Cough

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss and sleep centers

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Cough represents a critical reflex action aimed at maintaining clear airways, vital for optimal respiratory function. It becomes a symptom of concern when it is chronic or when it suggests an underlying disease or disorder.

Coughing icon

Definition and Description

Symptoms of coronavirus disease 2019 2.0

A cough can be classified as either dry or productive. A productive cough leads to the expulsion of mucus, also known as phlegm or sputum. On the other hand, a dry cough does not produce mucus.

Furthermore, coughs can be categorized into acute or chronic based on their duration. Acute coughs, commonly resulting from a cold, flu, or sinus infection, are sudden in onset and typically resolve within 2 to 3 weeks. Chronic coughs persist for more than 2 to 3 weeks and may signal a more serious condition.

Causes

Several factors can trigger a cough, including:

• Recent upper airway infections such as the common cold and flu
• Allergies and asthma
• Lung infections like pneumonia or acute bronchitis
• Chronic lung diseases such as COPD (emphysema or chronic bronchitis)
• Sinusitis leading to postnasal drip
• Lung diseases such as bronchiectasis, interstitial lung disease, or tumors
• GERD
• Cigarette smoking or exposure to secondhand smoke or air pollutants
• Certain medications, such as ACE inhibitors used for blood pressure control

Self-Care and Management

Several home remedies can alleviate a cough:

• Cough lozenges or hard candy may help dry, tickling coughs. However, these should not be given to a child under 3 years old due to the risk of choking.
• A vaporizer or a steamy shower may increase air humidity and help soothe a dry cough.
• Drinking extra fluids can thin throat secretions, making them easier to cough up.
• Over-the-counter medications, such as guaifenesin and decongestants, can assist in mucus expulsion and clearing postnasal drip, respectively.
• Despite its discomfort, a cough is often a beneficial response aiding the body's healing process. Therefore, using cough suppressants may not always be recommended. Patients should consult a healthcare provider before starting any over-the-counter cough medicine. Furthermore, patients should not expect antibiotics for viral infections, as they are ineffective against viruses and will not alleviate a cough due to allergies.

When to Seek Medical Attention

Patients should immediately seek medical care if they experience:

• Shortness of breath or difficulty breathing
• Hives or a swollen face or throat with difficulty swallowing
• Violent, sudden-onset cough
• Cough that produces blood
• Fever, which may suggest a bacterial infection
• Thick, foul-smelling, yellowish-green phlegm, another possible sign of a bacterial infection

Symptoms suggestive of congestive heart failure, such as a history of heart disease, leg swelling, or a cough that worsens upon lying down

• Exposure to someone with tuberculosis
• Unintentional weight loss or night sweats
• Cough persisting for longer than 10-14 days
• Cough in an infant less than 3 months old

Diagnosis

Diagnostic investigations can include a physical examination, focusing on the ears, nose, throat, and chest, and may include further diagnostic tests such as:

• Bronchoscopy
• Lung scan
• Pulmonary function tests
• Sputum analysis, if the cough produces sputum
• Chest X-ray

Prevention

Preventive measures include avoiding smoke and exposure to allergens. For seasonal allergies, individuals should try to stay indoors on high-allergen days, and those with year-round allergies should consider using dust mite covers, air purifiers, and avoiding pets and other known triggers.

References

Irwin RS, Madison JM. The diagnosis and treatment of cough. New England Journal of Medicine. 2000 Dec 7;343(23):1715-21. Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan 1;129(1):95S-103S. Pratter MR. Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan 1;129(1):63S-71S.

External links

• FamilyDoctor.org – Chronic cough: causes and cures
• Asthma cough treatments
• Home Remedy for Cough
• http://www.chestnet.org/patients/guides/cough/p8.php
• FASEB Journal article on theobromine effectiveness as a cough suppressent
• BBC Article about chocolate as cough medicine
• Effective Asthma Action Plan

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