Cough

A cough is a reflex action that helps clear your airways of mucus, irritants, and foreign particles. It's one of the most common reasons people seek medical care. While most coughs are not serious and resolve on their own, some can indicate underlying health conditions that require treatment.

Coughs can be acute (lasting less than 3 weeks), subacute (3-8 weeks), or chronic (more than 8 weeks). The cause, duration, and characteristics of the cough help determine if and how it should be treated.

Coughs can vary in type and characteristics:

Types of Cough:

• Dry cough: No mucus production
• Wet/productive cough: Produces mucus (phlegm)
• Persistent cough: Lasts for weeks
• Barking cough: Harsh, like a seal (croup in children)

Associated Symptoms (may accompany cough):

• Sore throat
• Runny or stuffy nose
• Fever
• Shortness of breath
• Wheezing
• Chest pain
• Fatigue
• Hoarseness
• Postnasal drip

Cough Characteristics:

• Timing: Worse at night, morning, or constant
• Triggers: Cold air, exercise, lying down
• Duration: How long it's lasted
• Quality: Dry, wet, harsh, etc.

Call Emergency Services (112 in Sweden) if:

• Cough with severe difficulty breathing
• Cough with choking
• Coughing up blood (significant amount)
• Cough with chest pain
• Cough with severe wheezing
• Cough in child with difficulty breathing
• Blue or gray lips or fingernails

For most coughs:

1. Stay Hydrated:

   • Drink plenty of fluids
   • Warm liquids can be soothing
   • Helps thin mucus
   • Water, tea, broth

2. Humidify Air:

   • Use humidifier
   • Steam from shower
   • Moist air soothes airways
   • Especially helpful at night

3. Honey (for adults and children over 1 year):

   • Can help soothe cough
   • Small amount before bed
   • Don't give to children under 1 year

4. Over-the-Counter Medications (if appropriate):

   • Cough suppressants (for dry cough)
   • Expectorants (for wet cough)
   • Follow instructions
   • Don't give to young children without doctor approval

5. Rest:

   • Get adequate rest
   • Helps body fight infection
   • Don't overexert

6. Avoid Irritants:

   • Don't smoke
   • Avoid secondhand smoke
   • Avoid other irritants
   • Stay away from pollutants

7. Elevate Head (for nighttime cough):

   • Prop up with pillows
   • Reduces postnasal drip
   • Helps with acid reflux-related cough

• Cough with severe difficulty breathing
• Coughing up significant amount of blood
• Cough with chest pain
• Cough with severe wheezing
• Cough in child with difficulty breathing
• Blue or gray lips or fingernails

• Cough lasting more than 3 weeks
• Cough with fever
• Cough with chest pain
• Coughing up blood (any amount)
• Cough with shortness of breath
• Cough with wheezing
• Cough not improving
• Cough in child (especially if persistent)
• Questions about cough

• Mild cough with cold
• Improving over time
• No other concerning symptoms
• Short duration (few days to week)
• No difficulty breathing

Evaluating a cough may involve:

1. Medical History and Physical Exam:

   • Description of cough
   • Duration and characteristics
   • Associated symptoms
   • Physical examination
   • Listen to lungs

2. Chest X-ray:

   • Shows lungs and heart
   • Rules out pneumonia, other conditions
   • May show other causes

3. Lung Function Tests (if asthma suspected):

   • Spirometry
   • Measures lung function
   • Helps diagnose asthma, COPD

4. Blood Tests (if infection suspected):

   • Complete blood count
   • Other tests as needed

5. Other Tests (if needed):

   • CT scan of chest
   • Bronchoscopy (scope into airways)
   • Allergy testing
   • Acid reflux testing

Treatment depends on the cause:

Viral Infections (common cold, flu):

• Supportive care
• Rest and fluids
• Symptom relief
• Usually resolves on its own

Bacterial Infections:

• Antibiotics (if bacterial)
• Supportive care
• Rest and fluids

Asthma:

• Inhalers (bronchodilators, steroids)
• Avoid triggers
• Long-term management

Allergies:

• Antihistamines
• Avoid allergens
• Nasal sprays
• Other allergy medications

Acid Reflux (GERD):

• Antacids
• Acid-reducing medications
• Dietary changes
• Lifestyle modifications

Postnasal Drip:

• Nasal sprays
• Decongestants
• Antihistamines
• Treat underlying cause

Other Causes:

• Treat underlying condition
• Medications as needed
• Lifestyle modifications

Prevent coughs by:

• Wash Hands: Frequently, especially during cold season
• Avoid Sick People: When possible
• Don't Smoke: Smoking causes chronic cough
• Avoid Secondhand Smoke: Can cause cough
• Get Vaccinated: Flu and pneumonia vaccines
• Manage Allergies: Avoid triggers, take medications
• Control Acid Reflux: If you have GERD
• Stay Healthy: Good nutrition, exercise, sleep

Cough can result from:

Infections:

• Viruses (common cold, flu)
• Bacteria (pneumonia, bronchitis)
• Irritate airways
• Cause inflammation

Allergies:

• Allergic reactions
• Postnasal drip
• Irritate airways

Asthma:

• Airway inflammation
• Bronchospasm
• Triggers cough

Acid Reflux:

• Stomach acid irritates airways
• Can cause chronic cough
• Worse when lying down

Irritants:

• Smoke
• Pollution
• Chemicals
• Dust

Medications:

• Some medications cause cough
• ACE inhibitors (blood pressure)
• Other medications

Other Causes:

• Chronic lung diseases
• Heart problems
• Other medical conditions

• Colds very common
• May have croup (barking cough)
• May need different treatments
• Watch for difficulty breathing
• Don't give cough medicine to young children without doctor approval

• May have chronic conditions
• Higher risk of complications
• May need more aggressive treatment
• Monitor closely

• Asthma, COPD, heart disease
• May have persistent cough
• Need to manage underlying condition
• Regular monitoring important

Most acute coughs from colds last 1-2 weeks. If a cough lasts more than 3 weeks, see a healthcare provider. Chronic cough (more than 8 weeks) needs evaluation.

Seek immediate care if cough is accompanied by difficulty breathing, chest pain, or coughing up blood. See a doctor if cough persists more than 3 weeks or is severe.

You can reduce risk by washing hands, avoiding sick people, not smoking, getting vaccinated, and managing allergies. However, some coughs cannot be prevented.

For mild coughs with colds, it's often not necessary. If cough is bothersome, over-the-counter medications may help. For persistent or severe coughs, see a doctor.

No. While infections are common causes, coughs can result from many things including allergies, asthma, acid reflux, medications, and other conditions.