Cough

Quiet, please!

One of the most annoyingly common symptoms is the cough. You naturally cough a couple times an hour every day, as your body clears out your lungs. When you begin to cough more often, however, it can signal an irritation or illness.

Synonyms

  • Tussis

Detailed Description

A cough is an important way the body defends itself against harm: it clears the lungs and throat of mucus and foreign particles, including bacteria. Coughing really helps the lungs to receive oxygen correctly. In a sense, it's a life-affirming response.

It's important for you to distinguish between acute and chronic cough, and know when to tell your doctor. An acute cough of about three weeks' duration often follows a viral or bacterial infection. Anything longer than three weeks signals a chronic cough.

A cough can be dry or it can contain sputum -- a combination of debris, mucus, and cells from the lungs. The appearance of sputum is useful, because it can help your doctor make a diagnosis.

Possible Underlying Causes

Yellowish, green, or brown sputum suggests a bacterial infection. Clear, white, or watery sputum may show a virus, allergy, or irritant is present. Yellow sputum can also appear after a viral infection. Your doctor may send your sputum to the lab to determine its exact nature.

The most common cause of chronic, or ongoing, cough is inhaling tobacco smoke, whether primary or secondhand. The most common causes among nonsmokers are allergies, asthma, post-nasal drip, gastroesophageal reflux (caused by stomach acid backing up into your throat), or inflamed sinuses.

Some medications will provoke coughing as a side effect, such as ACE inhibitors and beta-blockers (used for high blood pressure and heart disease). Tuberculosis and lung cancer also cause coughing, and congestive heart failure has nighttime coughing as a symptom.

The following conditions or habits may have coughing as a symptom:

  • Allergies or inhaling environmental irritants
  • Asthma
  • Bronchitis
  • Chronic obstructive pulmonary disease
  • Common cold, flu, or other upper respiratory disorder
  • Cystic fibrosis
  • Emphysema

  • Foreign body in airways
  • Lung tumors or cancer
  • Pleurisy (an inflammatory lung condition) and/or pneumonia
  • Whooping cough (pertussis)

Diagnostic Procedures

In order to make a diagnosis, your doctor will question you about other symptoms you might have and take your personal history. Your occupation and whether or not you smoke will be important. He or she will also perform a physical exam and may culture a sample of your sputum. In some cases, your doctor may want you to take further tests such as chest X-rays, lung scans, CT scans, or lung function tests. In addition, he or she may use a bronchoscope to view your lungs.

Goals of Treatment

Getting rid of an irritant is most important to reducing a cough. Upper respiratory infections are often treated with antihistamines combined with decongestants, antibiotics, or inhaled bronchodilators, which relax the lungs. Asthma can also be treated in a similar way.

Treatment Options

  • Antibiotics for bacterial infections
  • Antihistamines or nasal steroids for allergic post-nasal drip
  • Bronchodilators for asthma
  • Treatment of gastroesophageal reflux

Other Medications

Naturopathy

Naturopaths are physicians who generally reject drugs in favor of natural treatments. This naturopathic cough remedy may be helpful: Soak onion slices in honey overnight. Strain out the onion and take a teaspoon of the mixture four times a day.

Herbs

WARNING -- don't use coltsfoot! While it was once widely recommended in traditional herbal medicine to treat coughs, researchers have discovered that this plant contains pyrrolizidine alkaloids that may cause liver damage. Herb expert Varro Tyler, Ph.D., warns against using it, even though it can still be found in throat lozenges available at many health food stores. [1]


Source

1 Tyler, V. Herbs of Choice. New York: Pharmaceutical Products Press, 1994.

Preventive Measures

Exposure to steam, as in a hot shower or humidifier, or hot liquids will help thin and release the sputum that the body is trying to cough up. Treating the primary cause of the coughing will, of course, be helpful. Seek medical help if you cough for over two to three weeks.

Self-Care Measures

To calm a persistent cough, try some of the following techniques:

  • Try drinking hot liquids, which loosen respiratory mucus and make it easier to cough up. (Hot liquids also soothe a sore throat and have decongestant action.) Tea sweetened with honey is effective. One study suggests that chicken soup, a traditional cold remedy, is particularly effective.
  • Raise the head of your bed half a foot if a cough disrupts your sleep. This may prevent coughing due to gastroesophageal reflux.
  • Pay attention to milk's effects on you. Some people swear it thickens their respiratory mucus, adding to their congestion and coughing. This effect hasn't been proven, but if milk seems to aggravate your cough, avoid dairy items for a few days.
  • If you smoke, quit. Cigarette smoke is extremely irritating to the throat and lungs and provokes coughing.
  • Avoid respiratory irritants, such as pollen, dust, and chemical fumes.

