When To Worry About A Cough That Won't Go Away

Nobody wants to deal with coughing and hacking during the holidays. But with influenza and flu-like illness activity being on the rise this season, many of us may already be experiencing such symptoms.

But just how long is it supposed to last? When could it indicate something that needs more than over-the-counter medication? Such questions would have likely crossed your mind when experiencing a particularly severe bout of coughing.

"If your cough has lasted past the 18-day mark, it may be time to see a doctor," wrote Benjamin Kaplan, M.D., an internal medicine physician at Orlando Health. If that seems a lot longer than you expected, you are not alone.

One study revealed that most patients expect a cough to last seven to nine days at most, around half the aforementioned figure. The researchers noted how this could raise the risk of unnecessary antibiotic use.

A chronic cough, defined by a duration of at least six to eight weeks, is an indicator of an underlying medical issue. However, while duration is one factor, you should take note of accompanying symptoms that could tell you when something is up. 

Gastroesophageal reflux disease, for instance, can also cause a lingering cough without heartburn. You may have a reason to suspect this, if you are left with bad breath and a sour taste in the mouth.

In addition, Dr. Kenneth Patton of Bethesda North Hospital in Cincinnati recently noted a rise in cases of a bad respiratory infection. Typically, a lingering postnasal drip (which lasts even after the infection) is to blame for the cough.

Most patients, he said, come in reporting shortness of breath which has gradually worsened, different from the flu which arrives suddenly. "They are retracting, their ribs are doing a lot of work. You can see their neck muscles, you can really see that they are having a hard time breathing," Dr. Patton said.

If you are a smoker or someone who faces second-hand exposure, you should be aware that the tobacco smoke itself could be prolonging the cough. There is also a possibility of lung cancer if the cough is accompanied by chest pain, unexplained weight loss, or bloody sputum. If you experience any of these symptoms, you should see a doctor as soon as possible to ensure early detection. 

In other cases of a chronic cough, the doctor may suspect asthma and will decide to perform a pulmonary function test, Dr. Kaplan noted. There is also a subtype known as cough-variant asthma which is harder to diagnose.

The bottom line is that you do not need to worry just because your cough has lasted over ten days. Do see a doctor if you notice that it is worsening or not responding to over-the-counter medication and home remedies. As noted, keep an eye out for accompanying symptoms as they can help your doctor make the right diagnosis.