Do not put the cough down to old age or just being unfit, as it could be something serious
If you keep coughing and can’t quite figure out why, it could be that you have a condition called IPF. Many people put coughing down to a cold or even old age – but this may not be the case at all.
It could be Pulmonary Fibrosis. This is a terminal health condition which causes scarring on the lungs and breathing to become increasingly difficult.
Pulmonary refers to the lungs while fibrosis refers to scarring. According to charity Action for Pulmonary Fibrosis (APF), there is no cure and, while treatments can help, they can only delay its progression. But the sooner you seek help, the sooner you can get treatment, which should hopefully soothe your cough.
Common symptoms for pulmonary fibrosis can include:
- shortness of breath (breathlessness)
- dry cough
- tiredness (fatigue)
- unexplained weight loss
- clubbing of fingers and toes (swollen and rounded finger and toe tips)
Risk factors for pulmonary fibrosis can include:
- Ageing
- Family history (the genes inherited from your parents)
- Breathing in something that irritates the lungs, such as smoke or dust – this will usually happen repeatedly over a long time
- Some medications
- Other conditions, such as rheumatoid arthritis
- Gastro-oesophageal reflux disease (GORD)
Why do I cough?
Discussing coughing, it explains: “Cough is a natural reflex that protects the lungs from things that could damage the lung tissue. When we cough, our vocal cords close together forcefully.
“If you cough a lot, this process can cause the vocal cords to become inflamed and irritated, which can make the cough worse. This can then lead to production of mucus, which can trigger even more coughing. This cycle can be difficult to break.”
In a recent APF cough survey 57% of respondents said their cough affected everyday life with a staggering 100% of responders reporting exercise, talking or even a change of position could trigger a coughing fit.
What types of pulmonary fibrosis cough are there?
Acute cough – this lasts less than three weeks and is usually due to upper or lower respiratory infections, asthma, or having breathed in irritants such as smoke or chemical fumes.
Sub-acute cough – lasts for three to eight weeks. This type of cough may be due to a prolonged recovery phase after an infection, or due to other conditions such as whooping cough or tuberculosis(TB).
Chronic cough – this is a persistent cough which lasts for more than eight weeks. Chronic cough is a very common symptom when you have been diagnosed with a long-term respiratory condition.
Refractory cough – this is a cough which persists despite ongoing treatment.
With pulmonary fibrosis your cough may be dry and tickly, or it can be productive of mucus. Some people with pulmonary fibrosis will have a combination of both dry and productive cough.
Dry/unproductive cough (or cough hypersensitivity)– this can be triggered by many different factors such as changes in temperature of the environment, smoky/dusty/polluted atmospheres, aerosol sprays, talking, laughing, exercise or physical activity.
Productive cough – this is a cough which moves phlegm (mucus) from the airways or shifts fluid/food which has gone down the wrong way. It’s our body’s way of protecting the airways so that you can breathe normally again.
How to treat coughing
Managing a persistent cough in pulmonary fibrosis can be challenging as it often does not respond well to standard medications. However, there are alternative drug treatments that may help reduce the frequency or severity of coughing episodes.
These medications are commonly used for persistent cough in other conditions as well and are primarily palliative – meaning they focus on relieving symptoms rather than treating the underlying cause.
The experts stress: “It is also important that you speak to your doctor or specialist healthcare team about other possible causes which may be contributing to your cough e.g. acid reflux, postnasal drip (sinus problems), side effects of certain medications, infections, inflammation, other chest conditions. These will need to be treated/managed effectively to minimise their impact.”
You can try some tips listed on the Action for Pulmonary Fibrosis website to help reduce how much you cough, as well as manage how to cope with it.
Specialist Cough Clinics in the UK
If your cough persists despite treatment from your local respiratory team, you may wish to explore a referral to a Specialist Cough Clinic for further assessment and management. There are currently eight such clinics across the UK.
The charity notes that a referral to a Specialist Cough Clinic must be made through your ILD Consultant and will only be considered if previous treatment options have been fully explored and found to be ineffective.