Important Facts About That Cough You Have

Cough is a frequent symptom seen in medical offices at this time of year. It can be a source of aggravation, frustration and anxiety for many patients. A cough falls into one of the following categories based on its duration: it can be acute, lasting less than 3 weeks; subacute, lasting from 3 to 8 weeks; or chronic, which lasts over 8 weeks.

The acute cough is mostly a result of upper respiratory tract infections and acute bronchitis. Most of the time, these are due to viruses and do not require the use of antibiotics. Fever may or may not be present and phlegm can be discolored. Pertussis, or whooping cough, is on the rise in the United States and may manifest by violent coughing and should be treated with an antibiotic. Approximately 15% of users of commonly prescribed blood pressure medications, lisinopril or zestril, may develop a cough, which usually begins within a week of beginning the medication. Treatment is stopping the offending medication and waiting 1-4 weeks for resolution, which you’ll want to coordinate with your primary care provider so you can get on an appropriate replacement medication. Lastly, pneumonia may also cause you to develop a cough. Depending on what incites coughing, therapy is supportive with cough medication, antihistamines, decongestants, antibiotics (if needed), and possible inhalers if asthma-like signs are present.

A subacute cough is most commonly a result of a prior upper respiratory infection. It can also be caused by asthma, postnasal drip, gastric acid reflux (even if heartburn is not present) or a primary lung disease. At this time, a chest X-ray should be obtained, especially for smokers or former smokers. Specific therapy is suggested depending on the cause.

Finally, chronic cough should be evaluated by requesting appropriate tests which may include sinus imaging, CAT scans, cardiac or gastroenterologic evaluations. A referral to a specialist may be needed.

If you or a loved one is suffering with a cough, particularly one that has lasted for more than 3 weeks, see your primary care provider, who can then determine an appropriate course of treatment.


Janice Rutkowski, M.D.Janice Rutkowski, M.D. is an MPCP partner and is certified by the American Board of Internal Medicine. She sees patients at the Arundel Mills office.