4 things that trigger my IPF chronic cough
While the causes of chronic cough vary, a columnist shares her observations
I wouldn’t wish the effects of a chronic cough on anyone. The cough that often accompanies idiopathic pulmonary fibrosis (IPF) is dry and persistent. It’s difficult to address and find relief, and it can be exacerbated by several things.
That’s been my experience since I was diagnosed with IPF nearly seven years ago. Today, I’ve noticed that my chronic cough is getting progressively worse.
I can only speak from my own experience when I say that the IPF cough is painful. It causes a sharp pain in my chest and irritates the back of my throat. I’ve heard other patients mention similar experiences. When my cough is really bad, whether due to an IPF exacerbation or a viral or bacterial infection, or when triggered by something environmentally, I experience pain in my ribs that takes a long time to subside.
The COVID-19 pandemic created social implications for the IPF cough as well. I wrote about this in a 2020 column, in an effort to bring awareness about the issue and reduce the stigmatization of this IPF symptom.
In addition to prompting glares from people who thought I was sick in public, my cough sometimes became so bad that it worried complete strangers. People have asked me if I were choking, they’ve offered me water, and they’ve asked me if I needed an ambulance. As a young adult living with this disease, it’s embarrassing to have this cough, but unfortunately, it’s nearly impossible to control at this point in my disease’s progression.
In recent months, I’ve been paying closer attention to things that trigger my cough in an effort to avoid them. I’m curious if other IPF patients notice that their cough is worsened by the following as well:
Being full after meals
One of my favorite things to do every few weeks is to go for sushi with friends. Because I’m immunocompromised, I’m careful to avoid eating anything raw, but there are still lots of foods I can enjoy. Most important, it’s a nice opportunity to catch up with friends over a meal that isn’t rushed.
One of the downsides of going for sushi is that we often eat too much. We simply get caught up spending quality time with one another and continue ordering various dishes. Afterward, I find myself uncomfortably full, but I never learn the lesson that I should eat less. I’ve noticed that my IPF cough and my breathlessness are worse after I’ve eaten a lot and am full.
Seasonal allergies
Spring is on the way here in Canada, and while it’s one of my favorite seasons, it also exacerbates several symptoms.
Environmental allergies wreak havoc on a lot of people, but some of us with IPF require supplemental oxygen to breathe due to congestion caused by the snow melting or flower pollen in the air. Congestion is unpleasant for anyone, but coupled with reduced lung function, breathlessness, and a chronic cough, it can lead to severe respiratory distress.
While we’ve only had a couple of warm days so far this year, I’m already noticing the increased frequency of my cough due to seasonal allergies.
Chopping onions
This task might seem like an unusual trigger for a cough because most people get watery eyes when chopping onions. But when I’m using onions while cooking, my cough worsens. I suspect that the intense smell causes my nose and eyes to water, and then postnasal drip causes the cough.
Cigarette smoke
Secondhand smoke is unpleasant for many, but for those of us with IPF, inhaling it often prompts a trip to the hospital.
In Canada, smoking is prohibited within 9 meters (30 feet) of a public building, including grocery stores and schools. But sadly, not everyone follows the law. If I inhale a whiff of cigarette smoke, my cough escalates quickly.
I mention this as a trigger for my IPF cough because it takes me days to recover after inhaling secondhand smoke. I don’t know if there’s any truth to this physiologically, but it feels like the smoke lingers in my throat and chest, causing me to constantly clear my throat and cough. Cigarette smoke is hands down the worst trigger for my IPF cough.
What triggers your IPF cough? Please share in the comments below.
Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.
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Comments
Judi Frost
My cough is constant and persistent . It does have product , not always ! In the morning is the worst, and if I am walking in the city have noticed that car exhaust triggers coughing and in the home cleaning ! I cannot vacuum (which is great my husband does that task now) . I can sweep and dust with a mask on, but literally all house dust causes me to cough.
Walking in very cold weather was extremely difficult, with fits of coughing, now that the spring is here, the relief in my chest is apparent ! shopping in the cleaning product or soap aisle is avoided, otherwise severe coughing and many looks!
My constant coughing became worse after having covid this December. However I have coughed for years, and that was the beginning of my IPF diagnosis in January 2022
Steve Rasmussen
My diagnosis for ILD was Oct 2019. In June of 2017 and again in June of 2019 I had pneumonia. Both times I barely even knew I had pneumonia. It passed quickly after I took medicine.
But my story includes ten years or more of excessive cough that the Kaiser internist attempted to treat with allergy medicines, acid reflux medcine and Tessalon Perles. Nothing reduced my frequent cough.
