Why do I have Persistent Coughing with Phlegm?

Overview of persistent coughing

Persistent coughing is a reflex action that expels foreign irritants or clears mucus from your throat. We all cough occasionally to clear the mucus from our throat or chest. However, several factors may cause persistent coughing (i.e. coughing more frequently).

If your cough resolves within three weeks, then it is an acute cough. Most coughing episodes improve within two weeks.

A subacute cough lasts between 3 – 8 weeks, with an improvement coming by the end of that period. On the other hand, persistent coughing lasting beyond eight weeks is chronic.

It is important that you consult a doctor if there is blood in your clough, or if you have a cough that sounds like a “bark.” Also, contact your doctor if there is no improvement in your cough within a few weeks. This could be an indication of a serious medical condition.

What causes cough?

Several conditions may trigger a cough. These conditions could be temporary or permanent.

Throat clearing

Coughing is the best way of clearing one’s throat. When mucus or foreign matter clog your airways, a cough reflex will help to get rid of these particles, thus easing the breathing process.

In most cases, this type of coughing is not persistent but will increase as the affected individual gets exposed to irritants like smoke.

Bacteria & viruses

The infection of the respiratory tract is a major cause of cough. Common infections of the respiratory tract include the flu or a cold.

Infections of the respiratory tract are usually caused by viruses and may last up to a week. Flu infections take a while to clear up and may even require antibiotics.

Smoking

Smoking causes persistent coughing. Cough from smoking has a distinctive sound. It is often referred to as the smoker’s cough.

Asthma

Asthma is a common cause of cough, especially in kids. A person who has asthmatic cough usually wheezes. This makes it not difficult to identify.

Asthma exacerbations should be treated with an inhaler. There is always the possibility of children outgrowing asthma as they get older in age.

Medications

Some medications trigger a cough. This, however, is a rare side effect. One of the medications that cause soughing is the ACE inhibitors, used for the treatment of heart conditions and high blood pressure. The most common ones are Vasotec and Zestril.

Coughing ceases after discontinuing the medication.

Other conditions that may cause coughing include

A cough may be caused by other conditions, including:

• Postnasal drip
• Damage to the vocal cords
• Serious underlying medical conditions like heart failure and pulmonary embolism
• Infections from bacterial agents like whooping cough, pneumonia, and croup.

Persistent coughing may also be caused by gastroesophageal reflux disease. GERD is characterized by a “flowing back” of stomach contents into the esophagus. This stimulates a tracheal reflex, resulting in a cough.

Is persistent coughing an emergency?

Most coughs clear up or improve within 2 weeks. If there is no improvement within this period, then you’ll have to see a doctor as this may be an indication of a serious underlying medical condition.

If you develop more symptoms, then contact your doctor without delay. Symptoms that you should be wary of include:

• Chest pains
• Confusion
• Drowsiness
• Headaches
• Fever

Or difficulty breathing that requires prompt medical attention.

Treatment for cough

There are various ways of treating cough, depending on the cause. Healthy adults require self-care for the most part.

Home treatment

You cannot use antibiotics to treat a cough caused by a viral infection. However, it can be soothed in several ways:

• Stay hydrated by taking enough water
• Keep your head elevated when sleeping.
• Soothe your throat with cough drops.
• You can soothe your throat with warm water (with the salt of course), or gargle regularly to remove the mucus.
• Avoid irritants. They are not worth it.
• Spice up your tea with ginger or honey. This will relieve you of your cough.
• Unblock your nose with decongestant sprays.

Medical treatment

A doctor is usually involved in medical care. He or she will examine your throat, monitor your cough and inquire about other symptoms.

If the cough is caused by bacteria, you will be treated with oral antibiotics. You may have to take the medication for a week or thereabouts. Your doctor may also prescribe cough syrups or suppressants with codeine content.

If no cause is detected, they will order for more tests, such as:

• An x-ray of the chest to assess lung clearance.
• Skin and blood tests to verify the presence or absence of an allergy
• Mucus or phlegm analysis for tuberculosis or signs of bacteria.

It is not common to see a cough being the only symptom of a cardiovascular condition, but your doctor may ask for an echocardiogram to ensure the proper and full functioning of the heart.

Extreme cases may require further testing:

• CT scan. A computed tomography scan offers an in-depth analysis of the chest and airways. It helps when determining the cause of a cough.
• Esophageal pH monitoring. If the cause of the cough cannot be identified, then you may be referred to a lung specialist or a gastrointestinal specialist. Esophageal pH monitoring is used to search for evidence of GERD.

What happens if the cough is left untreated?

Most times, a cough resolves on its own within a week of its development. Coughing naturally doesn’t cause long-lasting damages.

However, persistent coughing may cause some complications including:

• Dizziness
• Tiredness
• Fractured ribs
• Headaches

They are very rare, and they resolve the moment the cough disappears.

A cough that indicates a serious condition will not resolve on its own. If it is not treated, the condition could deteriorate and trigger a lot of other symptoms.

Preventive measures to avoid persistent coughing

• Quit smoking
• Make healthy changes to your diet

Tonika Bruce

Tonika Bruce, also known as The Network Nurse, is a multi-talented individual with a career spanning over 20 years. She’s a Registered Nurse, speaker, author, and advocate for change, excelling in business building and team development. Tonika holds two Master’s degrees in Nursing and Business Administration, (MSN & MBA) and is currently pursuing her Doctorate of Nursing Practice in Executive Leadership.

Her expertise extends to various fields such as nursing, entrepreneurship, business, basketball coaching, and executive leadership. She is a published author of “Relentless Pursuit: Proven Tips for Unlocking Your Potentials, Limitless Success and Post COVID Syndrome: A Guide to Repositioning the Nursing Profession for A Post COVID Era”. Currently, Tonika is working on Thrudemic, an anthology examining the impact of the coronavirus pandemic on medical professionals and patients.

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