What’s causing that cough?

If you are nursing a nasty bark as the weather changes, the reason could be anything from heartburn to heart trouble

So your cold's long gone, but have you now been left with a lingering cough that is keeping everyone awake and annoying colleagues? New research shows the average time for a cough to last after a virus is an exhausting 18 days — with many coughs sticking around even longer.

Coughing has an important purpose, say experts. It's your body's way of keeping unwanted stuff from getting into your lungs. But unfortunately, post-virus, this irritating symptom can linger. The majority of viral coughs are safe to treat at home, but you may need your GP's help to shift it if it develops into a secondary chest infection.

However, some persistent coughs aren't viral at all. Anything still bashing away after three weeks needs investigating, say doctors. Prolonged coughs can be a sign of anything from asthma and heartburn to more serious lung disease — especially in smokers who often wrongly assume their cough is just par for the course.

Here are the six most common cough causes, and their treatments.

1. Post-viral cough
An irritating cough following a cold.
Causes: It's normal to have a cough with a virus, as it's triggered by mucus draining down the back of the throat. The inflammation this causes often stays long after the initial illness.
Treat it: Some 90 per cent of cases aren't bacterial, so antibiotics won't help. Use an over-the-counter syrup to loosen phlegm, or even just a hot drink, which promotes secretions in the airways, soothing irritation.

2. Heartburn
A 'throat' cough following a meal, or waking you at night, often with a nasty acid taste in your mouth.
Causes: Heartburn, or acid reflux, occurs when stomach acid flows back up the oesophagus, irritating the throat and triggering a cough. Large or rich meals late at night are triggers.
Treat it: Sleeping with an extra pillow can help reduce the backflow of acid. If it's occasional, an overthe-counter antireflux treatment should cure. If it's frequent, talk to your GP who may want to investigate.

3. Chest infection
A hacking cough with greenish phlegm, plus a fever that follows after a cold. Causes: A chest infection, or acute bronchitis, affects the lower airways. It's generally caused by the same viruses that cause colds, but inflammation spreads lower into the lungs, leaving the area open to attack by bacteria.
Treat it: Drink plenty of fluids and take paracetamol to reduce a fever. Because most bronchitis is caused by a virus, your doctor will only prescribe antibiotics if he suspects a secondary bacterial infection has occurred.

4. Medication cough
A dry, niggling cough, often worse at night.
Causes: ACE inhibitors, a drug used to control high blood pressure, can cause a chronic cough in 20 per cent of patients.
Treat it: If your cough coincided with starting a medication, talk to your doctor who can supply alternative blood pressure drugs.

5. Smokers' cough
It's easy to get used to a smokers' cough but if it changes in any way, for example, becomes more frequent or you cough up blood, it needs to be taken care of immediately.
Causes: Smoking irritates the airways causing a cough, which in the long-term can be a sign of COPD — Chronic Obstructive Pulmonary Disease, including emphysema and chronic bronchitis — meaning there's irreversible damage to your airways, worsening if you continue puffing away.
Treat it: If you're a smoker or exsmoker with a persistent cough, your GP should send you for X-ray. It's never too late to quit — giving up will lessen or abolish the cough in 94 per cent of people within four weeks, and will stop the rate of deterioration in COPD cases.

6 Heart problems
Persistent coughing or wheezing, plus extreme tiredness, breathlessness on exertion and fluid retention.
Causes: When you suffer heart failure, fluid can build up in the lungs and cause a lingering cough.
Treat it: See your GP immediately. If they suspect heart failure you'll be referred to a clinic for an ECG and blood tests. Treatments include ACE inhibitors to prevent fluid build-up and beta-blockers to slow the heart rate.

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