with CHF to prevent further cardiac deterioration, can cause a dry cough. So, if you already have CHF and are on an ACE-inhibitor, it can sometimes be difficult to decide whether your cough is due to your CHF, or due to your medication.
- If your heart isn't pumping properly, a condition called congestive heart failure, or CHF, can develop.
- So, if you already have CHF and are on an ACE-inhibitor, it can sometimes be difficult to decide whether your cough is due to your CHF, or due to your medication.
Post-Nasal Drip
Chronic sinusitis, whether as a result of infection or allergy, can lead to post-nasal drip. The fluid in your sinuses drains into your nose, and from there, into the back of your throat. Once in the back of your throat, this mucous triggers a coughing reflex. Chronic sinusitis can be a difficult condition to diagnose, but is often identified by symptoms such as chronic headache and nasal congestion.
- Chronic sinusitis, whether as a result of infection or allergy, can lead to post-nasal drip.
- Chronic sinusitis can be a difficult condition to diagnose, but is often identified by symptoms such as chronic headache and nasal congestion.
Gastrointestinal Conditions
Medical Reasons for Constant Dry Cough
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Gastroesophageal reflux disease, or GERD, is a condition in which stomach acid refluxes into the esophagus. If this acid travels high enough, it can wind up in your throat, a condition called laryngopharyngeal reflux, or LPR. This can irritate your throat and cause a cough in the same way as post-nasal drip. GERD is usually diagnosed on the basis of typical symptoms; the sensation of reflux, an acid taste in your mouth, or discomfort in your upper stomach all can suggest this disease. LPR may be suspected if you have a hoarse voice, dry cough or a constant need to clear the throat.
- Gastroesophageal reflux disease, or GERD, is a condition in which stomach acid refluxes into the esophagus.
- GERD is usually diagnosed on the basis of typical symptoms; the sensation of reflux, an acid taste in your mouth, or discomfort in your upper stomach all can suggest this disease.
Warning Signs
A dry cough lasting more than a week or so probably deserves a workup by a trained medical professional, particularly if it's getting worse or if you have no clear explanation for why it's occurring. That said, there are a few cases in which help should be sought sooner rather than later. These include a dry cough associated with weight loss, fatigue, shortness of breath, abnormal leg swelling or coughing up blood.
Related Articles
References
- Harrison's Principles of Internal Medicine, Eighteenth Edition; Dan L. Longo, M.D., et al.
- Tintinalli's Emergency Medicine: A Comprehensive Study Guide, Seventh Edition; Judith Tintinalli, M.D., et al.
- Current Medical Diagnosis and Treatment, 2014; Maxine A. Papadakis, M.D., et al.
- Principles and Practice of Hospital Medicine; Sylvia C. McKean, M.D., et al.
- Gibson P, Wang G, Mcgarvey L, et al. Treatment of unexplained chronic cough: CHEST guideline and expert panel report. Chest. 2016;149(1):27-44. doi:10.1378/chest.15-1496
- Irwin RS, French CL, Chang AB, Altman KW. Classification of cough as a symptom in adults and management algorithms: CHEST guideline and expert panel report. Chest. 2018;153(1):196-209. doi:10.1016/j.chest.2017.10.016
- Harvard Health Publishing, Harvard Women's Health Watch. By the way, doctor: what causes acid reflux in the throat? Updated August 2, 2019.
- Yıldız T, Dülger S. Non-astmatic eosinophilic bronchitis. Turk Thorac J. 2018;19(1):41-45. doi:10.5152/TurkThoracJ.2017.17017
- Michaudet C, Malaty J. Chronic cough: Evaluation and management. Am Fam Physician. 2017;96(9):575-580.
- French CT, Irwin RS. Cough. Am J Respir Crit Care Med. 2016;194(8):P15-P16. doi:10.1164/rccm.1948P15
- Field SK, Escalante P, Fisher DA, Ireland B, Irwin RS. Cough due to TB and other chronic infections: CHEST guideline and expert panel report. Chest. 2018;153(2):467-497. doi:10.1016/j.chest.2017.11.018
- Ng LP, Goh PS. Incidence of discontinuation of angiotensin-converting enzyme inhibitors due to cough, in a primary healthcare centre in Singapore. Singapore Med J. 2014;55(3):146-9. doi:10.11622/smedj.2014034
- Harle A, Molassiotis A, Buffin O, et al. A cross sectional study to determine the prevalence of cough and its impact in patients with lung cancer: a patient unmet need. BMC Cancer. 2020;20(1):9. doi:10.1186/s12885-019-6451-1
- American Heart Association. Warning signs of heart failure. Updated May 31, 2017.
- Gildea TR, Dacosta byfield S, Hogarth DK, Wilson DS, Quinn CC. A retrospective analysis of delays in the diagnosis of lung cancer and associated costs. Clinicoecon Outcomes Res. 2017;9:261-269. doi:10.2147/CEOR.S132259
- Del ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR. Missed lung cancer: when, where, and why? Diagn Interv Radiol. 2017;23(2):118-126. doi:10.5152/dir.2016.16187
- American Cancer Society. Lung cancer risks for non-smokers. October 31, 2019.
- Turner RD, Bothamley GH. Chronic cough and a normal chest X-ray - a simple systematic approach to exclude common causes before referral to secondary care: a retrospective cohort study. NPJ Prim Care Respir Med. 2016;26:15081. doi:10.1038/npjpcrm.2015.81
- Dąbrowska M, Grabczak EM, Arcimowicz M, et al. Causes of chronic cough in non-smoking patients. Adv Exp Med Biol. 2015;873:25-33. doi:10.1007/5584_2015_153
- Damaraju D, Steiner T, Wade J, Gin K, Fitzgerald JM. Clinical problem-solving. A surprising cause of chronic cough. N Engl J Med. 2015;373(6):561-6. doi:10.1056/NEJMcps1303787
- Kasper DL, Fauci AS, Hauser SL. Harrison's Principles of Internal Medicine. New York: Mc Graw Hill Education, 2015. Print.
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Alex Folkl has been writing for more than eight years and has had work appear in several peer-reviewed and non-peer-reviewed scientific publications. He has a bachelor's degree in biology, a master's degree in pathobiology, and an MD.