Persistent Cough? When to Worry
Question: I have a friend who has been suffering with a cough for several months. Her doctor thinks it is a virus and hasn’t given her any medication because she is pregnant. But shouldn’t it have cleared up now? When is it time to worry about a cough?
Answer: Coughs that last longer than one month are often evaluated by a clinician to look for an underlying cause. While infections (viral or bacterial) can last a bit longer in pregnancy, owing to an altered immune system, your friend’s hacking is understandably concerning.
When to seek urgent help
Seek medical advice promptly if the cough is worsening, comes with shortness of breath, chest tightness/pain, fever, confusion, dehydration, or any blood in the phlegm. Pregnancy itself can increase risk from respiratory illness, so do not wait if symptoms escalate.
Concerning Conditions or Symptoms
Coughs that don’t go away in a month are of particular concern if:
- You have a known risk of lung disease, such as previous lung cancer, chronic obstructive pulmonary disease or are a past or current smoker
- The cough is accompanied by a fever or shortness of breath.
In either of the above cases, a prompt medical assessment is commonly recommended.
Coloured Phlegm
Producing yellowish, green or blood-tinged phlegm or sputum is typically treated as a reason for urgent medical assessment. Yellow or green sputum can occur with both viral and bacterial infections, so it does not automatically mean antibiotics are needed; blood-tinged sputum requires urgent medical care, especially if you have chest pain.
Persistent Cough Causes
A variety of things can cause a cough that won’t go away. They include the backup of stomach acid into your esophagus (esophageal reflux), voice-box growths, allergies, asthma, and tuberculosis. Less typical causes include histoplasmosis and certain parasites or fungal infections.
Seek medical advice at any time you are concerned about your symptoms, or if you have worsening symptoms, shortness of breath, or chest tightness that lasts more than 10 minutes.
In the case of a pregnant woman who has been suffering from a cough for several months (or anyone else, for that matter), I am concerned about the lack of a diagnosis. A clinician may wish to rule out treatable causes.
Treating Coughing Spells
As for treating the coughing spells in the meantime, humidified air is a harmless approach. But be careful not to introduce mould spores by keeping the device clean. If your friend has allergies (or suspects she might), it might be useful to run a high-quality air filter, too.
Throat lozenges, honey and lemon tea and, yes, chicken soup can relieve symptoms. But they are not a cure.
People with a long-running cough are often evaluated by a doctor to determine the cause.