People who keep coughing warned it could be painful and fatal condition

Do not put your coughing down to being unfit or old age, as if it does not shift, you need to seek help from a doctor

If you have a persistent cough and it does not seem to be going away no matter what you are doing, it could be worth visiting your GP as something more sinister could be going on.

If you are talking to your doctor, it may be worth considering a condition called Pulmonary Fibrosis. While many people attribute coughing to being unfit, long-covid or simply getting older, it needs to be checked out.

Pulmonary Fibrosis is a progressive and life-limiting lung condition that leads to scarring of the lung tissue, making breathing increasingly difficult over time.

"Pulmonary" refers to the lungs, while "fibrosis" means scarring. According to the charity Action for Pulmonary Fibrosis - APF for short - there is currently no cure for the condition. Although treatments are available, they can only slow its progression.

However, the earlier you seek medical advice, the sooner treatment can begin which may help to ease 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, they explain: "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 reported that their cough impacted their daily life. Sadly, evryone they asked - all 100% - said that activities such as exercise, talking or even changing 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 can I manage my cough?

Managing a persistent cough in pulmonary fibrosis can be difficult. This is because it often does not respond to conventional medications.

However, there are alternative drug therapies that may help lessen the frequency or intensity of coughing episodes. These treatments are also used for chronic cough in other conditions and are mainly palliative which are aimed at symptom relief rather than addressing the root cause of the cough.

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 managing how to cope with it.