The top 3 causes of chronic cough will surprise you. They aren’t cancerous and they aren’t smoking-related. They are all things you can control.
1. POST NASAL DRIP (a.k.a. upper airway cough syndrome)
The term post-nasal drip only refers to the production of mucous in the nasal cavity. This mucous spills over into the back of the mouth and throat, irritating the lower airways.
This definition does not tell us why the mucous is there in the first place. Chronic rhinitis or nasal inflammation from allergies are usually the most common triggers. Seasonal allergies may create nasal itching for a few months, but environmental allergies can continue year-round. These can include allergens like dust, mold and pet dander. Doing a skin-prick allergy test can raise awareness as to the allergens to avoid, but the hard part comes from actually eliminating them.
2. ASTHMA
Asthma is one of the most common causes of chronic cough among nonsmokers. There are the “classic” and “typical” forms of asthma that present with difficulty breathing, wheezing and chest pain. In this form, a cough signals the onset of an asthma attack or event. However, there is a whole other category of “Cough Variant Asthma”, which includes a cough outside of asthmatic events.
It is thought that in individuals with Cough Variant Asthma, one of the triggers is more consistently present in a smaller quantity. This could be an environmental trigger as mentioned above. This causes airway hyper-responsiveness or slight narrowing of the airways, which means the irritant receptors are poised and ready to signal the cough reflex to the brain. The entire immune system remains on edge, and every little trigger will initiate a cough.
It is important to note that this subtype of asthma does not present with a wheeze or difficulty breathing. The cough can present any time of the day, but is most noticeable at night. It is sometimes alleviated with puffers and bronchodilators, but as long as the immune system remains on edge, the cough will persist.
3. GastroEsophageal Reflux Disease (GERD)
GERD on its own can cause a cough. GERD in combination with asthma and/or post-nasal drip will drastically increase the intensity of the cough, and make treatment a little more challenging.
In GERD, there is failure in the signalling of the digestive tract to close the lower esophageal sphincter (doorway to the stomach from the esophagus). Acid from the stomach splashes back into the esophagus and can travel all the way into the mouth. This can present as heartburn, or be completely asymptomatic until it reaches the mouth.
Acid is corrosive and can damage our tissues, which is why we have a thick layer of mucous around the inside of our stomachs. But when acid travels into the esophagus, we feel the burning because we don’t have that same layer of mucous to protect us. Over time our bodies will learn to produce mucous in the esophagus, which we can even feel as a lump at the back of the throat.
We may feel like we constantly have to clear our throats and our voices may get hoarse or raspy. This excessive mucous can act as an irritant that initiates the cough reflex. Depending on the foods we eat, when we eat them and how much we eat of them, we may notice this GERD cough all day and all night.
What can we do about it?
Get a proper checkup. This might mean getting a chest x-ray to rule some things out or just having someone listen to your lungs.
Identify food sensitivities. These create inflammation, which can show up as mucous production or acid production. Eliminating them will help to reduce symptoms and open the airways.
Humidify the bedroom. You don’t need to get a humidifier. You can add steam to a room through a diffuser, an open pot of boiled water, or by leaving a wet towel hanging in the room.
Drink lots of water. If you are trying to eliminate something from the lungs, water is the best way to moisten the tissues and unstick the mucous.
Whatever the cause of your chronic cough, get it checked out. It could be an easier fix than you think!