8 reasons why your cough is not improving!

Coughing, a protective reflex of the body, from time to time helps clear particles and secretions from the lungs. However, sometimes a cough can become a chronic condition. A chronic cough is usually defined as a cough that lasts for eight weeks or longer. Continuous coughing can be annoying. Coughing frequently is embarrassing, can make you physically tired, make it hard to sleep, and cause you to be dizzy, hoarse, strain muscles, sweat, and leak urine (especially in women). If your cough is not improving for long time, or recurring frequently, you may have one of the following medical problem.

1. Postnasal Drip
Postnasal drip occurs when secretions from the nose drip or flow into the back of the throat from the nose. These secretions can irritate the throat and trigger a cough. Postnasal drip can develop in people with allergies, colds, rhinitis, and sinusitis.
Signs of postnasal drip include a stuffy or runny nose, a sensation of liquid in the back of the throat, and a feeling you need to clear your throat frequently. However, some people have so-called “silent” postnasal drip, which causes no symptoms other than a cough.

2. Asthma
Asthma is the second most frequent cause of chronic cough in adults, and is the leading cause in children. In addition to coughing, you may also wheeze or feel short of breath. However, some people have a condition known as cough variant asthma, in which cough is the only symptom of asthma. Asthma-related cough may be seasonal, may follow an upper respiratory infection, or may get worse with exposure to cold, dry air, or certain fumes or fragrances.

3. Acid Reflux
— Gastroesophageal reflux, also known as acid reflux, occurs when acid from the stomach flows back (refluxes) into the esophagus, the tube connecting the stomach and the throat. Gastroesophageal reflux disease (GERD) refers to symptoms caused by acid reflux. Many people with cough due to acid reflux have heartburn or a sour taste in the mouth. However, some patients with GERD have cough as their only symptom.

Other Causes —
A number of other conditions can lead to chronic cough. These include:
4. Respiratory Tract Infection —
An upper respiratory infection such as a cold can cause a cough that lasts more than eight weeks. This may be due to postnasal drip (as described above), or to irritability in the airways that developed as a result of the infection.
Sometimes bacterial tracheobronchitis or bacterial sinusitis can develop following a viral upper respiratory tract infection. In almost all cases of bacterial tracheobronchitis, patients will have a cough that produces sputum. The sputum is colored from light yellow to dark green or even brown.

5. Use of ACE Inhibitors —
Medications known as angiotensin converting enzyme (ACE) inhibitors, which are commonly used to treat high blood pressure, cause a chronic cough in up to 20 percent of patients. The cough is usually dry and hacking. Switching to another medication often improves the cough over the course of one to two weeks.
6. Chronic Bronchitis —
Chronic bronchitis is a condition in which the airways are irritated, causing you to cough, sometimes raising phlegm. Most people with chronic bronchitis are current or past smokers.

7. Lung Cancer —
Although lung cancer can cause coughing, very few people with a chronic cough have lung cancer. Cancer is possible, however, especially if you are a smoker and your cough changes suddenly, you begin to cough up blood, or if you continue to cough more than one month after quitting smoking.
8. Eosinophilic Bronchitis —
A special type of inflammation in the airways called eosinophilic bronchitis can cause a chronic cough. This is diagnosed when your breathing tests show no evidence of asthma, but your phlegm or airway biopsy shows cells called eosinophils. Eosinophilic bronchitis is much less common than asthma.

CHRONIC COUGH DIAGNOSIS
To investigate the cause of a chronic cough, your healthcare provider will ask about your symptoms and perform a physical examination.
Based upon your symptoms and examination, your clinician may recommend a trial of treatment before other testing is performed. If you improve with treatment, no further testing is generally needed. If you do NOT improve, or if your diagnosis is not clear, further testing may be recommended, such as:
1. Lung Imaging – If you are a current or former cigarette smoker, or if you have other medical conditions that can affect the lung, a chest X-ray or even a chest CT scan may be done.
2. Lung Function Tests – If asthma is suspected but cannot be confirmed, the clinician may perform lung function tests that measure the pattern of air flow into and out of the lungs.
3. Acid Reflux Testing — – To confirm a diagnosis of acid reflux, a test may be done to measure the acid level of fluid in the esophagus. This test is called a pH probe. In some people, a test called upper endoscopy will be done to look for irritation of the esophagus and to obtain a biopsy of the esophagus.