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Everyone coughs and there is nothing to worry about when it comes to the occasional event. Allergies and short-term illnesses, such as the common cold, can cause a repeated cough. While the cough can be bothersome, it is how the body clears the throat and airways and helps prevent infection. Coughs from a cold or the flu usually go away on their own without treatment. However, if your cough doesn’t improve – and especially if it raises blood, disrupts your sleep, or affects your job – it might be time to call your healthcare provider.
The symptoms of cough are divided into three categories: acute, subacute and chronic.
Common causes of acute cough
Acute coughs often start suddenly and go away within one to three weeks. They are usually caused by the common cold or other upper respiratory infections, including the flu, pneumonia, and whooping cough. The cough caused by the common cold often improves within a week without specific treatment, although symptoms may persist for up to three weeks.
Common causes of subacute cough
Subacute coughs last three to eight weeks and persist after the end of a cold or other respiratory infection. The airways may remain swollen and inflamed after an infection, causing you to keep coughing. This is called hyperresponsiveness of the airways.
When a cough persists for more than eight weeks (four weeks in children), it is considered chronic. Chronic cough can have several causes. Postnasal drip syndrome (also known as upper respiratory cough syndrome), asthma, and gastroesophageal reflux disease are the most likely causes of chronic cough in adults. These conditions, alone or in combination, are responsible for 90 percent of chronic cough cases.
Other important causes of chronic cough include whooping cough (pertussis), chronic obstructive pulmonary disease caused by smoking, angiotensin converting enzyme inhibitors (medicines for hypertension), pneumonia, heart failure and chronic bronchitis due to exposure to cigarette smoke or other irritants. Less common causes include tuberculosis, lung cancer, cystic fibrosis, pneumothorax, bronchiectasis, and pulmonary embolism (a blood clot in the lungs).
- If you are feeling well and have been coughing for a short time, you may have nothing else to do but wait for it to go away on its own. Steps you can take at home to relieve a sharp cough are as follows: Breathe in steam through a spray bottle or take a hot shower to soothe a dry, sore throat.
- Drink plenty of fluids, including warm liquids with honey or lemon, to help thin mucus and soothe your throat.
- Avoid exposure to irritants that can trigger a cough; if you smoke, make an effort to quit.
- Try hard candy or cough drops to soothe a dry, ticklish cough (never give them to children under 3).
A cough that lasts for more than three weeks, or gets worse, requires a visit to your healthcare professional for prompt medical attention and to rule out something more serious. Call your healthcare professional right away if you have any of the following problems:
- Cough of thick, yellow, or green mucus
- A fever of 101.5 degrees Fahrenheit or higher
- Spit blood
- Wheezing or shortness of breath
- Sleeping troubles
- Night sweats
- Weakness, fatigue or loss of appetite
- Chest discomfort
- Involuntary weight loss
What to expect from your healthcare professional
Determining the cause of a persistent, chronic cough is essential for effective treatment. Your healthcare professional will ask for a complete medical history and perform a physical exam. He or she may ask about the duration of your cough, your symptoms, your medications, if you smoke, and how exercise and cold air affect your breathing and coughing (table).
Questions Your Healthcare Professional May Ask You About Your Chronic Cough |
| How long have you had your cough? |
| Do you smoke? |
| Did your cough start with a lung infection or other disease? |
| Do you have heartburn? |
| When do you cough? Is there a time of day when it’s worse? |
| Are you short of breath even when you don’t have a cough? |
| Are you taking any blood pressure medication? |
| Do you have a fever? |
| Do you have chest discomfort or pain? |
| Do you wheeze with your cough? Are you coughing up mucus? If so, what color is it? Is there blood? |
| Have you lost weight? |
| Do you have night sweats? |
| Have you been in contact with someone with tuberculosis or have you recently traveled? |
| Does anything ease your cough? |
| Source: Pharmacy Time |
Chest x-rays, CT scans, lung function tests, and lab tests may be done.
Coughing is important for clearing mucus and other irritants and can help prevent infection. For this reason, cough medicines are usually only used when a cough causes a lot of discomfort and interferes with daily activities. Your healthcare professional may recommend the following medications:
- expectorants. Some coughs are dry, while others, called productive coughs, produce mucus (phlegm). For a productive cough, an expectorant called guaifenesin (brand names include Mucinex and Robitussin) helps thin or loosen the mucus, making it easier to move it. Drink plenty of fluids if you are taking guaifenesin.
- Decongestants. Phenylephrine and pseudoephedrine are examples of decongestants used to help clear a stuffy or runny nose and relieve postnasal discharge. The use of these drugs is not recommended in people with high blood pressure.
- Steroid nasal sprays. A steroid nasal spray can help with postnasal drip. Flonase (fluticasone propionate) and Nasacort (triamcinolone acetonide) are examples of over-the-counter steroid nasal sprays.
- Antihistamines. If you have allergies, a cold, or the flu, antihistamines may be more effective than over-the-counter cough medicines. This is because antihistamines such as brompheniramine and chlorpheniramine decrease the production of mucus and widen the airways. Unfortunately, these medications can make you drowsy and it may be best to only take them at night.
- Analgesics. Pain relievers, such as Tylenol (acetaminophen) and Advil (ibuprofen), may be taken for fever and body aches. Be careful not to take more than the recommended dose of acetaminophen as too much can cause liver damage and even death. Be aware that some combination cough and cold medicines contain acetaminophen.
- Bronchodilators. Albuterol and other bronchodilators help relax the airways and make breathing easier.
- Cough suppressants. When nothing else works, prescription cough suppressants can be helpful in suppressing a dry cough. There is no evidence to show that over-the-counter cough suppressants relieve coughs.
Talk to your child’s healthcare professional before giving an over-the-counter cough medicine to a child 6 years of age or younger, even if it is labeled for children. These medicines may not be helpful, depending on the case, and may have serious side effects.
Note: This article originally appeared on April 13, 2016 on PharmacyTimes.com. It was edited and republished by US News. The original version, with references, can be seen here.
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