When Does a Cough Require Medical Attention?

Coughing may classified by duration:

• acute coughs last less than 3 weeks
• subacute coughs last 3–8 weeks
• chronic coughs last over 8 weeks

Most acute coughs do not arise from a serious condition. Often, a minor ailment (e.g., a cold) is the culprit. A medical evaluation is not necessary in these cases. In contrast, subacute and chronic coughs may indicate a significant medical condition. Other warning signs of a more serious ailment include chest pain, coughing up blood, shortness of breath, fever, and unexplained weight loss.

Among the most common cause of cough is a respiratory infection or “head cold.” Usually, this is due to a viral infection, and may be accompanied by sore throat, sneezing, headache, aches, fatigue, and runny nose. A medical evaluation is not necessary unless symptoms persist beyond ten days or cause significant discomfort or fever.

Allergies, a very frequent cause of cough, occur as a result of an abnormal reaction of the immune system to an otherwise harmless protein substance including animal dander, dust mites, pollens, and molds. If inhaled, these substances also invoke sneezing, runny or stuffy nose, itching of nose, eyes, and throat, and red and watery eyes. If symptoms are severe, a medical evaluation including allergy testing is appropriate. If symptoms don’t improve with medication, immunotherapy by means of allergy injections or sub-lingual tablets can alleviate symptoms by suppressing the allergic response of the immune system.

Asthma is a chronic lung disease that results in difficulty with breathing. Some episodes are triggered by exposure to allergens, irritants, or viral infections. Asthma can cause coughing that is more severe at night and disrupts sleep. Symptoms may be provoked by laughter, crying, or exertion. Associated complaints include wheezing, shortness of breath, and chest pain or tightness. Asthma requires prompt medical attention. Treatment with inhaled medications is usually effective. Severe cases may require treatment with recently approved injections that suppress the inflammation that often underlies asthma. Bronchitis, another common ailment, occurs when the airways in the lungs become inflamed. Symptoms may resolve in 2-3 weeks, but chronic bronchitis can persist for months. One may also experience headache, fatigue, nasal congestion, runny nose, sore throat, aches and chills. Symptoms usually resolve spontaneously with rest and do not require medical attention. If symptoms persist beyond 2-3 weeks, one should seek medical evaluation.

Pneumonia, another possible cause of cough, often results in expectorating thick colored discharge. Fever, shortness of breath, and chest pain may also be evident. Some patients experience nausea, vomiting, and confusion. If pneumonia is suspected, one should promptly seek medical attention. Hospitalization may also be necessary.

Gastroesophageal reflux disease (GERD) is a chronic condition resulting from the presence of stomach acid in the esophagus. “Heartburn” along with coughing, nausea, vomiting, difficulty with swallowing, and chest pain may also be noted. Non-prescription medications which suppress the effects of stomach acid are available; persistent symptoms require medical attention.

Chronic obstructive pulmonary disease (COPD) is a lung disease usually causes by smoking. Symptoms include cough, wheeze, shortness of breath, and expectoration of phlegm. Medical attention is necessary for this condition. In addition to medication, some patients may require supplemental oxygen.

In summary, one should visit a health care professional if a cough persists for longer than 3 weeks or is associated with other “red flags” such as shortness of breath, coughing up blood, chest pain, or weight loss. Allergy Partners physicians are experts in the diagnosis and treatment of cough and can help give you the answers you need and the relief you deserve.”

By Dr. Williams Harris
Allergy Partners of Orange County