A cough that lasts more than three weeks in adults (or four weeks in children) needs a proper check-up, not just repeated cough syrups. Common causes include post-viral cough, asthma, nasal allergy and sinus drip, acid reflux, smoking and some BP medicines, and important causes such as TB must be ruled out. Dr A. Ashok Kumar, a pulmonologist in Chittoor, finds the cause and treats it.
Common symptoms of persistent cough
- Dry, tickly cough or cough with phlegm for more than 3 weeks
- Cough worse at night or after meals
- Throat clearing, nasal drip
- Cough after cold drinks, dust or smoke
Get urgent care if you have
- Blood in the cough
- Weight loss, fever or night sweats
- Breathlessness or chest pain
- Smoker over 40 with a changing cough
Emergency? Call 093448 53689 or 108, or go to the nearest hospital.
Causes and risk factors
Asthma, nasal allergy and sinusitis, acid reflux, after-effects of a viral infection, smoking, TB, bronchiectasis, ILD, certain BP medicines and, rarely, lung cancer.
Tests that help
Chest X-ray and HRCT chest
Pictures of the lungs. A high-resolution CT (HRCT) shows fine detail and is important for ILD, bronchiectasis, unexplained cough and lung spots. Dr Ashok arranges the right scan and explains the report with you.
Pulmonary function test (PFT) / spirometry
You blow hard into a tube while a machine measures how much air your lungs hold and how fast you can push it out. It confirms asthma or COPD, shows how severe it is and tracks whether treatment is working. Where needed, lung volumes and DLCO (how well oxygen passes into the blood) are also measured.
Sputum and TB tests
Testing a sample of phlegm under the microscope and with rapid molecular tests finds TB germs and other infections, and shows whether TB germs are resistant to medicines.
How Dr Ashok manages it
- Careful history and examination
- Chest X-ray, lung function test and sputum tests as needed
- Treating each cause: inhalers, allergy care, reflux care, stopping smoking
- Review of medicines that can cause cough
Living well
- Avoid smoke, incense and mosquito coils
- Drink warm water
- Avoid late heavy meals if reflux is suspected
- Don't keep changing cough syrups: find the cause
Questions patients ask
Should I worry if my cough lasts more than 2 weeks?
A cough over 2 weeks should be checked for TB, especially with fever, weight loss or night sweats. Most long coughs have simpler causes, but a check-up gives peace of mind and the right treatment.
Why do cough syrups not help me?
Syrups only quieten the cough. If the cause is asthma, allergy or reflux, treating that cause is what stops it.