Soh you already at last Have been recovering from a cold for a few weeks but have a persistent cough back Is it cold? It doesn’t seem to give up. If you’re wondering why your lungs still rupture long after the worst of a cold is over, there are a number of possible culprits.
For one, you may have residual irritation in your airways. Or, you might have postnasal drip, which causes a persistent itchy feeling in the back of your throat. Most causes of a persistent cough are nothing to worry about, but it can still be an annoying side effect that you may want relief from, especially if all your other cold symptoms have gone away.
Experts in this article
- Nima Majlesi, DO, Director of Medical Toxicology, Staten Island University Hospital, Northwell
- Wayne Altman, MD, FAAP, Professor and Chairman of Family Medicine at Tufts University School of Medicine
- William Schaffner, MD, infectious disease specialist, professor of preventive medicine and health policy at Vanderbilt University School of Medicine
Here, we break down the main causes of coughing after a cold and how to get rid of it for good.
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What causes a persistent cough after a cold?
While most common coughs go away after a week or two, some stubborn coughs persist. The following issues may be the cause of a persistent cough.
1. Postnasal instillation
Of the many possible causes of a persistent cough, postnasal drip is the most important, said Dr. Nima Majlesi, chief of medical toxicology at Staten Island University Hospital in Northwell. Postnasal drip occurs when mucus accumulates and drips into the back of the throat. During a cold, you tend to produce more mucus (which helps fight infection). But even afterward, you may still have residual sinus congestion, which can lead to irritating dripping, Dr. Majlesi says.
One clue that a cough is related to postnasal drip is that it bothers you mostly at night, says Wayne Altman, MD, FAAFP, professor and chair of the department of family medicine at Tufts University School of Medicine. According to the Cleveland Clinic, other signs of postnasal drip to watch for include:
- sore throat
- I feel like there’s a lump in the back of my throat.
- There is a feeling of mucus flowing into the throat
- frequent swallowing
- Grunting or hoarse voice
- Urging you to clear your throat
- Bad breath (bad breath)
- Excess mucus drained into the stomach causing nausea and vomiting
2. Bronchial stimulation
“Bronchial irritation occasionally persists after the acute phase of infection,” Dr. Majlesi said. The bronchi are the airways that carry air in and out of the lungs. When they become irritable, mucus can build up.
This irritation is often caused by long-term inflammation from a cold. “The initial viral infection triggers the body’s inflammatory response, which is the body’s way of fighting the infection,” said William Schaffner, MD, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center. “Sometimes, even after the cold virus disappears, the inflammatory response continues, irritating the mucous membranes and causing coughing.”
3. Lack of rest
Dr. Altman believes this is the most likely cause of a lingering cough. This makes sense: When you’re sick, lack of sleep can slow down your recovery time. “Antibiotics don’t help when you have a viral infection,” he said. “Your immune system is at the mercy of your immune system, and strengthening your immune system’s capabilities is by getting more rest.”
According to the Mayo Clinic, when you nap, your immune system gets a “boost” by releasing cytokines — proteins that help protect you from infection and inflammation. Without enough sleep, you won’t produce enough cytokines (or infection-fighting antibodies and cells) to fight off the virus, and your cold symptoms, including coughing, will last longer.
4. Over-the-counter cold medicine
Hate to break it to you, but the medicines you take to relieve cold symptoms (such as antihistamines and decongestants) may be prolonging your cough. “I have found that these medications dry out the secretions, which may provide mild short-term relief from congestion and runny nose, but they often cause the secretions to thicken, making them harder to pass,” Dr. Altman says. If thick mucus builds up, it can lead to problems like postnasal drip, which is known to trigger coughing.
5. Another potential condition
A chronic cough can be a sign of other health problems. For example, allergies are notorious for causing an itchy throat. If you also sneeze, have itchy eyes, have a runny nose, and watery eyes, your persistent cough is most likely due to allergies.
Likewise, silent reflux (also called laryngopharyngeal reflux) can irritate the vocal cords and cause coughing, according to the University of Texas Southwestern Medical Center. Silent reflux occurs when stomach acid travels down the esophagus and into the larynx and throat. It’s called “silent” because it doesn’t cause common acid reflux symptoms like heartburn.
According to the University of Texas Southwestern Medical Center, in addition to chronic cough, other signs of silent reflux may include the following:
- asthma
- There is a bitter taste in the throat
- Excessive clearing of throat
- difficulty swallowing
- hoarse
- postnasal drip
- Feeling of lump in throat
- Throat pain or burning sensation
A cough that lasts longer than four weeks may also be caused by reactive airway disease (RAD), Dr. Altman said. RAD describes a set of respiratory symptoms that occur when the bronchi become swollen (similar to asthma). Researchers don’t yet know what causes RAD, but people with RAD tend to develop a chronic cough, shortness of breath, difficulty breathing, wheezing and chest tightness, according to the Cleveland Clinic.
