How Long Is Too Long? Is My Cough Chronic?

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

A little coughing can be a good thing. It's your body's way of expelling microbes, allergens, and other unwanted invaders from your airways. Most coughs go away on their own in a few days or a couple of weeks. But 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 considered chronic, according to the American Lung Association.

Whenever a cough lasts that long—and especially if it's accompanied by other worrisome symptoms–it needs to be checked out by a medical professional. Luckily, 90% of the time, it's related to post-nasal drip, acid reflux, or asthma, per UpToDate. In the minority of cases, a persistent cough can be something more serious—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 significant repercussions of its own, like making it hard to sleep or causing you to strain muscles, sweat, and feel dizzy. Your voice may become hoarse and, in some cases, your bladder may even leak.

If you have a chronic cough, ask yourself these questions to decide if you need to seek medical attention.

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

This may be your main clue that something is amiss. Most coughs—like the ones caused by colds and the flu–go away on their own within three weeks, according to MedlinePlus. These coughs also tend to get better gradually as time passes.

"In general, we don't [worry] about a chronic cough until it has been present for about four weeks," Norman Edelman, MD, 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."

If a cough with no obvious cause lasts beyond the four-week mark, and definitely if any cough lasts longer than eight weeks, see your healthcare provider, says the American Lung Association. It's probably nothing serious, but at the very least they may be able to relieve some of your discomfort.

"In general, when someone comes in with a chronic cough, we can identify the cause and treat it," Joshua Septimus, MD, 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 it severe hacking that causes you to double over and others to move far, 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."

Extreme coughing may be a sign of something serious like an infection, but even if it's not, a cough that interferes with your quality of life is reason enough to seek help. One study published in 2021 in The Journal of Allergy and Clinical Immunology: In Practice found that chronic cough was self-reported to be a burdensome condition.

Am I Coughing Up Colored Mucus?

Average colds usually produce white or clear sputum. That isn't a big deal. Yellow or green mucus, on the other hand, suggests a more serious infection or other underlying cause, according to MedlinePlus.

"If you are raising colored sputum, you should see a doctor," said Dr. Edelman.

The same goes if your coughing is making you tired or light-headed, results in chest or stomach pain, or causes your bladder to leak—all of which can be complications of chronic cough, according to a 2020 article published in Chest.

Am I Coughing Up Blood?

If you're coughing up blood, you should be concerned. "That's one of those alarm-bell symptoms that you really need to see your doctor," said Dr. Septimus. "The most common cause is bronchitis, but you don't want to assume that."

It could also be pneumonia, a blood clot in the lung, tuberculosis, lung cancer, or an autoimmune disease such as lupus, according to MedlinePlus.

"If you're coughing up blood, you need a chest X-ray," said Dr. Septimus. Per MedlinePlus, you should seek immediate medical attention if you cough up more than a few teaspoons of blood or have other symptoms such as chest pain, dizziness, or severe shortness of breath.

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, says the Centers for Disease Control and Prevention (CDC). Other symptoms, especially shortness of breath, could spell bigger trouble.

"In the context of a cough this is very important because it can indicate a number of different things," said Dr. Septimus. Not being able to catch your breath could mean whooping cough (pertussis) or asthma. It could also mean tuberculosis, COPD, lung cancer, or heart failure.

According to a 2018 article published in Patient Assessment in Clinical Pharmacy, 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 you're lying down, could indicate heart failure. A fever could signal pneumonia, bronchitis, or whooping cough.

See your 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 just won't go away (lasting weeks on end), if you are coughing up blood or yellow or green mucus, or you simply feel like something is off, it's best to see a healthcare provider about it. While it could turn out to be nothing, it could also turn out to be something, and a healthcare provider can help you determine the best treatment options based on your particular cough and other symptoms.

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