An occasional cough is normal — it helps clear irritants and secretions from your lungs and prevents infection. However, a cough that persists for weeks is usually the result of a medical problem. In many cases, more than one cause is involved. The following causes, alone or in combination, are responsible for the majority of coughs:
- Postnasal drip. When your nose or sinuses produce extra mucus, it can drip down the back of your throat and trigger your cough reflex. This condition is also called upper airway cough syndrome (UACS).
- Asthma. An asthma-related cough may come and go with the seasons, appear after an upper respiratory tract infection, or become worse when you’re exposed to cold air or certain chemicals or fragrances. In one type of asthma (cough-variant asthma), a cough is the main symptom.
- Gastroesophageal reflux disease (GERD). In this common condition, stomach acid flows back into the tube that connects your stomach and throat (esophagus). The constant irritation can lead to coughing. The coughing, in turn, worsens GERD — a vicious cycle.
- Infections. A cough can linger long after other symptoms of pneumonia, flu, a cold or other infection of the upper respiratory tract have gone away. A common but under-recognized cause of a cough in adults is pertussis, also known as whooping cough. Cough can also occur with fungal infections of the lung, tuberculosis (TB) infection or lung infection with nontuberculous mycobacterial organisms.
- Chronic obstructive pulmonary disease (COPD). COPD, a chronic inflammatory lung disease that causes obstructed airflow from the lungs, includes chronic bronchitis and emphysema. Chronic bronchitis can cause a cough that brings up colored sputum. Emphysema causes shortness of breath and damages the air sacs in the lungs (alveoli). Most people with COPD are current or former smokers.
- Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause cough in some people.
- Environmental factors: Exposure to smoke, pollution, and chemicals can irritate the airways and cause coughing.
Less commonly, cough may be caused by:
- Aspiration (food in adults; foreign bodies in children)
- Bronchiectasis (damaged, dilated airways)
- Bronchiolitis (inflammation of the very small airways of the lung)
- Cystic fibrosis
- Laryngopharyngeal reflux (stomach acid flows up into the throat)
- Lung cancer
- Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
- Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)
- Idiopathic pulmonary fibrosis (chronic scarring of the lungs due to an unknown cause)
Risk factors
Being a current or former smoker is one of the leading risk factors for cough. Frequent exposure to secondhand smoke also can lead to coughing and lung damage.