Should I Worry About My Chronic Cough?

A long-term cough can be due to post-nasal drip, acid reflux, asthma or, in rare cases, cancer

Adam Rosenbluth, M.D.,

AARP

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Published January 27, 2025

illustrated gif of someone coughing in an armchair

James Yates

I have been coughing for several months. Why do I cough so much? Should I be worried?

Around 30 million people a year visit their health care provider because they’re coughing. Even though misery may love company, it won’t stop your hacking. So, let’s go over the most common causes of a long-term cough and then discuss ways you can relieve it.

A chronic cough is defined as one that lasts more than eight weeks. Often this type of cough is the symptom of another condition.

Thankfully, cancer is a very unlikely one. If you’re not experiencing additional symptoms such as coughing up blood, chest pain or significant weight loss, your chronic cough is probably the result of one of these three conditions: post-nasal drip, acid reflux or asthma. This trifecta is the issue behind 90 percent of all chronic coughs.

To find out which underlying condition you may have, you’ll need to see your health care provider. Your doctor will take a detailed medical history, give you a physical exam and, depending upon other information, may order further testing.

If along with your cough, you have a stuffy or runny nose, a feeling that there’s liquid in the back of your throat and a frequent urge to clear your throat, my first thought would be that you have post-nasal drip. You may need to make an appointment with an ENT (ear, nose and throat doctor) to be sure.

The ENT will perform an endoscopy, a procedure that uses a little camera to look inside your nose and throat. Allergies, a sinus infection or certain medications (such as those for high blood pressure) might be contributing to your post-nasal drip. Your ENT can prescribe over-the-counter antihistamines and decongestants to help. Stronger prescription medications are also available.

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Another common cause of chronic coughing is acid reflux, also known as GERD — gastroesophageal reflux disease. Around a third of all Americans experience an episode of acid reflux every week. It happens when acid from your stomach flows back into your esophagus, which is the tube that connects your stomach and throat. You may have other symptoms too, like a sour taste in your mouth or heartburn, but plenty of people only experience a chronic cough.

Acid reflux can be "silent," meaning it’s not always associated with indigestion. I frequently mention reflux/GERD as a possible reason for a chronic cough to my patients. They are often surprised and respond with something like "… but I don't have any stomach issues.”

Different treatments are available for acid reflux. Your doctor might suggest antiacids, histamine blockers or proton pump inhibitors and prokinetic agents. I don’t want to get into specifics about how these medications work. Instead, I suggest you discuss them with your doctor.

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Some lifestyle changes help acid reflux, including losing weight if your BMI is high, avoiding big meals and staying away from foods that make your reflux worse, which can include citrus fruits, chocolate, caffeine and spicy or fatty foods. It’s not good to lay down for several hours after a meal, either. Taking a walk when you’re finished eating is a better choice.

There’s a likelihood that asthma might be the reason for your cough, since it’s the second-leading cause of coughing in adults. Acid reflux can actually exacerbate asthma. A primary symptom of asthma is inflamed or constricted airways, which can lead to coughing episodes. Common allergies to irritants like dust mites, mold, pet dander and pollen can trigger an asthmatic episode and bring on a bout of hacking. Avoiding these triggers is a great way to help prevent coughing. A combination of inhalers and oral medications can also help treat your asthma.

It’s no fun to endure chronic coughing. It can irritate your lungs and cause sleepless nights, daytime fatigue, even dizziness and headaches. You’ve waited long enough. I hope you make an appointment with your doctor soon and get to the bottom of it.