Reader's Digest Asia Pacific

10 Causes of Persistent Coughing

Got a chronic cough that just won’t go away? One of these medical reasons could explain what’s going on

- BY Marissa Laliberte

HERE are some possible causes of a nagging cough.

REFLUX

Gastroesop­hageal reflux disease, or acid reflux, causes stomach contents to leak backwards into the oesophagus. Typically this causes heartburn, but in some cases, it can trigger persistent coughing and wheezing.

“Acids that are supposed to stay in the stomach come up the oesophagus and trigger a cough from the underside of vocal cords,” says respirator­y tract specialist Dr Jason Turowski.

WORSENED ALLERGIES

Irritants in the air during spring and autumn cause seasonal allergies in many people. If your usual allergy symptoms get worse or aren’t responding to your usual medication­s, your underlying allergies might require different treatment, says lung expert Dr Albert Rizzo. “A doctor might suggest inhaled steroids to help control the airwaves,” he says.

TWO INFECTIONS

If you thought you were over a virus but your cough isn’t getting any better, you might have developed a second infection. “Someone who has a cough or runny nose and suddenly has green drainage might have a bacterial

infection on top of it,” Dr Rizzo says. Check with your doctor, who might prescribe antibiotic­s.

POST-VIRUS COUGH After a virus, some people develop a cough that sticks around because their airways overreact to a virus. The smooth muscle tissue that lines the airways clamps down and traps secretions in the wrong place, Dr Turowski says. “Anybody and everybody, after a severe respirator­y condition, can develop a chronic cough,” he says.

ACE INHIBITORS

Taking ACE (angiotensi­n converting enzyme) inhibitors for high blood pressure could cause a cough, probably because they disrupt histamine pathways and inflame airways in some people, according to Dr Rizzo. Even if you’ve been taking the medication for a while, check with your doctor to see if it could be causing your cough.

BETA BLOCKERS

Not only does your heart have beta receptors, but your airways have them, too. “If activated by beta blockers, lungs can clamp down, and when they restrict, they cause a cough,” Dr Turowski says.

POOR AIR QUALITY

Persistent coughing is most common in people who live in cities or near a lot of air pollution. But working in an old office space for years could also start to irritate your lungs. “Sometimes people in old office spaces or dirty, dank environmen­ts where mould or mildew builds up develop an allergic, infectious kind of cough,” Dr Turowski says.

LUNG SCARRING

Up to 40 per cent of people who have rheumatoid arthritis also have pulmonary fibrosis, a lung disease that scars lung tissue, according to the National Institutes of Health. Rheumatoid arthritis is a systemic connective tissue disease, which means it can damage the lungs and lead to persistent coughing, Dr Turowski says. In fact, a cough might be the only early symptom of pulmonary fibrosis. “It’s difficult to detect but involves a dry cough that persists for a number of months,” Dr Rizzo says.

MISCOMMUNI­CATION FROM THE NERVOUS SYSTEM

In rare cases, the nerves might send the wrong informatio­n to the lungs, triggering a cough. “There’s some discombobu­lation and disregulat­ion in feedback with the nerves and the delicate respirator­y system,” Dr Turowski says.

DIFFICULTY SWALLOWING

If you feel like you’re choking when eating or talking, swallowing problems might be behind your persistent coughing. Dr Rizzo suggests practising swallowing exercises.

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