A Cough That Won’t Go Away: Chronic Cough Evaluation
In adults, a cough that lasts more than eight weeks is called chronic, and it often has a treatable cause, such as postnasal drip, asthma or reflux. Dr. David Kupferberg, a pulmonologist board certified in the US and Israel, works through the likely causes step by step.
Dr. Kupferberg sees patients aged 16 and over.
Dr. David KupferbergPulmonary & Critical Care Physician
What is a chronic cough?
In adults, a cough that lasts more than eight weeks is called chronic. A chronic cough is a symptom, not a diagnosis: it can be dry or bring up phlegm, and it can disturb sleep, work and daily life.
Sometimes more than one cause is involved, which is why finding it often takes a step-by-step approach.
When should I see a lung specialist about a cough?
See a lung specialist if your cough has lasted more than eight weeks, keeps returning after infections, or hasn’t improved with the treatment you’ve tried.
Seek care sooner if you have any of these:
- Coughing up blood
- Weight loss
- Fever or night sweats
- Breathing that is getting worse
How does Dr. Kupferberg evaluate a chronic cough?
Spirometry is charged in addition to the consultation. Dr. Kupferberg’s evaluation works through the common causes step by step:
- A detailed history: when the cough started, triggers, medicines (such as ACE inhibitors), reflux, nasal symptoms, smoking and exposures.
- An examination.
- A short cough severity form that you fill in.
- Spirometry before and after a bronchodilator, to look for asthma or airway narrowing.
- Arranging chest imaging, if needed.
- Treating the likely cause and following up to see what helps.
Why can it take more than one visit?
Finding the cause of a chronic cough usually means testing and treating one step at a time, so it often takes more than one visit. Follow-up can be in the clinic in Jerusalem or Efrat, or by video.
If your regular doctor is abroad, Dr. Kupferberg can send them a medical report in English.
Frequently asked questions
Why do I keep coughing when I’m not sick?
The most common causes of a long-lasting cough in non-smokers are postnasal drip from the nose and sinuses, asthma (including a form where cough is the main symptom) and acid reflux. Some blood-pressure medicines (ACE inhibitors) also cause cough. Smoking, COPD and, less often, other lung diseases can too. Finding the cause usually means testing and treating one step at a time.
How long is too long for a cough?
A cough after a cold or flu can last three weeks or more. A cough lasting more than eight weeks in an adult is called chronic and should be checked. See a doctor sooner if you cough up blood, lose weight, have fever or night sweats, or become more breathless.
Why does my cough linger after COVID or a chest infection?
After an infection, the airways can stay irritated and sensitive for weeks, so a cough often continues after you feel better. Most post-infection coughs settle within about eight weeks. If yours lasts longer, keeps worsening, or comes with breathlessness, it’s worth checking for asthma, reflux, sinus problems or other causes.
What does a lung doctor check for a chronic cough?
A lung specialist takes a full history, including medicines, reflux, nasal symptoms, smoking and exposures; examines you; usually does a breathing test (spirometry before and after a bronchodilator) to look for asthma or airway narrowing; arranges chest imaging if needed; and treats the likely cause and follows up to see what helps.
Is a dry cough that won’t go away dangerous?
Most persistent dry coughs have treatable causes such as postnasal drip, asthma or reflux, and are not dangerous. But a cough lasting over eight weeks should be evaluated. Seek care promptly if you have warning signs: blood in the phlegm, weight loss, fever, night sweats, chest pain, or worsening breathlessness.
Sources
Get your cough checked
Book a visit in Jerusalem or Efrat to start looking for the cause of your cough.
In an emergency, such as severe shortness of breath or chest pain, call Magen David Adom at 101 or go to the nearest emergency room.
Related pages
Asthma
Diagnosis and follow-up of asthma in adults, with breathing tests in the clinic and a written plan.
Pneumonia & Chest Infections
Follow-up after pneumonia, and evaluation of a lingering cough or of chest infections that keep coming back.
Breathing Tests
Spirometry, lung volumes and walking oximetry in the clinic, with spirometry and oximetry also offered at home visits, plus clear instructions on how to prepare.
COPD
Evaluation and long-term care of COPD, with breathing tests, an oxygen check while walking and a plan for flare-ups.