Symptoms and Signs of Chronic and Acute Coughs

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/30/2021

Doctor's Notes on Chronic and Acute Coughs

A cough is a reflex action the body takes to clear out substances that irritate the airways. Infectious causes of acute cough include viral upper respiratory infections (the common cold), sinus infections, acute bronchitis, pneumonia, and whooping cough. Noninfectious causes of cough include flare-ups of chronic conditions such as chronic obstructive pulmonary disease (COPD, including chronic bronchitis and emphysema), asthma, and environmental allergies.

Symptoms that accompany acute infectious coughs include

Symptoms that accompany acute noninfectious coughs include

  • wheezing,
  • coughs that worsen at certain locations or when a person does certain activities, or
  • coughs that improve with inhalers or allergy medications.

Signs and symptoms of chronic cough depend on the cause. Depending on the cause, the cough may worsen when exposed to certain environmental irritants, in certain locations, or performing certain activities. The cough may improve with the use of allergy medications, quitting smoking, with the use of inhaled or oral steroids or other inhaled medications.

  • Chronic cough associated with GERD may be accompanied by heartburn.
  • If a chronic cough is a warning sign of an underlying cancer, symptoms may include
    • coughing up blood,
    • worsening fatigue,
    • loss of appetite,
    • unexplained loss of weight, or
    • decreased ability to swallow solid or liquid foods.

What Is the Treatment for Coughs (Acute, Chronic) Symptoms?

The treatment of a cough depends on the cause of the cough and if the cough is acute or chronic.

Treatment of acute cough depends on the cause: 

  • Acute cough from upper respiratory infections (usually viruses) be treated with over-the-counter (OTC) cold remedies or cough medicines to relieve the symptoms
  • Acute cough caused by allergies is often relieved with allergy medication
  • Acute cough due to environmental irritants will respond to elimination of the irritating agent

Treatment of a chronic cough with a known cause is directed at treating the underlying cause of the cough. This should be done in close consultation with a doctor or with a specialist. Some of the most common causes of chronic cough and treatments for chronic cough are as follows:

  • If the patient has a cough caused by smoking, allergies, or environmental irritants, elimination of the offending substance will help. It may take several weeks for the doctor to assess the response to this approach because of the length of time required to repair damage to the lungs and air passages from the offending agent.
  • If the patient has a lung disease, ongoing therapy to treat the condition may be needed. Therapies used will depend largely on the type of disease. Multiple treatments are often used at the same time to help reduce symptoms. In cases where home therapy fails and symptoms worsen, the patient may need hospitalization so that additional or more intensive therapies may be attempted.
  • If the cough is suspected to be caused by a medication, improvement usually occurs when the medication is stopped though the cough may take up to a few weeks to resolve. 
    • Never stop taking a prescribed medication without first talking to your doctor. 
  • If the cough is caused by gastroesophageal reflux disease (GERD), treatment is needed to reduce the amount of acid reflux from the stomach. This is typically done with diet changes and medication.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.