Fast Forward: After my ILD diagnosis I moved my health plan to Stanford Medical Hospital. When I first met my new pulmonologist I emphasized that I had been coughing for years, long before the ILD onset. The doctor acknowledged this and had me go thru a series of tests with different specialists. After about a year, I met with the Allergy department. The only thing that showed up in a very minor way was a slight reaction to "dust mites". Two days later we replaced all of our bedding including pillows and a comforter. About FOUR days later it was obvious to me that my long time cough was dramatically reduced ! Why? The only apparent answer is that we took out our down pillows and down comforter. The sinus congestion, the post nasal drip, the "sinus cough" all improved greatly. As those reading this know, Ideopathic PF refers to a condition that exists for unknown reasons. I do not believe my condition is IPF. I have discovered that "goose down" or "duck down" is a well known contributor to PF. The many years I was coughing, probably due to down, may have migrated down into my lungs and the rest is history. I am quite certain that medical General Practitioners and Internists don't have Goose Down or Duck Down on their radar when a patient comes in with a cough. Have any of you reading this also connected your bedding to your ILD ? Thanks, Steve
Catherine
Charlene and Judi,
Thank you. I am with you on this journey, glass of water or tea always at my side.
Same here as to coughing precursors: After eating a full portion, Changing position (mornings are the worst), Talking, Cold air, Dust, Certain scents..
And I agree with awkward social aspects of coughing in public.
At times coughing is so intense I have dislodged my back, or bruised my pleura and then deal with the pain from one or the other, or I'll cough up food from the top of my stomach (after eating). In general a major coughing bout leaves me weak from decreased oxygen and an increased heart rate, after which I just have to sit and wait until I recover.
In seeking relief, my pulmonologist has told me the main cough suppressants approved for IPF/ILD cough are opium derivatives, which she offered and I declined, not entirely because of the drug's addictive nature as much as they would make me even more fatigued than I already am, and would dull my mind. I think I'd rather cough and be present.
Karen W
I was diagnosed with IPF in 2017 from a CT scan and and lung biopsy after returning from a trip and found myself winded with low endurance. We discovered mold in our crawl space and had it mitigated. Since then I have PFTs every 6 months and have been stable. I initially worked with an osteopath who treated me with supplements very early on. I tried OFEV and did not feel well on it. I walk almost every day on a treadmill and do breathing exercises from the book, Breath by James Nestor. I have also been treated regularly with Chinese Herbs and needles by an experienced acupuncturist. He rotates the herbs according to how I am doing. One herb is for breathing and the other is for my cough which is exacerbated by allergies. I stay indoors and walk on a treadmill when the pollen is high. I am very grateful for all the support I have received and hope others with this disease can find what helps them the most.
Patti Johnson
I was diagnosed with IPF in Nov 2022. The cough is one of the worst things to deal with. I have been bothered by scents and smoke for a long time but it is worse now. Recently the smell of homemade popcorn, laundry detergent, stain remover all bother me even though they never used to. So I often have to wear a mask at home.
Kaye-Maree Hollingsworth
I was diagnosed with IPF October, 2019. Household dust, strong flowers like oriental lilies are the two worst triggers for my cough. I have found relief by drinking Mullein tea. Use one heaped teaspoon of the Mullein leaves (preferably organic) and let it stand for 10 minutes. Then strain it through calico cloth to make sure there are no fine leaf fibres and drink. It has been a God send for the cough. I hope this may help you as much as it has helped me. I started out with one mug a day, now I'm on 3 mugs a day.
Luciano Molina
I was diagnosed with IPF in 2016. About three years prior, I had a bad cough that lasted 2 months and had the same 2 months cough the following year. On the following year the cough lasted 3 months and that's when I decided to see my Primary Doctor who in turn referred me to a Pulmonologist. I was prescribed OFEV 150ml twice daily which I feel did slow the progression, but my cough is getting bad. I'm been on the llist for 3 months and being an O+ blood type kind of hinders my ability of a donor. I can absolutely relate to all the above comments and everone well.
William Morris
I was diagnosed in 2022 for pulmonary fibrosis, which was diagnosed as existing since 2020. I am on inhalers but am constantly exercising. A cough ignited in 2023 sporadic especially during the spring season. Allergies have increased my breathing need and tiredness. If I do not have allergy reaction my breathing is not so difficult, but still have to use inhalers. I do not know what progression my fibrosis is moving. I go to pulmonologist in June for another test, whichi is to determine any progression. My father, brother and older sisters daughter passed away from pulmonary fibrosis. My father 78, my brother73, my sisters daughter 55. I am 87 an just living day to day
jerry reynolds
Received a diagnosis of IPF in 2020 but had coughing episodes a couple years earlier. Found relief with Guaifenesin 400mg. Take 1 tab daily while coughing very little now. Can purchase across the counter. Good luck in your journeys.
Midge
Do any of you who have a persistent cough use an inhaler? Does it help? I tried the "pearls" medication which didn't help. Cough drops help for a very limited amount of time. I don't want to depend on cough medicine with codeine. I would appreciate any ideas. Thank you!