When to Call the Doctor

Consult your doctor:

  • If you have chest pains, swollen neck glands, or an earache
  • If the cough lasts longer than three weeks
  • If you have a fever above 102?F
  • If your cough produces blood or discolored phlegm
  • If you are also wheezing or breathless

Also inform your doctor:

  • If you smoke.
  • If you work in a job that involves contaminated air.

Websites & Organizations

American Academy of Family Physicians
8880 Ward Parkway
Kansas City, MO 64114
Phone: 816-333-9700
Email: fp@aafp.org

American Association For Respiratory Care
11030 Ables Lane
Dallas, TX 75229
Phone: 214-243-2272

American Public Health Association
1015 Fifteenth St., NW
Washington, DC 2005
Phone: 202-789-5600

Health World Online

Mayo Clinic Health Oasis

National Institute of Allergy and Infectious Diseases
9000 Rockville Pike
Building 31, Room 7A-03
Bethesda, MD 20205
Phone: 800-644-6627

Sources & Further Reading

Books

Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.

Bennett, J. Claude and Plum, Fred. Cecil Textbook of Medicine, eds. Philadelphia: W. B. Saunders, 1996.

Fauci, Anthony J. et al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.

Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw Hill, 1996.

Hurst, J. Willis. Medicine for the Practicing Physician eds. Stamford, CT: Appleton & Lange 1996.

Murray, Michael T. Encyclopedia of Natural Medicine. Prima, 1998.

Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.

Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.

Rakel, Robert E. Conn's Current Therapy eds. Philadelphia: W.B. Saunders, 1998.

Taylor, Robert B. Family Medicine: Principles and Practice. New York: Springer-Verlag, 1998.

Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.

Tyler, V. Herbs of Choice. New York: Pharmaceutical Products Press, 1994.



Articles

Banner, AS, Green, J, O'Connor, M. "Relation of Respiratory Water Loss to Coughing after Exercise." N Engl J Med. 311(14):883-6. Oct 1984.

Curley, FJ, Irwin, RS, Pratter, MR, Stivers, DH, Doern, GV, Vernaglia, PA, Larkin, AB, Baker, SP. "Cough and the Common Cold." Am Rev Respir Dis. 138(2):305-11. Aug 1988.

Holinger, LD. "Chronic Cough in Infants and Children." Laryngoscope. 96(3):316-22. Mar 1986.

Irwin, RS, Rosen, MJ, Braman, SS. "Cough. A Comprehensive Review." Arch Intern Med. 137(9):1186-91. Sep 1977.

Munyard, P, Bush, A. "How Much Coughing is Normal?" Arch Dis Child. 74(6):531-4. Jun 1996.

Pavia, D, Agnew, JE, Clarke, SW. "Cough and Mucociliary Clearance." Bull Eur Physiopathol Respir. 23 Suppl 10():41s-45s. 1987.

Piiril'a, P, Sovij'arvi, AR. "Objective Assessment of Cough." Eur Respir J. 8(11):1949-56. Nov 1995.

Sakethoo, K. et al. "Effects of Drinking Hot Water, Cold Water, and Chicken Soup on Nasal Mucus Velocity and Nasal Airflow Resistance," Chest, 74:408, 1978.

Silverstone, T. "Coughs and Colds: Advising on What to Take." Prof Care Mother Child. 7(1):13-6. 1997.

Smyrnios, NA, Irwin, RS, Curley, FJ. "Chronic Cough with a History of Excessive Sputum Production. The Spectrum and Frequency of Causes, Key Components of the Diagnostic Evaluation, and Outcome of Specific Therapy." Chest. 108(4):991-7. Oct 1995.

Thomson, AH, Pratt, C, Simpson, H. "Nocturnal Cough in Asthma." Arch Dis Child. 62(10):1001-4. Oct 1987.

 


Have you or a family member had an experience with this? Help others by sharing your story now.

  7. Leave this field empty

Required Field