Cough

Coughing is a complex reflex that involves the coordinated action of muscles in your chest, abdomen, and throat. When sensors in your airways detect irritants, they send signals to your brain, which responds by triggering the cough reflex. This creates a powerful burst of air that can travel up to 50 miles per hour, helping to expel irritants and protect your lungs.

While coughing is usually beneficial, persistent or severe coughing can be exhausting and may interfere with sleep, work, and daily activities. It can also lead to complications such as sore throat, hoarseness, headaches, and in severe cases, rib fractures or fainting.

Coughs are classified by duration: acute (lasting less than 3 weeks), subacute (3-8 weeks), and chronic (more than 8 weeks). They're also categorized by type: productive (bringing up phlegm) or dry (non-productive). These distinctions help doctors determine the likely cause and appropriate treatment.

Respiratory Infections

• Common cold: Most frequent cause of acute cough
• Influenza (Flu): Often with fever and body aches
• COVID-19: Dry cough is common symptom
• Acute bronchitis: Inflammation of bronchial tubes
• Pneumonia: Lung infection with productive cough
• Whooping cough (Pertussis): Severe coughing fits
• Tuberculosis: Chronic cough with blood

Chronic Lung Conditions

• Asthma: Cough with wheezing and breathlessness
• COPD: Chronic productive cough, especially in smokers
• Chronic bronchitis: Productive cough for months
• Emphysema: Part of COPD spectrum
• Bronchiectasis: Damaged airways with chronic cough
• Cystic fibrosis: Thick mucus production
• Interstitial lung disease: Dry, persistent cough

Upper Airway Conditions

• Postnasal drip: Mucus dripping down throat
• Sinusitis: Sinus inflammation and drainage
• Allergic rhinitis: Hay fever causing throat irritation
• Laryngitis: Voice box inflammation

Digestive System Causes

• GERD: Acid reflux irritating throat
• Aspiration: Food or liquid entering airways
• Esophageal disorders: Various conditions affecting swallowing

Environmental and Lifestyle Factors

• Smoking: Primary cause of chronic cough
• Air pollution: Irritants in the air
• Occupational exposures: Dust, chemicals, fumes
• Allergens: Pet dander, dust mites, pollen
• Cold air: Can trigger coughing
• Exercise: Exercise-induced cough

Medications

• ACE inhibitors: Blood pressure medications causing dry cough
• Other medications: Various drugs can cause cough as side effect

Serious Conditions

• Lung cancer: Persistent cough, may have blood
• Heart failure: Cough worse when lying down
• Pulmonary embolism: Sudden cough with chest pain

Cough often occurs with other symptoms that can help identify the cause:

• Fever: Often indicates infection
• Shortness of breath: May suggest lung or heart problems
• Wheezing: Common with asthma or COPD
• Chest pain: Could indicate various conditions
• Fatigue: Common with infections
• Sore throat: Often with upper respiratory infections
• Runny or stuffy nose: Common cold or allergies
• Headache: From coughing or underlying illness
• Body aches: Suggest viral infection
• Night sweats: May indicate tuberculosis or cancer
• Weight loss: Concerning if unexplained
• Hoarseness: From throat irritation

Medical History

• Duration and pattern of cough
• Type of cough (dry vs. productive)
• Timing (day vs. night, seasonal)
• Triggers and relieving factors
• Associated symptoms
• Smoking history
• Occupational exposures
• Current medications

Physical Examination

• Listening to lungs with stethoscope
• Checking throat and nasal passages
• Examining neck for lymph nodes
• Assessing vital signs
• Looking for signs of respiratory distress

Diagnostic Tests

• Chest X-ray: First-line imaging for persistent cough
• CT scan: More detailed lung imaging
• Pulmonary function tests: Assess lung capacity
• Sputum culture: Identify infections
• Blood tests: Check for infections, allergies
• Bronchoscopy: Direct airway examination
• Allergy testing: If allergies suspected

• Don't smoke: Primary prevention for chronic cough
• Avoid secondhand smoke: Protect your lungs
• Hand hygiene: Prevent respiratory infections
• Vaccinations: Flu, pneumonia, whooping cough vaccines
• Manage allergies: Reduce exposure to triggers
• GERD management: Elevate bed head, avoid late meals
• Stay hydrated: Keep airways moist
• Use protective equipment: In dusty or chemical environments
• Exercise regularly: Maintain lung health
• Avoid sick people: During cold and flu season

Adults Should Seek Care For:

• Cough lasting more than 3 weeks
• Coughing up blood or rust-colored sputum
• Cough with unexplained weight loss
• Night sweats with chronic cough
• Cough interfering with daily activities
• Worsening cough despite treatment
• Cough with chest pain or shortness of breath
• History of smoking with new cough

Children Need Medical Care For:

• Cough in infant under 3 months
• Cough with difficulty breathing
• Whooping or barking cough
• Cough with high fever
• Refusing to eat or drink
• Signs of dehydration
• Cough lasting more than 1 week
• Getting worse instead of better

For those dealing with chronic cough (lasting more than 8 weeks), these strategies can help:

• Work with specialists: Pulmonologist or other appropriate specialist
• Keep a cough diary: Track triggers and patterns
• Speech therapy: Can help with cough suppression techniques
• Breathing exercises: Learn proper breathing techniques
• Lifestyle modifications: Based on underlying cause
• Support groups: Connect with others with chronic cough
• Regular follow-ups: Monitor for changes or complications
• Workplace accommodations: If needed