6 Reasons Your Chronic Cough Hasn’t Stopped

A chronic cough is not just uncomfortable and disruptive, it could also indicate a more serious health issue.

Woman in bed coughing

Bursting into a coughing fit is inconvenient, not to mention uncomfortable, especially if the cough has been lingering for weeks. If this describes your situation, you could have a chronic cough. Not only would it interrupt your speech and disrupt your sleep, but it also probably creates major discomfort in your throat and chest. 

Your cough can be defined as chronic if it persists for longer than eight weeks. This hacking could be a sign of something more serious. But not to worry, there are some probable causes of your chronic cough and methods of treating it. 

Other Symptoms that Present with Chronic Cough 

  • A runny or stuffy nose 
  • A feeling like liquid running down the back of your throat (postnasal drip) 
  • Throat clearing and a sore throat 
  • A hoarse throat and voice 
  • Wheezing and shortness of breath 
  • Heartburn or a sour taste in your mouth 
Woman holding chest feeling pain
A chronic cough can be accompanied by other symptoms such as a runny nose, wheezing and shortness of breath.

Coughs According to Traditional Chinese Medicine (TCM) 

TCM categorises coughs into two main types. According to physician Vong U Chan, the first type is caused by external pathogens, are acute and usually happens for a short duration.

The second type is caused by internal functional imbalances. Those coughs last longer, develop gradually and can develop into chronic coughs.

“Coughs are not only related to the Lungs,” she says. “In TCM, internal functional imbalances in the Lungs, Liver, Spleen and Stomach can all result in a chronic cough.” 

These are the four types of coughs in TCM: 

The Lung-Yin Deficiency cough  

This is characterised by a short dry cough, sometimes accompanied by scanty and sticky white phlegm. If you have this type of cough, you will often also experience symptoms related to yin (陰) deficiency, such as a dry nose, mouth and throat, flushed cheeks, a sore throat and night perspiration. 

The Liver Fire cough 

A person with Liver Fire cough produces a high-pitched cough that occurs in bursts, feels pain in the chest and rib area, and produces sticky yellow phlegm that is difficult to expectorate. Breathlessness, tightness around the chest, headaches, dizziness, a flushed face, a dry throat, constant thirst, and constipation are also common. A bitter sensation in the mouth is common too.

Phlegm-Dampness cough 

This is a continuous cough with a heavy turbid sound that produces great quantities of white, watery or foamy phlegm. It is aggravated by sweet, fried and oily food. If you have this type of cough, you will usually complain of indigestion, a feeling of fullness in the chest, poor appetite, fatigue and loose or watery stools. 

Phlegm-Heat coughs 

Phlegm-Heat coughs are rough, husky coughs accompanied by rapid breathing, thick yellow or blood-tinged phlegm that is difficult to expectorate, and distension or pain in the chest. Aversion to heat, dry and sticky aftertaste in the mouth and feeling thirsty are also common. 

Causes of Chronic Cough 

Most chronic coughs are caused by the following: 

Postnasal drip 

This happens when your nose or sinuses produce extra mucus. The mucus drips down the back of your throat, triggering your cough reflex. It is also known as upper airway cough syndrome (UACS). 

Asthma 

If your chronic cough is asthma-related, it can present after an upper respiratory tract infection or when you are exposed to cold air, chemicals and fragrances.

Gastroesophageal reflux disease (GERD) 

This is when stomach acid flows back into the esophagus that connects your stomach and throat, causing irritation and leading to chronic coughing. The coughing worsens GERD and it becomes a vicious cycle.

Illustration of abstract viral infection causing chronic disease
 A chronic cough could be infection-related.

Infections 

A common cause of chronic cough in adults is pertussis, or whooping cough. It 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 affects those who are smokers or who used to smoke. It is a chronic inflammatory lung disease that causes obstructed airflow from the lungs and includes chronic bronchitis and emphysema.

Taking blood pressure drugs 

If you have high blood pressure or heart failure and have been prescribed Angiotensin-converting enzyme (ACE) inhibitors, that can be a cause of chronic cough. 

Preventing chronic cough 

In TCM, the lungs occupy the uppermost position among the five organs. It is delicate in character and is connected to the external environment, meaning it is most susceptible to attack by external pathogens. To prevent a chronic cough, you should always protect yourself from external pathogens to prevent an acute cough from developing into a chronic one.

Physician Vong advises that you should always keep yourself warm by wearing clothing to avoid wind from entering the body. “It is also important to strengthen the body’s qi (which is yang in nature),” she says. “Hence, avoiding the cold (be it cold food or a cold environment) is one way to preserve one’s yang qi. Treat any acute cough timely to prevent it from developing into a chronic cough. 

 Cup of hot tea
Avoiding cold food and cold environments can preserve one’s yang qi. Stick to hot drinks like tea.

Treating a chronic cough 

Some strategies that can be implemented to manage a chronic cough include the following: 

– Stop smoking 
– Avoid triggers that cause the chronic coughing 

– Stop using an ACE inhibitor and switch to an alternative anti-hypertensive 

TCM recommends a combination of herbs depending on the type of cough. Physician Vong states, “A cough is a very tricky illness – it is not simply about suppressing the cough, but rather, helping the Lung to regain its function of descending and ascending action of qi to allow regular movement of overall qi in the body, and treating the organ that is the root cause for the persistent cough. Hence, there is no one-size-fits-all solution for a chronic cough.” 

The following are some common prescriptions used for the various coughs:  

– Lung-Yin Deficiency cough: Sha shen mai dong tang, (沙参麦冬汤), Lily Gujin soup {百合固金汤) 

– Liver Fire cough: Dai clam powder (黛蛤散), Drain the White Powder (泻白散)  

– Phlegm-Dampness cough: Er chen tang (二陈汤), San zi yang qin tang (三子养亲汤) 

– Phlegm-Heat coughs: Qing jin hua tan tang (清金化痰汤

– Acupuncture can also relieve chronic coughs, though it is most effective during its early stages.

– Hou Ning Powder (喉宁药粉): Contains Capra hircus bezoar and is used to relieve cough, bronchitis and asthma, and reduce phlegm. 

Because there are many COVID patients who are recovering from a cough as a symptom, it is highly recommended that you seek treatment from a doctor or licensed TCM practitioner to identify the root issue of your chronic cough and be prescribed the correct medication. 

References

  1. NIH. Chronic Cough in Adults: Make the Diagnosis and Make a Difference [online] [Accessed 21 April 2022] 
  2. NIH. 2018. Managing patients with chronic cough: challenges and solutions [online] [Accessed 21 April 2022] 

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