Acute vs. Chronic Cough: What Is It Really Trying To Tell You?

Want to be the least popular person in a crowd? Start coughing. You will surely draw the attention of everyone within earshot—and probably not in a good way. You may even notice people inching away from you and your perceived germs, (whether real or not). But, if strangers can interpret the signs and symptoms of a cough so quickly, why are we sometimes last to pay attention to it? Here’s what’s true: A cough is an important symptom that’s trying to tell you something.

The Anatomy of a Cough

Your cough begins when nerve endings send a cough impulse to the brain as a response to an irritant in your throat and airways. Signals from the brain stimulate the chest wall to push air out of your lungs. Therefore, a cough is designed to push foreign matter out of the body to protect you. With the power of your lungs, the irritant is expelled through your mouth with an airspeed force of up to 500 miles per hour! The velocity of a cough is fast moving, which is why it’s important to cover your mouth to help stop the spread of germs.

Since coughing is essentially your body’s response for clearing up irritants in your breathing passages, it’s important to find out what exactly is causing the problem. There are a number of possibilities:

• Exposure to smoke, dust, or chemical fumes
• Upper respiratory infections of the lungs, including flu and pneumonia
• Asthma or allergies causing inflammation or other conditions including chronic bronchitis or chronic obstructive pulmonary disease (COPD)
• A more serious condition causing the problem and you may need to see a doctor right away

An untreated cough that persists and is forceful can cause exhaustion, sleeplessness, headaches, urinary incontinence, and even broken ribs. So it’s important to find out the cause.

Acute versus Chronic—How Long Has This Been Going On?

A good way to evaluate the seriousness of a cough is by figuring out how long you’ve had it. A cough is considered acute when it lasts fewer than three weeks and chronic when it lasts more than eight weeks. There’s also a middle category—a cough is subacute if it lasts three to eight weeks.

Acute cough is common. Something as simple as a common cold or seasonal allergies and hay fever can cause acute cough, in which case self-care may be needed for symptom relief. There are a few things to consider when an acute cough is more serious (and you need to see a doctor). For instance:

• If it occurs with other symptoms, such as a cough plus a fever, chest pain, shortness of breath, or green or blood-tinged phlegm output. These may be signs of severe flu, pneumonia, tuberculosis or other respiratory illnesses.
• If it sounds unusual, such as wet, dry, scratchy, productive, hoarse, or barking. These can help signify the underlying cause. A good example is pertussis, a serious illness that has a whooping-like sound with the cough.

Chronic cough may mean you need medical attention. Chronic cough is commonly caused by:

• Smoking cigarettes or other tobacco products is the major cause of chronic bronchitis
• Asthma
• Post-nasal drip (also called upper airway cough syndrome)
• Gastroesophageal reflux disease (GERD)

Other less common causes include certain medicine side effects, long-term lung diseases, exposures to airborne pollutants, and long-lasting infections. Few people who have a cough will have lung cancer, but most people with lung cancer will have a persistent cough as an early symptom. The same is true for heart failure, a condition in which fluid builds up in the lungs and causes a chronic cough.

Treat Beyond the Symptom

Although the cause of some coughs may remain unknown, most can be found after a healthcare professional conducts evaluations with blood tests, chest x-rays, and other imaging. The good news is that there is an array of therapies for most kinds of coughs—from medications to speech therapy.

Identifying what’s causing your cough is important. In most cases, if you listen to what your body is trying to tell you, and see your doctor for appropriate treatment as necessary, you can usually shake that cough. You may also want to consider making lifestyle changes that include more physical activity, quitting smoking if you smoke, and avoiding irritants and allergens. These are just some of the steps you can take that may help you recover from the condition that’s causing that cough.

Dr. Roslyn F. Schneider was previously the Global Patient Affairs Lead driving patient-centricity within Pfizer's Medical Organization. Previously, she was also in clinical practice and medical education for twenty years in New York City.

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