How Long Is Too Long? Is My Cough Chronic?

Ask yourself these questions to determine if a lingering cough could signal something more serious.

Coughing is your body's way of expelling microbes, allergens, and other unwanted invaders from your airways. Signs a cough is getting better include one that goes away on its own in a few days or weeks. 

In contrast, some coughs can linger, lasting a month or longer, and might make you wonder if something more serious is going on. A cough that lasts eight weeks or more is chronic.

A healthcare provider should check out any cough that lasts that long, especially if you have other worrisome symptoms. Luckily, 90% of the time, post-nasal drip, acid reflux, or asthma causes chronic cough. In the minority of cases, a persistent cough can be an infection like pneumonia, chronic obstructive pulmonary disease (COPD), and even lung cancer.

Even if it's just due to a lingering cold, a chronic cough can have major repercussions, like impacting sleep or causing you to strain muscles, sweat, and feel dizzy. Your voice may become hoarse, and, in some cases, your bladder may leak.

Learn about the signs a cough is getting better. Then, if you develop a chronic cough, find out what questions you should ask to decide if you need to consult a healthcare provider.

Signs a Cough Is Improving

One of the most evident signs a cough is getting better is that it gradually improves as time passes. Most coughs, like those that occur with common colds and the flu, go away on their own within three weeks.

Generally, during that time, your cough is improving if you don't develop any of the following:

  • Fever and chills
  • Difficulty breathing and/or chest pain
  • Change in phlegm consistency and/or color
  • Change in appetite and/or energy

Those may be signs of a moderate to severe viral or bacterial infection, like bronchitis or pneumonia, which are reasons to consult a healthcare provider right away.

Also, consider asking yourself some of the following questions to figure out whether you should visit a healthcare provider.

How Long Have I Had the Cough and Is It Getting Better?

See a healthcare provider if a cough with no obvious cause lasts beyond the four-week mark, and definitely if any cough lasts longer than eight weeks.

"In general, we don't [worry] about a chronic cough until it has been present for about four weeks," Norman Edelman, MD, a senior scientific advisor for the American Lung Association, told Health. "If you've had a really bad cold, sometimes it takes six to eight weeks for a cough to go away, and I wouldn't worry about it if there's a clear-cut, obvious cause."

Your cough may be nothing serious. At the very least, a healthcare provider may be able to relieve some of your discomforts.

"In general, when someone comes in with a chronic cough, we can identify the cause and treat it," Joshua Septimus, MD, an associate professor of clinical medicine at Houston Methodist Hospital, told Health.

How Bad Is the Cough?

Consider what your cough is like. Is it just a polite little ahem that hardly anyone notices? Or is your cough severe hacking that causes you to double over and others to move far away?

"If you're coughing your head off, it's a big deal," said Dr. Edelman. "If you're waking up at night, it's a big deal."

The same goes if your coughing makes you tired or light-headed, results in chest or stomach pain, or causes your bladder to leak. All of those symptoms can indicate a chronic cough.

Extreme coughing may be a sign of something serious like an infection. Still, even if you don't have an infection, a cough that interferes with your quality of life is reason enough to seek help. Some evidence suggests that chronic cough can be a burdensome condition.

Am I Coughing Up Colored Mucus?

Common colds usually produce white or clear sputum. In contrast, yellow or green mucus may suggest a serious infection or other underlying cause.

"If you are raising colored sputum, you should see a [healthcare provider]," said Dr. Edelman.

Pay particular attention if you notice changes in your phlegm—like if the color changes or it becomes thicker or more watery. That would also require a visit to a healthcare provider.

Am I Coughing Up Blood?

Coughing up blood is a reason for concern.

"That's one of those alarm-bell symptoms that you really need to see [a healthcare provider]," noted Dr. Septimus. "The most common cause is bronchitis, but you don't want to assume that."

Other reasons for coughing up blood include:

  • Pneumonia
  • A blood clot in the lung
  • Tuberculosis
  • Lung cancer
  • An autoimmune disease, such as lupus

"If you're coughing up blood, you need a chest X-ray," said Dr. Septimus. Seek immediate medical attention if you cough up more than a few teaspoons of blood. Also, if you have other symptoms, like chest pain, dizziness, or severe shortness of breath, consult a healthcare provider right away.

Do I Have Other Symptoms?

If you have a runny nose and a sore throat, there's a good chance the cough is just from a cold. 

In contrast, other symptoms could spell bigger trouble, such as:

  • Difficulty breathing
  • Chest or abdominal pain
  • Feeling dizzy or confused 
  • Seizures
  • Trouble urinating
  • Muscle aches and pains
  • Feeling weak or unsteady
  • A fever or cough that returns or does not improve
  • Underlying health conditions that worsen 

"In the context of a cough, this is very important because it can indicate a number of different things," said Dr. Septimus. 

Research has found that asthma can come not only with a cough but also with wheezing and chest tightness. Tuberculosis typically also causes weight loss, while swelling in your legs, especially when lying down, could indicate heart failure. A fever could signal pneumonia, bronchitis, or whooping cough.

See a healthcare provider right away any time you have a high fever, if the cough or shortness of breath comes on suddenly, or if you have chest pain.

A Quick Review

If you have a cough that lasts several weeks or more, is changing in characteristic, or developing concerning associates symptoms, or you feel like something is off, it's best to see a healthcare provider about it. 

While it could be nothing, a healthcare provider can help figure out the best treatment options based on your cough and other symptoms.

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