Persistent Cough: When Should You Get Tested?

A cough is among the most frequent symptoms suffered by people of all ages. Often occurs on the heels of the common cold, seasonal flu, or a mild upper respiratory infection and will most likely clear up within days or even weeks. If the cough lasts longer, however, it could be a sign of an underlying health condition that requires medical care.

Although it is easy to dismiss a persistent cough as usual or natural, and hope that it will pass, certain coughs cause serious health problems. Some coughs can be ignored as just normal and standard, and expect that to go away; some coughs are serious health issues. In some instances, this happens; in other instances, a cough may be a warning sign of a more serious health issue in the lungs, airways, heart, or digestive tract. 

Evaluation at an early stage assists in the determination and/or recognition of etiology and proper diagnostic testing and treatment on time. There should be someone available to help the person recognise when a cough is a problem and for whom tests may be ordered, so that an appropriate action can be taken to get his/her health back on track.

What Is Considered a Persistent Cough?

Usually, a cough is classified by length. An acute cough is a cough that does not last more than three weeks, and often occurs with a viral infection, for example, if someone catches a 'cold'. A sub-acute cough can persist for 3-8 weeks, and usually follows an infection such as a respiratory infection.

Persistent or chronic cough in adults is typically considered a cough lasting more than 8 weeks. The length of a cough is significant, but it is actually several other considerations, including the level, symptoms associated with the cough, and medical history, that can determine if additional testing is needed.

Common Causes of Persistent Cough

Many possible causes of coughing that last a long time. Some are insignificant, while others may need a more comprehensive medical assessment. It is one of the most common causes of respiratory infections. Airway inflammation can still cause coughing for several weeks even after an infection has cleared up.

Chronic coughing can also be due to allergies. Dust, pollen, pet dander, or irritants in the environment can lead to continued irritation of the airways. Coughing at night, while exercising, or after exposure to allergens is another common occurrence, and it's often caused by asthma.

Coughing may happen because of the reflux of food or liquid contents of the stomach into the throat and airways, a condition called gastroesophageal reflux disease (GERD) or acid reflux. Chronic smoking or air pollution exposure can worsen chronic cough due to the effect of causing inflammation and irritation of the respiratory system.

When Should a Persistent Cough Be Evaluated?

While not all coughing is a medical emergency, there are some situations in which it is and requires immediate medical evaluation. However, if a cough continues after several weeks with no sign of improvement may be a good time to talk to a health care provider. Patients with a cough that persists beyond a couple of days should be seen for underlying problems, which may need to be diagnosed and treated.

A cough that slowly increases over time also needs to be investigated. Symptoms may gradually get worse if inflammation or infection persists or if your child has a different lung problem. Persistent cough is a symptom to watch for in those who have ever smoked or have chronic lung disease, and could be a sign to seek medical help at the earliest opportunity.

Warning Signs That Require Testing

Some other symptoms that go with a never-ending cough might signal more severe health problems, so it should not be overlooked. The first important hint of bleeding from the lungs is to cough up blood, which you should immediately get checked out. It is likely to have more than one cause, but it may be a sign of severe lung disease from time to time.

If you lose weight very rapidly or if you have a cough that does not go away, more tests may be needed since this may be a health problem. Symptoms that may indicate a need for a diagnostic test include shortness of breath, wheezing, chest pain, frequent fevers, or fatigue. Again, if night sweats or persistent respiratory problems occur, consider it, particularly if symptoms do not go away following treatment.

Physical Examination and Medical History

A comprehensive medical evaluation is typically the first investigation that's performed when someone has a persistent cough. History taking of symptoms, smoking history, occupational history, allergies, medications, and past illnesses. A physical examination to look for evidence of respiratory, cardiovascular, and/or systemic disease, which could be triggering the cough. This information may help in selecting the diagnostic tests that might be most useful.

Chest X-Ray

A chest X-ray is one of the most popular tests ordered for any persistent cough. The x-ray of the chest gives a general image of the lungs, airways, heart, and surrounding structures. It can be used in detecting infection, inflammation of the lungs, fluid buildup in the lungs, tumors, or abnormalities. Chest X-ray is commonly performed in the initial investigation of people with chronic respiratory complaints, as it is easily accessible and is relatively fast.

CT Scan of the Chest

A CT scan might be suggested to get more information, if necessary. CT gives very detailed images of the lungs and chest that appear as cross sections. It is able to detect abnormalities that are not always evident in conventional radiographs. If the symptoms continue despite normal beginning tests or if further evaluation is needed, doctors may order a CT scan.

Pulmonary Function Tests

PFTs are used to determine the functioning or working capacity of the lungs. These tests are used to show lung flow, lung volume, and lung efficiency. These can also be particularly useful if asthma or chronic obstructive pulmonary disease (COPD) is suspected or if bronchial conditions are suspected. If symptoms indicate that airway blockage or pulmonary dysfunction are playing a role in coughing, a pulmonary function test could be beneficial in making that diagnosis.

Laboratory Testing

Sometimes, as well, blood tests may be requested to determine the cause of the cough if this is suspected. Lab tests sometimes help identify infections, inflammation, allergies, and even medical problems that may be related to their breathing symptoms. Some specific tests may be conducted to assess the immune function and/or confirm the presence of an infectious disease.

Conclusion

Although many coughs will go away, you should not ignore a cough that persists on and off for more than a few weeks. Chronic coughing disease can be attributed to a host of conditions, ranging from infection, asthma, allergies, acid reflux, smoking-related lung disease, to more serious medical conditions.

Blood coughed up, unexplained weight loss, chest pain, shortness of breath, and longer duration of fever should be treated immediately. Chest X-rays, computed tomography (CT) scans, pulmonary function tests, and laboratory tests may help determine the underlying cause and proper treatment for the condition.

Molecular Diagnostics and Therapy provides diagnostic support and offers advanced imaging technologies, thorough laboratory services, and provides patients with accurate evaluation of their persistent respiratory conditions to help aid timely diagnosis and effective Healthcare management.