Chronic Cough: Causes and Treatment

Health Professional

A giveaway sign of COPD is the development of a chronic (it’s always there) cough. So what makes a cough chronic, and what can be done about it?

First, what is a cough?  It’s a natural, primitive reflex. When foreign irritants and mucus enter the back of your throat it causes a tickle.  The Mayo Clinic says this causes nerves in the area to send an impulse to your brain to cause muscles in your abdomen and chest to contract and push a strong force of air through your airway to expel the unwanted particles or mucus. The force of air in a healthy person can reach up to 500 miles per hour.

A cough is part of a complex immune response that also involves:

  1. Goblet cells: These are cells that are scattered throughout your airways. When foreign particles get into your airways, your immune system sets off a series of reactions that cause goblet cells to produce sputum. This helps to ball up particles.
  2. Cilia.  These are fine hair-like structures that wave in rhythmic fashion. They work together and act like an escalator, moving mucus to your upper airway. Once in your upper airway mucus is called sputum.
  3. Expectorate or swallow.  Sputum tickles your upper airway. This causes you to cough and spit it out. Swallowing is also acceptable, as acids in your stomach will destroy the sputum.

And there are different kinds of coughs, too:

  1. Random Coughing.  It’s good because it helps keep you healthy by keeping your airways open and free from infection. It makes sure your breathing stays easy.
  2. Frequent Coughing.  A frequent cough can become annoying and even burdensome. Colorful sputum (yellow, brown, red, etc.) indicates a lung infection you should see a doctor for.
  3. Chronic Coughing.  It’s defined as a cough and increased sputum production at least three months a year for two straight years. It can be diagnosed as chronic bronchitis, although when it occurs with loss of lung function it’s usually diagnosed as COPD.

What causes a chronic cough? A common cause is chronic exposure to tobacco smoke. Chemicals in the smoke cause airway changes, such as:

  1. Cells lining airways become inflamed.  This is caused by your immune system attacking harmful chemicals year after year after year.
  2. Chronically inflamed airways become thicker. This is due to scarring. Thicker airways become chronically narrowed, resulting in airflow obstruction. This may make it difficult to generate enough flow to produce an effective cough.
  3. The number of goblet cells increase.  This increases the amount of mucus produced in response to irritants.
  4. Cilia are destroyed.  This makes it difficult to bring up sputum. This, along with increased sputum, can cause a constant tickle in the back of your throat triggering the cough response.
  5. Excessive secretions. These can block already narrowed airways causing increased airflow obstruction and flare-ups. They can also create breeding grounds for bacteria, resulting to pneumonias and flare ups.
  6. Chronic cough.  All of these combined cause constant irritation of airways, resulting in a cough that’s seemingly always present. Some call it a smoker’s cough.

How do you treat a chronic cough?   Again, it’s important to understand that a cough keeps airways clear and breathing easy. If sputum is present in your airway, you’ll want to cough it out. That said, there are things your doctor can recommend to help relieve your cough and improve the quality of your life.  These include:

  1. Quitting smoking. While this will not undo damage already done, studies suggest it will slow the natural progression of the disease.  We offer tips to quitting smoking in our post, “6 Tips to Quitting Smoking.”
  2. Coughing techniques. Various techniques are available that can help you produce a more effective cough.  These are discussed in our post “Best Coughing Techniques for COPD.
  3. Medicinal options.  Various medicines are available to open your airways, release trapped secretions, keep airways open, and reduce the amount of sputum produced. Some of these are discussed in our post, “Top 10 COPD Medicines.”
  4. Staying hydrated.  Dry mucus membranes are easily irritated resulting in flare ups. This is especially true during winter months when the air is dry. Drinking plenty of water can help keep them moist and less sensitive. Water also helps to thin mucus so it’s easier to cough up. As a general rule, most experts recommend 8-10 cups of water every day.
  5. Humidifier.  Dry air, or air with a humidity less than 30 percent, can trigger flare-ups. This is especially true during winter months. For this reason, most experts recommend you keep humidity in your home between 30-50 percent.

Conclusion.  Knowing that smoking can cause a chronic cough is a good reason to discourage kids from ever lighting up in the first place. For those who already have a chronic cough, the good news is that there are some nice options to help you live better with it.

You may also enjoy reading:

Your Journey Down the Respiratory Tract

What is Chronic Bronchitis?

Natural progression of the disease

Tips to Quitting Smoking

Best Coughing Techniques for COPD

10 Popular COPD Medicine