Tis the season for coughs, colds and the flu. Today, I’m exploring the former and how to stop coughing. I’ll be talking about the causes, the things that can cure you and when your cough could be the sign of something else entirely (because there are few things more annoying than a persistent cough). Read on for my doctor-approved guide to coughing.
What Is a Cough?
Coughing is an automatic reflex to clear and protect your airways. Many things can irritate our airways and cause us to cough; smoke, chemicals and food getting stuck in our oesophagus can also cause coughing. Coughing is also a symptom of chronic chest conditions such as asthma and chronic obstructive pulmonary disease).
It can also be a symptom of serious conditions including lung cancer. As the causes of coughing are so vast and reflect a variety of causes, it is important to know what symptoms are not to be ignored and when you should see your doctor for assessment. The simplest way to break down the causes of coughing is related to the duration of symptoms.
Coughs Typically Lasting Up to Three Weeks
Upper Respiratory Infections: About 80% to 90% of URTIs are caused by viral infections. Coughing is associated with typical symptoms of a cold including a blocked/runny nose, sore throat, fever, headache and fatigue.
Lower Respiratory Infections: LRTIs are less common than URTI’s and more serious. They can follow URTIs when “a cold settles on your chest” or they can occur independently. LRTIs can be caused by viruses, bacteria or fungus. Infective flare-ups (exacerbations) of chronic respiratory conditions like asthma or COPD can also cause a cough.
Coughs Lasting Over Three Weeks
Asthma and COPD: Both these chronic respiratory conditions have the same three symptoms: coughing, wheezing and shortness of breath. The key difference between them is that asthma is reversible (the symptoms can resolve when the trigger is removed and treatment of the asthma attack is effective). Chronic obstructive pulmonary disease, on the other hand, is a progressive disease and cannot be reversed. COPD is, in most cases, caused by smoking.
Acid-Reflux Cough: This is a common, non-respiratory cause of a cough. Gastroesophageal reflux disease causes acid to reflux up from the stomach and into the oesophagus, which can overspill into the airways and cause coughing.
Post-Nasal Drip: This is another common and non-respiratory cause of a cough. It occurs when mucus drips from the nose into the back of your throat and causes you to cough. There are many triggers that cause your nose to produce more mucus, including allergies, infection and nasal polyps.
Irritants: Chemical irritant of the airways can also lead you to cough on a chronic basis in the absence of infection. Classic causes are cigarette smoke and chemical fumes. It is especially common in people working in factories or chemicals when they are exposed to airborne chemical irritants on a daily basis.
Medications: Certain medications can also cause a chronic cough. Blood pressure medications and angiotensin-converting enzyme inhibiting mediations are classic causes.
Coughing can also be a symptom of more serious respiratory diseases like lung cancer. Here is a list of the red flag symptoms that need a doctor’s assessment. If you or your family have any of these symptoms, please see your doctor: coughing up blood, chest pain, shortness of breath, weight loss, fever, night sweats, persistent cough over a three-week period and cough not responding to treatment.
The treatment of a cough is dependant on the underlying cause. In most viral infections, the cough will clear up by itself. Antibiotics are only effective against bacterial infections. As most respiratory infections are causes by viruses, simple treatments can help to support your body to fight it naturally.
These treatments include paracetamol, ibuprofen, hot water with honey and lemon, sleep and a healthy diet.
Asthma and COPD need more specialised treatment involving reliever and preventer inhalers to help protect against exacerbations and keep the symptoms stable. If infective exacerbations do occur, a combination of antibiotics and oral steroids may be needed. Post-nasal drip may require a steroid nasal spray to be prescribed by your doctor. A reflux cough will be cleared up by treating the underlying cause of gastroesophageal reflux.
In all cases of a cough, maintaining your general health is key, so be sure to stop smoking, avoid triggers that you’re sensitive to (like chemicals or irritants), get lots of rest and exercise regularly.
In general, a cough is a common symptom that could be part of a wide range of underlying medical problems. If you or your family have a cough persisting over three weeks or any of the red-flag symptoms described above, see your doctor ASAP.