Coughing is an important way to keep your throat and airways clear. However, excessive coughing may mean you have an underlying disease or disorder.
Some coughs are dry, while others are “productive.” A productive cough is one that brings up phlegm (also called sputum or mucus). Coughs can be either acute or chronic:
- Acute coughs usually begin suddenly. They are often due to a cold, flu, or sinus infection. Typically, they do not last longer than 2-3 weeks.
- Chronic coughs last longer than 2-3 weeks.
Besides cold and flu, other common causes of coughs include:
- Allergies and asthma
- Lung infections like pneumonia or acute bronchitis (may start suddenly but then linger on)
- Chronic obstructive pulmonary disease (emphysema or chronic bronchitis)
- Sinusitis leading to postnasal drip
- Smoking cigarette smoke and pollutants
- Gastroesophageal reflux disease (GERD)
If a child has a barking cough, see croup.
- Cough lozenges or hard candy can help dry, tickling coughs. These should never be given to a child under 3 years old because of the risk of choking.
- A vaporizer or steamy shower may help a dry cough by increasing the humidity in the air.
- Drink extra fluids to help thin the secretions in your throat and make them easier to cough up.
- Zinc lozenges can reduce cold symptoms, especially cough.
Medications available without a prescription include:
- Guaifenesin (like Robitussin) can help you bring up phlegm. Drink lots of fluids if taking this medication.
- Cough suppressants like dextromethorphan (Vicks 44, Robitussin DM) may lessen your cough. Although coughing can be a troubling symptom, it is usually your body’s way of healing the underlying condition. Therefore, you may not want to supress a cough unless it is interfering with sleep or other factors important for healing.
- Decongestants, like pseudoephedrine and phenylephrine, can be used to clear a runny nose and postnasal drip. These should NOT be used if you have high blood pressure or for a child under 6 years old unless prescribed by your doctor.
Don’t expect a physician to prescribe antibiotics for viral infections like colds or flu. Antibiotics have no effect on viruses. Antibiotics also will not help coughs from allergies.
Call your health care provider if
Call 911 if you have:
- Shortness of breath or difficulty breathing
- Hives or swollen face or throat with difficulty swallowing
Call your doctor right away if you have:
- Violent cough that begins suddenly
- High-pitched sound (called stridor) when inhaling
- Cough that produces blood
- Fever (may indicate a bacterial infection requiring antibiotics)
- Thick, foul-smelling, yellowish-green phlegm (may indicate a bacterial infection)
- A history of heart disease, swelling in your legs, or a cough that worsens when you lie down (may indicate congestive heart failure)
- Exposure to someone with tuberculosis
- Unintentional weight loss or night sweats (may also indicate tuberculosis)
- Cough longer than 10-14 days
- Cough in an infant less than 3 months old
What to expect at your health care provider’s office
In emergency cases, the patient will be treated first to stabilize the condition. After the condition is stable, the doctor will ask questions about your cough, including:
- Are you coughing up blood? (How much, how often)
- Do you bring up any mucus/sputum when you cough? What does it look like? Is it thick and hard to cough up? How much sputum is produced per day?
- Is the cough severe? Is the cough dry?
- Does the cough sound like a seal barking?
- What is the pattern of the cough? Did it begin suddenly? Has it been increasing recently? Is the cough worse at night? When you first awaken?
- How long has the cough lasted?
- Is the cough worse when you are lying on one side?
- Are there sudden periodic attacks of coughing with gagging and vomiting?
- What other symptoms are present?
The physical examination will include emphasis on the ears, nose, throat and chest.
Diagnostic tests that may be performed include:
- Lung scan
- Pulmonary function tests
- Sputum analysis (if the cough produces sputum)
- X-ray of the chest
- Don’t smoke and stay away from secondhand smoke.
- If you have seasonal allergies like hay fever, stay indoors during days when airborne allergens are high. If possible, keep the windows closed and use an air conditioner. Avoid fans that draw in air from outdoors. Shower and change your clothes after being outside.
- If you have allergies year round, cover your pillows and mattress with dust mite covers, use an air purifier, and avoid pets and other triggers.
by Arthur A. Poghosian, M.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.