If your cough persists for more than two weeks, see your doctor. They can examine you, take a history of your symptoms, and help rule out (or identify) any underlying medical conditions that may be causing your chronic cough.
6. Your immune system is weakened
When your immune system isn’t functioning at its best, it can’t fight off colds as well as it should. This means symptoms such as coughing may persist. According to UnityPoint Health, you are more likely to develop a persistent cough if you are immunocompromised due to underlying medical conditions, age over 65, or smoking.
7. Other drugs
“If you have a dry cough that you can’t get rid of,” the culprit may be in your pill box, Dr. Altman says. Chronic cough can be a side effect of certain medications. For example, certain blood pressure medications, such as lisinopril (an angiotensin-converting enzyme (ACE) inhibitor), may cause a dry cough, he said.
If you suspect that your medicine is causing your cough, do not stop taking it. First, talk to your doctor, who may give you a different medication or a lower dose.
How long does a cough usually last?
Usually one week. However, “residual cough after a viral upper respiratory tract infection can sometimes last up to two weeks,” Dr. Majlesi said. Sometimes it can extend longer than that. “The cough after a chest cold can be bothersome for a while, even up to a few weeks,” Dr. Schaffner says.
A cough is considered chronic if it lasts for more than eight weeks, according to UnityPoint Health.
How to Treat a Chronic Cough
If you have a persistent cough, your symptoms may last for several weeks. This doesn’t mean you have to feel bad about yourself. The following strategies may help you feel better.
1. Get enough sleep
“I give my patients the #3NightChallenge: sleep 8 to 10 hours three nights in a row while relaxing during the day,” says Dr. Altman. “This almost always improves or resolves cold symptoms.”
2. Try a saline nasal spray
“If congestion is a problem, a saline nasal spray can be effective in helping dry sinuses,” says Dr. Majlesi.
3. Hydrate
Dr. Altman says keeping a water bottle within easy reach and drinking warm liquids, such as soup, can help dissolve mucus. “You know you’re well hydrated when your urine is clear,” he adds. On the other hand, avoid caffeinated drinks and alcohol, which can lead to dehydration.
4. Try honey
Dr. Altman says a cup of herbal tea with some honey can help relieve sore throats and hoarse voices caused by chronic coughs and postnasal drip.
5. Add an extra pillow when sleeping
If your cough is related to postnasal drip, try raising your head while sleeping, Dr. Altman says. This can help prevent mucus from flowing into your throat. Plus, if you feel more comfortable at night, you’ll sleep better. Quality sleep equals a stronger immune system.
6. Prescription drugs
While home remedies may help, in some cases they may not solve the problem. According to Dr. Majlesi, you may need to see your doctor, who can prescribe stronger medications, like these:
- Benzonatate: a cough medicine that may help treat postnasal drip
- Albuterol inhaler (similar to those used by people with asthma): may help relieve bronchospasm that occurs during coughing
- Corticosteroids (such as prednisone): Help relieve lingering inflammation
When to see a doctor
Although inconvenient, it’s not uncommon to have a lingering cough after a cold. In most cases, you can wait out your symptoms and use home remedies to treat your symptoms to make you feel more comfortable.
But if your cough shows no signs of relieving after two weeks, it might be time to see your doctor. According to UnityPoint Health, you may have a bacterial infection (such as acute bronchitis) or a secondary viral infection (such as a sinus infection or pneumonia).
Other red flags to look out for include the following, according to Dr. Majlesi and Schaffner:
- You coughed up blood
- Your mucus will turn dark green, brown, or bloody
- you have chest pain
- you have difficulty breathing or shortness of breath
- you feel tired
- you have loss of appetite
- you continue to have a fever
- have you lost weight
“Also, if the prolonged cough is a unique episode of multiple consecutive coughs (cough attacks) that interferes with working, eating, or even sleeping, and is accompanied by vomiting, you may have pertussis (whooping cough),” says Dr. Altman . According to the Centers for Disease Control and Prevention (CDC), the respiratory illness is caused by a bacterium called Bordetella pertussis that damages cilia, the tiny hair-like extensions in the upper respiratory system ) and cause airway swelling.
As the name suggests, a cough is its hallmark symptom and may last for weeks. If you are immunocompromised or have asthma, whooping cough can develop into a more serious infection, so seek medical attention immediately if you develop symptoms.
final harvest
In most cases, residual cough after a cold is nothing to worry about. Typically, this means your body needs a little extra time to help recharge and recover. “Think of fighting a cough/cold as a tug-of-war, with the immune system on one side and the virus on the other,” Dr. Altman says. “Strengthen your immune system by resting, eating healthily, and managing stress effectively. When you do this, you’ll have fewer coughs and colds and their duration will be shorter.
