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Harvard Medical School
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General Medical Questions
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Question : I have had a persistent cough for 6 weeks. Otherwise, I feel okay. What may cause this?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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June 30, 2014
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I advise a visit to your doctor for a cough that lasts 6 weeks or longer.

Do you smoke, or have you smoked in the past? Then you should get a chest x-ray. Depending on your age and how many years you have smoked, your doctor might also suggest a CT scan of your chest.

Even if you don’t smoke, many doctors would order a chest x-ray if a cough lasts as long as yours.

Let’s assume you are not smoking and your chest x-ray is normal. Then, the most common causes of a persistent cough are:

Hypersensitive airways following a cold or bronchitis

Sometimes, people develop a prolonged cough long after a viral upper respiratory infection. Your body clears the virus. But the bronchial tubes stay inflamed.

Your treatment: prescription inhalers.

Post-nasal drip

This may be due to allergies, prolonged congestion after a cold, or a sinus infection.

Your treatment: decongestants or antihistamines.

Occult asthma

With this type of asthma, you may have little or no wheezing. Coughing is the main symptom.  

Your treatment: prescription inhalers

Acid reflux

Acid from the stomach can wash back into the esophagus. It then tends to move up higher to the throat. This irritates the tissue and prompts you to cough.

Your treatment:

  • Not lying down for three hours after eating
  • Eating smaller meals
  • Noting which foods make the symptoms worse, and avoiding them
  • Acid blockers including proton pump inhibitors such as omeprazole or H2 blockers like ranitidine

Cough caused by medicine:

Some blood pressure medicines can also cause a constant throat tickle and cough. It’s a common side effect of ACE inhibitors like lisinopril and enalapril.

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