A dry cough that won’t go away? Don’t ignore it

Asian women with a dry cough

Updated: 12/01/2021

When you’re really down with a cold or flu that affects your lungs, the accompanying cough usually sounds quite dramatic. A chesty, phlegm-rattling, mucus-producing cough is a sure sign that something is wrong. In comparison, a dry cough can be irritating and maybe even exhausting sometimes, but it doesn’t always feel like something serious that requires medical attention. This is also true for the cough that tends to accompany mild COVID-19. For some people, it can feel like you just need to clear your throat with a little cough but you find you have to do this very often. You might also start coughing after eating or just after certain foods. A dry cough that won’t go away can have multiple causes and feel different for everyone. In this blog post, we try to outline the most common reasons and what you should do next.

Contrary to its presentation,  a dry cough can have serious causes and can get worse. It is a protective reflex, in response to inflammation or irritants, and should not be ignored. Read on to find out what’s causing your dry cough, and when you need to see the doctor.

5 TYPES OF DRY COUGH

1. The Cough That Doesn’t Go Away: A cough that you’ve had for a long time is called a chronic cough (as opposed to an acute cough, which is sudden and short-term). It tends to be at its worst during the day, and may include coughing fits. These coughs are stubborn, and can be painful, even leading to pulled muscles or incontinence in older patients with severe cases. This could have a number of causes, including allergies, inflammation, or be a side effect of medication. This could also be caused by “long COVID-19” and post-viral asthma.

2. The Tickly Cough: What is that irritating, ticklish feeling at the back of the throat that causes relentless coughing? It is sometimes the result of inflammation from a cold or flu virus, or from atmospheric factors like pollution or climate. Post-nasal drip could also be a factor (where mucus drips down from the sinuses into the back of the throat).

3. The Barking Cough: Named for its similarity to the woof of your pup, this cough may occur at day or night, possibly with some wheezing. It is usually caused by inflammation, such as following a cold or flu, and it can be painful.

4. Plum Pit Cough: It feels like there’s a lump in your throat that won’t go away, no matter how much you swallow. When you cough, you might notice a slightly acidic taste. This is usually due to GORD, or acid reflux, where the stomach acid rises up the oesophagus, and can lead to more serious conditions.

5. Wheezy Cough: This cough is often worse at night or when you first wake up. It is accompanied by a wheezing sound – a high-pitched sound that is a bit like a whistle. The sound is caused by a tightening of the airways (bronchospasm), and is usually caused by asthma.

General checkup, experienced GPs

COMMON CAUSES OF DRY COUGH

There are many common causes of cough. Some of these include:

  • Viruses, including COVID-19
  • Allergies / Hay fever (caused by pollen, dust, pollution, pet dander, second-hand smoke)
  • Climate (cold, dry climates, changes in temperature)
  • GORD / acid reflux
  • Post-nasal drip
  • Bronchitis, Tonsillitis, Sinusitis
  • Laryngitis (the larynx becomes inflamed and you “lose your voice”)
  • Medication (coughing is a side effect of ACE inhibitors)
  • Smoking
  • Asthma

 

DRY COUGH AND ASTHMA

It is thought that around 10% of people with asthma don’t actually have a diagnosis, so if you have been experiencing any type of chronic cough, it is worth having a check-up with a doctor to make sure that you aren’t asthmatic.

The asthmatic cough is usually accompanied by a wheezing sound, due to the effect that the condition has on the airways. Inflammation causes them to tighten and narrow, meaning that there is less space for the air to travel through. Whilst a dry, wheezy cough is one sign of this condition, it can become more serious, leading to difficulty breathing.

Some indications of asthma include a cough that gets worse with exercise or exertion, a feeling of tightness in the chest, difficulty catching your breath (or shortness of breath) or a general feeling of fatigue.

Allergic Asthma:
Allergic asthma is very similar to normal asthma. The difference is that it is triggered by allergens (dust, mould, pet dander, or pollen are some of the most common allergic triggers for people with allergic asthma), which lead to inflammation in the airways of the lungs, causing coughing, difficulty breathing, or a full-blown asthma attack. For some people with the condition, it can be triggered by cold weather, inhaling smoke or fumes, or certain strong smells such as perfumes. With this condition, knowing your triggers and avoiding contact with them is an important aspect of managing the condition.

Post-Viral Asthma:
If you notice that your asthma symptoms are worse after you’ve had a cold (rhinovirus) or flu (influenza), or you’ve been ill recently and you’re now experiencing an ongoing cough that won’t go away, you may have post-viral asthma. This condition is partly caused by the immune system’s inflammatory response to infection, which, if it occurs in the lungs, can trigger the airways to swell. In those who have this condition, prevention is key. The doctor may recommend flu shots, and other preventative measures to ensure that you don’t get colds and flus in the first place.

People with “long COVID-19” have reported that their cough can continue for weeks or months and be accompanied with ongoing breathlessness and loss of stamina. We will be writing a new blog post about this soon.

GP appointments and specialist referrals

WHEN IT’S SERIOUS

In all cases, if you have a dry cough that isn’t going away, it is important to make an appointment with a GP. They can help you to find out the cause, and get you proper treatment. Early treatment is always preferable. Whether you have a minor illness, or are recovering from an infection, see a doctor to ensure that your condition doesn’t worsen.

In the case of dry cough, this is especially important. Although it is rare, a chronic dry cough can be caused by some serious and even fatal conditions, such as:

Heart Failure:
It may come as a surprise that a dry cough can be a sign of heart failure. This is caused by a build-up of fluid in the lungs. This can happen when the heart is not pumping as well as normal. A cough associated with fluid build-up tends to be worse first thing in the morning. It may even cause you to wake up out of breath.

Pulmonary Embolism:
A pulmonary embolism is a blood clot in an artery in the lungs. These clots usually form elsewhere in the body and then travel through the bloodstream to the lung. A pulmonary embolism can be fatal if it isn’t treated urgently. A cough is a symptom of this, although it is likely to be accompanied by blood and severe chest pain.

Lung Cancer:
In its early stages, lung cancer may not have any symptoms at all. As the condition develops, a cough is one of the earliest signs. This will be a new cough that doesn’t go away, and which is different to the types of cough you have had in the past. The cough may include a hoarse throat, wheezing, shortness of breath, or repeated lung infections or colds.

BE SAFE

If you are feeling at all unwell, please don’t ignore your body’s signs. Make an appointment to see a GP as soon as possible, and get a diagnosis and appropriate treatment.

basic medical check up

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Author:

Alya Shakir

Alya Shakir

Alya has been responsible for the growth of the clinics, overseeing their expansion and development and creating policies and procedures to ensure optimum patient care and experience. Alya is the registered manager with the Care Quality Commission.

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